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Other Symptoms: Aging Or Pd
Because the biggest risk factor for developing PD is age , skeletal problems associated with aging are often experienced by people with PD. While it is not clear that PD increases the risk or even the severity of these other skeletal conditions, the problems of PD can make the symptoms of these conditions more prominent.
- Osteoarthritis, the joint damage associated with general wear and tear on the joints, is nearly universal in aging. Osteoarthritis tends to affect larger joints such as the hip and knee.
- Arthritis of the spine is also very common. This may contribute to the development of spinal stenosis, narrowing of the canal in the spine that houses the spinal cord. In severe cases, spinal stenosis causes damage to the nerves as they exit the spine or even to the spinal cord itself.
- Disorders of the fibrous discs between the bones of the spine can also cause pain, or limb numbness or weakness.
Nocturnal Leg Cramps Take Their Toll
Most nights I awake about 2 a.m. writhing in pain, drenched in sweat, and yelling for help. One of my legs is spasming out of control and the muscles feel hard to the touch. I try to move my leg, to forcefully extend it outside of the curled up ball that is now me, but it is too rigid to change position.
Tony, I cant move, I call to my husband, trying to tone down the panic Im feeling. Im paralyzed.
No, youre not, he responds as he sits down beside me on our bed, massages my limbs, and calmly reassures me that my cramping will relax in 10 minutes and we will go to the kitchen to have a snack, just like we always do. Thankfully, he is right.
The first I heard of nocturnal leg cramps was about two years ago when I started experiencing them myself. Gaining in frequency and intensity over time, the cramping has risen to the number 1 spot on my personal list of favorite PD symptoms, dropping incontinence to number 2. Imagine how painful leg cramps are that they beat out incontinence and the inconvenience and embarrassment that accompanies it.
- Narrowing of the arteries that deliver blood to the legs.
- Compression of the nerves in your spine.
- Too little potassium, calcium, and magnesium.
Muscle cramps and dystonia occur when muscles tighten or shorten involuntarily. Parkinsons muscle cramps are generally caused by muscular rigidity and reduced movement rather than by muscles contracting.
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How Are Parkinsons Tremors Treated
Tremor can be unpredictable. Some experts say itâs the toughest symptom to treat with medication. Your doctor may prescribe medication for your tremors:
- Levodopa/carbidopa combination medicines . This treatment is a type of medication called a dopamine agonist. Itâs usually the first treatment for Parkinsonâs.
- Propranolol . This drug is also used to treat high blood pressure, heart disease, and migraine.
- Clozapine . This medication is also used to treat schizophrenia. It requires weekly blood tests for the first 6 months.
Those taking levodopa/carbidopa may occasionally experience OFF periods in which their symptoms return. There are treatment options during these periods including a powder form of levopoda which can be inhaled or the medications istradefylline or safinamide .
Different Types Of Botulinum Toxin
There are eight different botulinum toxin species that occur in nature. There are only two however, that are produced commercially Botulinum toxin A and B.
The commercially available products are:
Each of the above agents are FDA approved for a slightly different list of clinical indications.
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How Can I Help Myself
You will need to try a variety of sensory tricks to see what works for you as dystonia affects everyone differently.
Spasms may be reduced by touching the affected part of the body either before or during any movement known to trigger dystonia. Although this may not prevent or stop a spasm, touching can distract or trick the brain and reduce the length and intensity of a muscle contraction.
Simple massage exerting pressure on the foot, or the use of a hot water bottle or heated pad can also help, as can movement and exercise see Coping Strategies Tips & Tricks.
For eye spasms, some people find lying down, singing, yawning, laughing, chewing, putting pressure on the eyebrows or just talking can help. Spasms in the vocal cords may respond to yawning or sneezing.
Simply relaxing may also help so try taking a bath, having a massage or a calming activity such as yoga.
Content last reviewed: June 2018
Leg Pain And Parkinsons
Interestingly enough, one of my early symptoms of the disease was deep searing pain in my left leg, the type of pain my grandma had complained about many times. Initially this type of pain was worst in the morning as well as at night, making me think is was some sort of fasciitis. However not only did typical anti-inflammatories and muscle relaxants not alleviate my pain but pain worsened over time to a constant burning pain that felt as if someone was tearing the muscle and pouring hot oil on it. The pain was so excruciating it was permeating into all aspects of my life. I was constantly in need of deep tissue massage asking my husband to massage my legs just as my grandmother had asked of us time and time again. This helped only temporarily.
Which brings me to the four types of leg pain in PD.
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Treatment Depends On Properly Identifying The Type
If pain is bilateral always assume it is central pain pain due to PD. In my experience Azilect works great for this type of pain. Other medications which can be employed for this pain as well.
Massage therapy works for all types of leg pain-my favorite therapy but can be costly. Water therapy may also work for all types except central pain. Physical therapy can alleviate dystonia pain, as well as musculoskeletal and radicular pain.
