Pain in Parkinson’s Disease

 

“Twenty years ago, I received a diagnosis of Parkinson’s disease. I was forty-three … it occurred to me to wonder whether it would affect my brain. I asked my neurologist at the time, and he answered carefully, “Well, after a few years you may lose your edge.” Lose my edge? Lose my edge? Oh, shit! I need my edge. My edge is how I make a living. More than that: My edge is my claim on the world. It’s why people are my friends, why they invite me over for dinner …” “Even after twenty years, if I take my meds I can seem almost symptom-free for most of the day … a standard-issue baby-boomer bad back has been more burdensome to me than Parkinson”.

 

James Parkinson first described the condition that became synonymous with his name, in ‘An Essay in the Shaking Palsy‘ in 1817. Since then, the motor symptoms of Parkinson’s have been its defining feature – tremor, bradykinesia, rigidity …  and understandably so. But many non-motor signs remain unnoticed and unexpected – pain being one of them. The above excerpt from The New Yorker gives some insight into this oversight. Although 30-85% of people with PD experience pain, it is under-reported (see this 2017 review in Nature for an exploration of non-motor PD signs).

 

As with all pain states, to effectively treat pain we need to understand the mechanisms underlying it. This is where a simple to use and administer scale comes in handy.  So in 2015, Chaudhuri et al. (open access) created and validated the first scale to identify and grade various types of pain in PD. The King’s Parkinson’s Disease Pain Scale (KPPS) has 14 questions relating to 7 categories. It factors in both severity and frequency, taking around 10-15 mins to administer. As a result, it classifies pain in PD to musculoskeletal, fluctuation related, central, nocturnal orofacial and peripheral pain.

 

We know that pain fluctuates with a patients motor state, so keep in mind this was tested during their ‘on’ phase. Perhaps using this scale to classify pain can help with the initiation of individualised therapies. Would this come in handy for your clinical practice?

 

– Hayley Leake

 

WOLLONGONG 14-16 JULY EP+GMI

SYDNEY 29-30 JULY MONIS (SOLD OUT)

DARWIN 4-6 AUGUST EP+GMI

BRISBANE 25-27 AUGUST EP+GMI (GMI SOLD OUT)

NEWCASTLE 8-10 SEPTEMBER EP+GMI

SYDNEY 3-5 NOVEMBER EP+GMI

2 Responses to “Pain in Parkinson’s Disease”

  1. Geir Øveraas

    Hi,
    I could not read any of the tables. Would it be possible to receive it on e-mail?

    Reply

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s

Basic HTML is allowed. Your email address will not be published.

Subscribe to this comment feed via RSS

%d bloggers like this: