Parkinson's Disease: Understading Symptoms and Elevating Care
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One of the most common neurological disorders is Parkinson's disease (PD), a progressive nervous system disorder that affects movement. An estimated 60,000 people a year are diagnosed with PD. Symptoms associated with Parkinson’s tend to start gradually and can be barely noticeable.

Interestingly, various signs of Parkinson’s have been recognized and described for over two thousand years, yet it wasn’t James Parkinson’s observations that caused him to develop the first description of this disease. Generally speaking, people with Parkinson’s disease have trouble controlling the speed and/or the size of their movements, but the form that takes may vary. Here is a list of symptoms associated with Parkinson’s disease and what to look out for if you or a loved one is experiencing any one of these. If you are concerned, be sure to discuss any symptoms with your doctor.

  1. Tremors. They are the most frequently noticed symptom of early Parkinson’s disease. A limb, most commonly the hand or fingers begins to tremble at rest.
    • 70% of patients experience tremors
    • Resting tremors are most common
    • Medications and, in some cases, surgery is recommended when tremors persist
  1. Slowed movement. This is considered one of the early symptoms of PD. One must be diagnosed with this, as well as one other major symptom such as tremor or rigidity, to be diagnosed with Parkinson’s disease. Simple tasks become difficult and time-consuming. Signs of slowed movement include:
    • Steps become shorter when walking and one may drag their feet as they try to walk
    • Simple tasks are difficult and time-consuming
    • Difficulty getting out of chairs or bed
  1. Rigid muscles. Muscle stiffness may occur in any part of the body and can limit your motor functions. This stiffness goes beyond the aches and pains of aging or arthritis. Many describe this symptom as a “tightening” of the muscles leading to a reduction in the range of motion.
    • The rigidity can go beyond the arms and legs to the trunk of the body
    • Facial muscles can seem to freeze leading to one of the advanced symptoms called facial masking
    • Rigidity is one of the primary symptoms that leads to a diagnosis of PD
  1. Decreased posture. Posture often becomes stooped and hunched over. Take notice if you are unable to stand up as straight as you used to. Try these methods to improve your posture:
    • Consider incorporating Tai Chi or Yoga into your exercise routine
    • Change your position often, whether you are sitting or standing
    • Use a mirror to check your posture throughout the day
  1. Trouble balancing. As your posture may become stooped, balance can also decrease.
  • Removing throw rugs
  • Installing grab rails in the bathroom
  • Clearing excess clutter
  • Using handrails on stairs
  1. Speech changes. Speech many soften or quicken. One may also slur or hesitate before talking and lose the usual inflections and become monotone.
    • The voice becoming softer or sounding hoarse may be an early indication of PD
    • Exercise your voice by reading out loud or singing everyday
    • Rest your voice when it’s tired
  1. Trouble swallowing. Difficulty swallowing may increase overtime and lead to dehydration, malnutrition and/or aspiration (when food or water goes down the wrong pipe). If you notice any difficulty swallowing try to:
    • Exaggerate your swallowing - and practice the muscle movement by swallowing food or drink harder than usual
    • Modifying your diet to fit your needs, talk to your doctor about the right consistency and how to avoid malnutrition
  1. Vertigo and Dizziness. While non-movement related symptoms are common in people diagnosed with PD, doctors often overlook them when considering Parkinson’s as a possible diagnosis. Dizziness can often be related to poor balance and should be discussed with one’s doctor.
    • Vertigo and dizziness can be caused by medications or a drop in blood pressure
    • If blood pressure drops, be sure to drink plenty of water and increase salt intake
    • Consider wearing compression stockings and moving your legs before standing to pump blood into the body
  1. Writing changes. One’s handwriting may begin to change. It can become difficult to write and writing may become smaller. A few helpful solutions include using a weighted pen and practicing writing as a daily exercise.
  2. Dystonia. The warning signs of dystonia include clenched toes or hands, and cramping in the hands or feet. It is caused by repetitive muscle spasms that twist muscles causing painful cramps.

    o Dystonia often occurs when beginning a movement. For example, one can start to walk and suddenly feel the toes curling or the foot turning in on itself at the ankle. Parts of the body most affected by dystonia include:

  • Arms, hands, legs, and feet
  • Neck (Causing the head to be pulled down or to one side)
  • Eyes (Causing a person to blink too much or to have difficulty opening their eyes)
  • Vocal cords (May cause a person’s voice to sound strained or hoarse)

Living with Parkinson’s Disease

These are a few of the common symptoms of Parkinson’s disease. While there is no cure, there are many proactive approaches that one can take to improve their quality of life. Once you talk to your doctor and have an understanding of the symptoms - creating an exercise routine, eating healthy foods, drinking lots of water, and getting plenty of rest can all help you maintain an active lifestyle.

Resources

Four Cardinal Signs of Parkinson's

Symptoms and Causes of Parkinson's

Understanding the Stages of Parkinson's

Non-Movement Symptoms of Parkinson's

About the Author(s)

As a Volunteer Caregiver to the Zen Hospice Project and a Course Manager at the CareGivers Project, Audrey Meinertzhagen is passionate about improving the standards of care for older adults and educating caregivers on the principles of mindfulness and self-care.

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