Every Person With Parkinson’s May Experience Different Movements
There are multiple types of movements that a person with Parkinson’s disease can experience. Some people may have just one or two of these symptoms, while another may experience all of them. Likewise, the degree of severity can vary from person to person, and symptoms that may bother some people may not bother others at all. It’s important to note that there’s not a single answer that works for every person with Parkinson’s, says Todd Herrington, MD, PhD, a neurologist at Massachusetts General Hospital in Boston and an instructor in neurology at Harvard Medical School in Cambridge, Massachusetts. “You have to ask the person, ‘What bothers you, and how much does it affect you?’” What the caregiver or the even the physician observes as the most severe symptoms may not feel that way to the person with Parkinson’s. Here are eight types of movements that people with Parkinson’s may experience. Learn more about what these symptoms are and what can be done to prevent them.
1. Tremors
Tremors are one of the hallmark symptoms of Parkinson’s disease and are observed most often when making the initial diagnosis. “Tremors are a rhythmic movement,” says Dr. Herrington. The movement is repetitive and could affect just the thumb, the head, or the whole arm. It also tends to be worse when a person is at rest, or not moving, he says. For the most part, tremors aren’t painful, and how bothersome they are can vary from person to person. “It’s an individual thing that you have to work out with each person,” says Herrington. In general, tremors can be reduced by levodopa, a type of Parkinson’s medication that is converted to dopamine in the brain.
2. Bradykinesia
Bradykinesia means slow movement, and in Parkinson’s disease, this symptom can affect how people walk, move their hands, and more. “This is a cardinal feature of Parkinson’s disease and is generally there from the beginning stages,” says Herrington. Early on, bradykinesia is often mild and can be hard to detect. Like tremors, bradykinesia generally gets better once a person starts taking levodopa, he says.
3. Rigidity
People with Parkinson’s disease may feel as if they can’t relax their muscles. This type of stiffness, known as rigidity, can make everyday movements — and even sleeping — a challenge. Just because you’re experiencing some rigidity, however, doesn’t mean you have Parkinson’s disease. Stiffness can also be a symptom of arthritis or spasticity, says Kathleen Poston, MD, an associate professor of neurology at Stanford University Medical Center in Palo Alto, California.
4. Dyskinesia
As with tremors, dyskinesia is a type of involuntary movement, but it’s actually a result of long-term levodopa use. (In other words, it’s not a symptom of the Parkinson’s disease itself.) “The majority of people treated for Parkinson’s will develop some level of dyskinesia,” says Herrington. Unlike tremors, dyskinesia is not rhythmic; it has a more writhing quality to it. To manage dyskinesia, your doctor may adjust your dosage of levodopa or prescribe additional medication. That said, some people with Parkinson’s prefer dyskinesia to the slow, stiff feeling they have when the medication has worn off.
5. Dystonia
People with Parkinson’s sometimes develop dystonia, a repetitive muscle twisting or cramping, as a complication of taking levodopa.“Dystonia can happen with dyskinesia and can also happen when [levodopa] medications are wearing off,” says Herrington. “It can happen in the face, in the arms, or in the legs and can be painful.” There’s no cure for dystonia, but your doctor may adjust your levodopa or prescribe other drug therapies to help. Physical therapy, speech therapy, and stretching may also help lessen some of the symptoms and pain as well. Although dystonia can be confused with cramping, even to the person experiencing it, these two symptoms have different causes and are therefore treated differently.
6. Freezing
Freezing (akinesia) is the inability to move your muscles voluntarily, and it happens to about one-third of people with Parkinson’s, according to the American Parkinson Disease Association. It can last a few seconds or up to several minutes. “When people go to take a step, their foot just doesn’t move,” explains Herrington. “Freezing can happen at any time, but it’s particularly triggered by certain stimuli, such as passing through a doorway or when turning at the threshold of stairs.”
7. Drooling
In Parkinson’s disease, drooling generally isn’t due to an overproduction of saliva. Instead, as the disease progresses, a person’s mouth may involuntarily hang open, causing the saliva to slip out, says Herrington. People with Parkinson’s may also not be able to swallow as well as they once could, which can also contribute to drooling, he adds.
8. Gait Disorder
One of the first things that people with Parkinson’s notice is that their arms may not swing as much when they’re walking, Herrington says. “Typically, Parkinson’s is asymmetric, so it usually affects one side of the body more than the other,” he says. “It may just be one arm that stops swinging. This often comes with a shorter stride, generally on the same side of the body.” As the disease progresses, he says, gait issues can worsen to the point where the person with Parkinson’s may shuffle and appear to be stooped over, explains Herrington. Another problem: When a person with Parkinson’s has balance problems, they often have trouble standing. “You have to be very careful to prevent falls at this stage because there can be a tendency to fall backward,” he says.