Roberta De Carolis Parkinson's disease, among all the problems it causes in patients, is also related to chronic pain, sometimes unbearable. But this aspect is very often overlooked. This is demonstrated by a study led by our University of Verona
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Chronic pain, often unbearable, is one of the most common and yet frequently neglected consequences of Parkinson’s disease, as shown by a study led by the University of Verona.
Parkinson’s disease and its symptoms
Parkinson’s disease is a neurodegenerative disorder characterized by muscle rigidity and resistance to passive movements. It manifests with tremors that appear during periods of rest, making it difficult to initiate and complete movements.
These symptoms, in turn, lead to balance disturbances, a shuffling gait, and a hunched posture. Additionally, depression often arises, either as a direct result of the condition or as an indirect consequence of the patient’s deteriorating health. There may also be a noticeable slowness in speech.
A recent study focused on this symptom, demonstrating that changes in speech can often occur before the characteristic symptoms of Parkinson’s disease emerge. This may explain why some individuals with early-onset Parkinson’s disease speak in a manner that is distinctly different from their usual way of speaking.
However, chronic pain is one of the most debilitating symptoms, affecting between 70% and 80% of patients.
Currently, there is no definitive cure for Parkinson’s disease. However, some treatments have proven effective in managing and slowing the progression of symptoms (though they cannot halt the disease’s advancement). These treatments primarily aim to restore dopamine levels, which gradually decrease starting from the onset of the disease.
The prevalence of Parkinson’s disease
Parkinson’s disease is the second most common neurodegenerative disorder, following Alzheimer’s disease. In industrialized countries, its incidence is about 12 cases per 100,000 people each year, with a prevalence of approximately 2 million individuals affected.
The disease is slightly more common in men than in women (60% vs. 40%). It affects around 1% of the population over the age of 60, rising to 4% among those over 85. Although the prevalence increases with age, it is not uncommon for the disease to appear before the age of 50, and even before the age of 40 (known as young-onset Parkinson’s disease).
Chronic pain: an overlooked symptom of Parkinson’s disease
The new study reviewed the scientific literature on Parkinson’s disease, showing that chronic pain is a disabling symptom for 70-80% of patients. It typically emerges in the early stages of the disease and progresses with varying characteristics.
However, the study also revealed that this pain is often overlooked in clinical practice because it is not considered a hallmark symptom of Parkinson’s disease.
“We highlighted that the management of chronic pain and other non-motor symptoms, such as fatigue, anxiety, depression, and sleep disturbances, is often inadequate,” said Michele Tinazzi, the lead researcher. “This results in increased use of common analgesic medications, such as non-steroidal anti-inflammatory drugs (NSAIDs) or even cannabinoids, despite the lack of solid scientific evidence supporting their effectiveness in Parkinson’s disease.”
The study also made significant strides in understanding the nature of this pain, distinguishing between pain that is related to the disease and pain that is not. This distinction could help in diagnosing and selecting the most appropriate treatment to improve patients’ quality of life.
“Whenever we visit a patient with Parkinson’s disease, we cannot limit ourselves to assessing motor symptoms,” concluded Marialuisa Gandolfi, the study’s co-author. “Non-motor symptoms, particularly pain, can have an even more negative impact on daily life. Early recognition is essential for targeted intervention.”
The study was published in The Lancet.
Sources: University of Verona Magazine / The Lancet