If pain is due to dystonia related to levodopa intake, find out when it occursend of dose or at peak dose. Typically adjusting medication doses will resolve problem. However, if dystonia is an initial symptom of PD, initiating treatment with levodopa will resolve. If medication adjustment does not work well for levodopa induced dystonia, another treatment option is DBS . Pain due to dystonia independent of cause can also respond well to Botox injections, as well as centrally acting muscle relaxants. To avoid and alleviate pain caused by stiff muscles, a great treatment option is activity in the form of stretching exercisesany number of activities will do such as tai-chi or yoga. For me when I start having radicular pain shooting down my leg it is time to up my levodopa dosage.
If you are having leg pain make sure to discuss it with your physician.
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Increased Urination Urgency And Frequency
Bladder problems are a common occurrence in people with Parkinsons, occurring in 30-40 percent of people with the disease. The most common urinary symptom is a frequent and urgent need to urinate even when the bladder is empty, as well as trouble delaying urination.
Trouble emptying the bladder is a less common feature of Parkinsons urinary dysfunction. It may be caused by difficulty in relaxing the urethral sphincter muscles that allow the bladder to empty.
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Muscle Cramps And Dystonia
People with Parkinsons disease often find that they are prone to a variety of aches and pains. For example, muscular rigidity and a reduction in, or absence of, movement can lead to cramps, which are often quite distressing and which may not be relieved by ordinary painkillers. Occasionally, people with PD may experience severe muscle spasms or dystonias that are different from ordinary muscle cramps and have different causes and treatments. This information sheet aims to describe the different types of muscle cramps and dystonias that may occur in PD and what treatments may be available for them
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Dystonia And Pain Management For Parkinson’s
Movement disorder specialist Alfonso Fasano, MD, PhD, outlines how to tease apart whether pain is a symptom of PD or due to an orthopedic issue. He explains how to approach the treatment of pain in concert with your medical team, going over several treatment options. Finally, Dr. Fasano focuses on causes of and treatments for dystonia and dyskinesias. After a 40-minute talk he spends 30 minutes answering questions.
Dystonia Or Muscle Cramps
Muscle cramps and dystonia occur when one of your muscles, or a group of muscles, tightens or shortens involuntarily.
Muscle cramps and dystonia can be confusing as they can feel very similar. You may not always be able to tell the difference between them, but they are caused by separate problems and are therefore treated differently.
Muscle cramps in Parkinsons are generally caused by muscular rigidity and reduced movement rather than by muscles contracting. But, like dystonia, cramps can also be painful and very distressing.
Normal painkillers do not usually relieve them, but cramps often respond well to massage and the use of a hot water bottle or heated pad. Movement and exercise may also help to release cramps and reduce stiffness. If these do not help, then your doctor may prescribe muscle relaxants.
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What Causes The Condition
Although there are several recognized risk factors for Parkinsons disease, such as exposure to pesticides, for now, the only confirmed causes of Parkinsons disease are genetic. When Parkinsons disease isnt genetic, experts classify it as idiopathic . That means they dont know exactly why it happens.
Many conditions look like Parkinson’s disease but are instead parkinsonism from a specific cause like some psychiatric medications.
Familial Parkinsons disease
Parkinsons disease can have a familial cause, which means you can inherit it from one or both of your parents. However, this only makes up about 10% of all cases.
Experts have linked at least seven different genes to Parkinson’s disease. They’ve linked three of those to early-onset of the condition . Some genetic mutations also cause unique, distinguishing features.
Idiopathic Parkinsons disease
Experts believe idiopathic Parkinsons disease happens because of problems with how your body uses a protein called -synuclein . Proteins are chemical molecules that have a very specific shape. When some proteins dont have the correct shape a problem known as protein misfolding your body cant use them and can’t break them down.
With nowhere to go, the proteins build up in various places or in certain cells . The buildup of these Lewy bodies causes toxic effects and cell damage.
The possible causes are:
What Are The Different Types Of Dystonia
There are several kinds of dystonia that affect different areas of the body. In its early stages, dystonia may show up only during certain movements or periods of stress or even at random. As it progresses, the disorders symptoms may become constant, even when the patient isnt attempting to engage his or her muscles.
- Generalized dystonia: Muscle contractions that affect the entire body.
- Segmental dystonia: Two or more neighboring body parts are affected .
- Multifocal dystonia: Spasms affect unrelated parts of the body.
- Primary focal dystonia: When the contractions are limited to one part of the body. Some common forms of this dystonia include the following:
- Cervical dystonia: Affecting the neck muscles, this can cause the head to twist or turn to one side.
- Blepharospasm: Causes the eyes to blink or close uncontrollably.
- Oromandibular dystonia: Affects the jaw, tongue, and face, often with the ability to eat and talk.
