What are the Most Common Symptoms of Parkinson's Disease?

Symptoms of Parkinson's vary from person to person and not everyone is affected by all of them.

In some people, the disease progresses quickly; in others it does not.

Here are the most common primary symptoms of Parkinson's disease:

Tremor:

In the early stages of the disease, about 70% of people experience a slight tremor in the hand or foot on one side of the body, or sometimes in the jaw or face. It looks like a 'beating' movement and is regular (4-6 beats per second).
 
Because tremor usually appears when the muscles are relaxed, it's called "resting tremor". This means that the affected body part trembles when it is at rest and not doing work and often stops when you start using (or working) that part of the body.

The tremor often spreads to the other side of the body as the disease progresses, but will remain most obvious on the side of the body where it first started.

A few more points on tremors include:

  • usually occur at rest, may occur at any time
  • may become severe enough to interfere with activities
  • may be worse when tired, excited, or stressed
  • finger-thumb rubbing (*pill-rolling tremor) may be present

*NOTE: ("Pill-rolling" is seen especially in the hands; this is fairly unique to Parkinson's disease. The term refers to the motion that a pharmacist uses to align a handful of pills before placing them in a bottle or, possibly, the motion used to roll a marble between the thumb and forefinger. Eventually the tremor becomes more generalized.)

Rigidity:

Basically this means stiffness or inflexibility of the muscles. Normally muscles contract when they move, and then relax when they are at rest. In rigidity, the muscle tone of an affected body part is stiff.

Rigidity can result in a decreased range of motion. For example a person may not swing his or her arms when walking. Rigidity can also cause pain and cramps at the muscle site.

Bradykinesia:

Bradykinesia is a slowing of voluntary movement. In addition to slow movements, a person with bradykinesia will likely also have incompleteness of movement, difficulty in initiating movements, and arrests of ongoing movement.

The person may begin to walk with short, shuffling steps (festination), which, combined with other symptoms such as loss of balance, increases the incidence of falls.

They may also experience difficulty making turns or abrupt movements. They may go through periods of "freezing", which is when the person is stuck and finds it difficult to stop or start walking.

Bradykinesia and rigidity can occur in the facial muscles, causing a "mask-like" expression with little or no movement of the face. The slowness and incompleteness of movement can also affect speaking and swallowing.

Here is a list of some secondary symptoms of Parkinson's disease:

Speech/Voice Changes:

  • slow speech
  • low-volume voice
  • monotone
  • difficulty speaking

Changes in Facial Expression: 

  • reduced ability to show facial expressions
  • "mask" appearance to face
  • staring
  • may be unable to close mouth
  • reduced rate of blinking

Loss of Fine Motor Skills:

  • difficulty writing, may be small and illegible (called micrographia)
  • difficulty eating
  • difficulty with any activity that requires small movements
  • movement is slow and uncontrolled

Other siymptoms may include:

Difficulty swallowing

Drooling

Pain, including muscle aches and pains (myalgia)

Dementia or confusion

Sleep disturbances

A variety of gastrointestinal symptoms, mainly constipation

Skin problems

Depression

Fear, stress or anxiety

Memory difficulties and slowed thinking

Sexual difficulties

Urinary problems

Fatigue and/or loss of energy

Unstable, stooped, or slumped-over posture