Tuesday, May 18, 2021

Parkinson’s and Pain



If you have PD and are experiencing pain, you are not alone.  According to the Parkinson’s Foundation (PF), 85% f people with PD “report pain as a troubling symptom”.  PF goes on to state:

“Pain can be classified as nociceptive, which relates to tissue damage, implicating the pain receptors in the skin, bones or surrounding tissues; as neuropathic, indicating pain arising in nerves; or as a mixed pain syndrome involving both nociceptive and neuropathic pain. Your Parkinson’s specialist, working with a pain specialist, may select treatments based on the nociceptive versus neuropathic classification.

In Parkinson’s, most pain experiences are nociceptive — seeming to result from tissue that is injured or has the potential to be damaged. Causes include persistent tremor, muscle rigidity, dystonia, musculoskeletal injury (i.e., sprains, bruises, bone fractures resulting from a fall etc.), burns and inflammation. The pain is typically well-localized to the affected body part; it may fluctuate with medication dosing. Pain caused by dystonia can be diagnosed when there is visible twisting, cramping or posturing of the painful body part. The most common areas of the body where people with Parkinson’s experience pain are the neck, upper back and extremities.

In Parkinson’s, neuropathic pain is less common, and includes conditions not directly related to PD, such as shingles, cancer pain, carpal tunnel syndrome, diabetic neuropathy, and peripheral neuropathy. The pain may present as burning, numbness and tingling, sharp sensations, or electric shock qualities. Pain due to nerve or root disease is most commonly caused by akathisia, an extreme inner restlessness.”

Pain had not been a significant problem for until a few months ago.  Following my final surgery for a detached retina in my left eye in May, I was unable to engage in much physical activity.  The first pain I noticed was in my right groin area.  I have had this type of pain in the past with hernias (on both sides).  However, I had hernia surgery on that side a few years ago.  I have also had peripheral neuropathy for about seven years (numbness in feet and legs plus cold feet and hands) and wondered if that could have anything to do with it.  After visits to both my movement disorder doctor and PCP, I had imaging that revealed a hernia in my LEFT side and significant arthritis in both hip joints.  My PCP said that the groin pain on the right side could be due to the arthritis and referred me to physical therapy (PT).

Before I had my first PT visit, I started to have worse pain in my right shoulder.  So my PT visits to date have focused on that problem.  The therapist is pretty sure the problem is inflammation in the tendon and is having me do exercises and alternate hot and cold treatments,  The pain is worst when I get up in the morning, which apparently could be arthritis.

Meanwhile, I have scheduled hernia surgery for early December.  Then, because nothing else was going on, my DBS battery decided it was time to be replaced.  So I am having THAT surgery next week.

On top of THAT (when it rains it pours) I jammed my right knee jumping off a rock (don’t ask).  I didn’t have the nerve to tell the PT about that, but thankfully it seems to be healing.  I am also starting to detect the type of pain that came out of nowhere (no apparent cause) in my left shoulder.

I have been attempting through all this get as much exercise as possible by walking and light workouts at our community recreation center (aerobic, strength, and stretching).  I get very stiff if I don’t stretch and normally take 800 mg of ibuprofen every night, which I can’t do for the next week due to the aforementioned surgery.

My movement disorder doctor has researched the topic of medical marijuana quite thoroughly.  His comments corroborated articles I have read that reported this “medication” is effective for reducing inflammation and can help with sleep and constipation (both are a BIG deal in my world).  Learn more about this subject at http://www.parkinson.org/understanding-parkinsons/treatment/complementary-treatment/medical-marijuana-and-parkinsons-disease.  I am going to try it.  I think I am correct in saying I can save 40% with paperwork I will receive based on my doctor’s approval.  He also says it is important to buy from a reputable (your guess is as good as mine) and continue to use the same one to increase your chances of product continuity (it can vary from place to place).

That’s all I have to say about that.



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