- Laryngeal dystonia: Affects the voice box muscles and can make a persons voice sound strained or, in severe cases, barely audible.
- Task-specific dystonia: Dystonia occurs only during a particular activity. Common forms include writers cramp, affecting muscles in the forearm and hand, and musicians dystonia, which affects just the muscles used to play the musical instrument.
- Hemidystonia: The arm and leg on the same side of the body are affected.
- Cranio-facial dystonia: Muscles in the head, face, and neck are impacted.
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Pain In Parkinsons Disease: A Spotlight On Women
This 2-page interview with neurologist, Dr. Jori E. Fleisher, discusses pain in Parkinsons disease with some interesting statistics about women and pain. Dr. Fleisher outlines the 4 primary types of pain in PD, how depression interferes with pain management, the role of exercise and medications in pain management as well as alternative therapies.
What Dystonia Treatments Are Available
To start treatment, your neurologist will likely first optimize your levodopa treatment. They may change your intake time, the doses, or the type of medication you are taking.If your dystonia does not respond to changes in your antiparkinsonian medications, your neurologist may prescribe medications that act as muscle relaxants such as clonazepam , or anticholinergic medications such as trihexyphenidyl and procyclidine.Botulinum toxin, commonly known as Botox, can also help treat dystonia in some people. It involves injections in the affected muscle to block abnormal signals from the brain. Botox also weakens the affected muscle, which helps to relieve pain. For an optimal and sustained effect, injections are repeated regularly, usually every three months.
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Exercise Stretch And Strengthen
- Even if you dont feel like it, exercising every day can increase flexibility in your muscles and joints, reduce pain and discomfort, and improve circulation. Exercise can increase the secretion of your happy hormones, improve your mood, and decrease anxiety and depression.
- If you have discomfort in your calves, ankles, feet, or toes, and try the eight exercises physical therapist Sarah King recommends.
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Managing And Treating Rigidity
Your doctor will diagnose rigidity by having you demonstrate various motor functions, like joint extension and flexing your muscles. â
Treatment options for managing Parkinsonâs disease work for managing rigidity. But if youâve caught the rigidity early and want to get ahead of future discomfort, there are treatment options available. â
Exercise. Specifically, exercise that focuses on flexibility and stretching your muscles. Itâs recommended that you stretch at least once per day. You can do this by having a stretching routine or using a program like yoga.
It can be difficult to start exercising when your muscles feel tight. This can compound and make you feel worse for not exercising. Break that cycle, take the first step, and work toward your overall health.
Soaks. Warm baths with Epsom salts help relax your muscles. This can provide instant relief for muscle stiffness and prolong your muscle effectiveness.
Physical therapy. Physical therapy can help target rigidity and soothe stiffness. It can also help you find routines and exercises that work for you. Speech therapy can be used to treat face muscle rigidity.
Medications. Your doctor can recommend medications to help with muscle stiffness. Many medications can be used to treat Parkinsonâs disease. Your doctor will work with you to develop a treatment plan.
Davis Phinney Foundation for Parkinsonâs: âRIGIDITY AND PARKINSONâS: WHAT IT IS AND HOW TO TREAT IT.â
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What Does Botulinum Toxin Treatment For Parkinsons Look Like
The effects of Botulinum toxin take hold about 3-10 days after the injections and last approximately three to four months, so the treatments typically need to be repeated on a regular basis. Although this means routine injections, it also means that Botulinum toxin injections do not have any permanent side effects. Some side effects may still occur with Botulinum toxin injections and the doctor who performs the procedure will review these with you. An advantage of using Botulinum toxin for the treatment of the conditions noted above, is that the toxin typically only impacts the areas into which it is injected, as opposed to oral medications which have a more widespread effect, and therefore more potential for side effects.
How To Cope With Dystonia
I have PD. First thing in the morning as I am getting out of bed, my left foot cramps severely and my toes curl downward, making it very painful to walk. I have found that it helps if I put my feet flat on the floor immediately after sitting up in bed. Also foot massages help. If I can force the cramped foot so it turns outward, my toes uncurl. nelleford
When my dads legs cramp, massage helps relieve them. You can usually feel where the spasms are. Rub your hands together to warm them up first. Start below where the spasm is and work up towards them. With your fingers and palms, give a deep massage where the cramp is. Give your loved one mustard or pickles to relieve the cramp. I know it is weird, but it works. To prevent them, exercise is best. Try to get them to walk every day, even if it is only half a block. This will also help prevent falls. A good multivitamin every day can be beneficial. Look for one with magnesium and potassium in it. These minerals helps to prevent cramping. My dad eats bananas almost every day for this reason. kathyt1
Calcium governs muscle contraction, and magnesium governs muscle relaxation. I take a magnesium supplement if Im having leg cramps. Perhaps have your loved ones levels evaluated with a simple blood test. Potassium can be dangerous if its too high or too low, and too low can often cause muscle cramps. sherry1anne
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