Three people clutch backs in pain.

Does Parkinson’s Disease Cause Back Pain?

Pain is commonly reported by those living with Parkinson’s disease (PD). It is thought that up to 3 out of 4 people with PD have some kind of discomfort or pain. This pain may be due to the disease itself or may be due to the motor symptoms of PD.1

PD pain is divided into 5 types, according to what causes it:2

  • Musculoskeletal pain is caused by injury to muscles, bones, or joints.
  • Radicular pain is sharp, shooting pain caused by pinched nerves.
  • Dystonic pain is caused by abnormal muscle contractions.
  • Akathisic pain is caused by restlessness or the sensation that you need to move around.
  • Central pain is caused by the brain misfiring and sending pain signals incorrectly.

Pain is one of the most troublesome PD symptoms but a 2018 study showed that it is often untreated.3

Those living with PD often report lower back pain. This pain can be constant or occasional, sharp, dull, or burning. It can also appear as sciatica, a pain that shoots down the back of 1one or both legs. This pain may also change day by day.1

What causes PD back pain?

Muscle stiffness is a common PD symptom. This stiffness may be in 1 area of the body or may be felt all over the body. It often leads to back pain and prevents people with PD from exercising and staying active. Lack of exercise then causes more stiffness and starts a vicious cycle.1

PD is known to cause motor symptoms like dystonia and dyskinesia. Dystonia is a long muscle contraction that causes an abnormal posture. This includes movements like foot cramps and often happens during “off times.” Off times are when a drug is wearing off and PD symptoms return. Dyskinesias are unintentional movements that occur after long-term use of dopaminergic drug like levodopa. These movements look like fidgeting and usually happen during “on times,” when drug is working.1

These movements and muscle stiffness pull the body in ways it is not used to. This can also result in a person walking or leaning to 1 side and stooping their back. The back muscles then must work harder to support the body and keep it stable. This extra work causes lower back pain in those living with PD. Joints also break down with age and contribute to this pain.3

People living with PD report various triggers that make their back pain worse. These triggers include physical stress, emotional stress, poor sleep, and depression.

How can PD back pain be treated?

Back pain may be caused by PD, made worse by PD, or may be unrelated. People with back pain should first try to identify what is causing their pain, if possible.1 When explaining your symptoms to your doctor, it is helpful to be able to describe where the pain is, how the pain feels, how long it lasts, and when you feel the pain.1

If you have symptoms like dystonia during “off times”, your doctor may increase your dose of dopaminergic medicine. This has been shown to decrease pain and increase mobility.3 Increased mobility can also help prevent future pain.

Gentle exercise can be very helpful to relieve and prevent future back pain. Exercise strengthens the back muscles and loosens muscle cramps. A physical therapist or occupational therapist can help create an exercise plan that is best for you.1

Some people find relief without drugs. Hot and cold compresses can relax muscles and decrease inflammation. Acupuncture, massage, and chiropractic therapy may also help. These alternatives may be particularly helpful if you work with someone who is familiar with PD.3 Mindfulness and meditation may reduce pain directly or reduce depression that can contribute to pain or feelings of isolation.1

If these treatments are still not effective, your doctor may recommend or prescribe drugs. NSAIDs like Advil and Aleve reduce inflammation in muscles and joints. These are generally safe to take and treat a variety of pain. Low dose opiates are an option but are not common because they can lead to constipation and dependence. Finally, central pain may respond to certain antidepressants.1

If you are experiencing back pain, talk to your doctor and movement disorder specialist to see what choice is right for you.

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