Pain in Parkinson's disease

Abstract

Pain and other nonmotor symptoms in PD are increasingly recognized as a major cause of reduced health-related quality of life. Pain in PD may be categorized into a number of different subtypes, including musculoskeletal, dystonic, radicular neuropathic, and central pain. The onset of pain can vary in relation to motor symptoms, and may precede the appearance of motor symptoms by several years, or occur after the diagnosis of PD has been made. Pain in PD is frequently under-recognized and is often inadequately treated. Levodopa-related dystonia may respond to manipulation of dopaminergic medication. Dopaminergic therapy may also improve musculoskeletal pain related to rigidity and akinesia, as well as akathisia in PD. Botulinum toxin injections can be effective for treatment of painful focal dystonia. Pain and dysesthesia have been reported to improve with DBS, in some cases. Increased understanding of basal ganglia pathways has provided further insights into the pathogenesis of pain in PD, but the exact mechanism of pain processing and modulation remains unclear.

Relationship between the non-motor items of the MDS–UPDRS and Quality of Life in patients with Parkinson's disease

“…Pain can be present in over 80% of patients with PD [19] and it has been repeatedly associated with worse Quality of Life [8,9,20], although not all studies found a significant difference in the association between pain and QoL when comparing PD patients and matched controls [21]. Pain in PD may be categorized into a number of different subtypes including musculoskeletal, dystonic, radicular neuropathies and central pain [19].…”

Effect of medical cannabis on thermal quantitative measurements of pain in patients with Parkinson's disease

“…Pain is one of the most common non-motor symptoms, with a prevalence of 40-80% (Ford, 2010;Ha and Jankovic, 2012). It may appear either before or years after onset of motor symptoms, and it does not always respond to anti-Parkinson medications or conventional analgesic agents.…”

Clinical Study on Chronic Pain in Parkinson's Disease Patients in Shanghai, China

“…Repetitive transcranial magnetic stimulation therapy has been shown to be effective in the management of dystonic pain [35]. Dystonic pain may also present as frozen shoulder or as foot dystonia, and analgesia in these presentations may include botulinum toxin injection in addition to optimizing dopaminergic therapy with levodopa or other agents [35,37]. IT might be an effective treatment for pain [38,39] or other nonmotor disorders in PD [13,14,15].…”