Management of pain in Parkinson's disease.
Pain is a common symptom in Parkinson's disease (PD) and accounts for substantial morbidity in up to 80 % of patients. Despite contributing to disease-related discomfort and disability, pain in PD frequently goes underacknowledged and undertreated in clinical practice. Although the exact underlying neurophysiology is unclear, there is increasing understanding of the role of the basal ganglia in somatosensory processing, as well as involvement of additional brainstem structures and non-dopaminergic pathways; appreciation of these mechanisms has implications for treatment strategies. Categorizing painful symptoms based on their clinical description into musculoskeletal, dystonic, radicular-peripheral neuropathic and central pain categories provides a useful framework for management. Importantly, these symptoms should be evaluated in relation to motor symptoms and dopaminergic therapy. A multi-disciplinary approach is recommended as follows: physical therapy, liaison with pain management and consultations to rheumatological, orthopaedic and neurosurgical services should be considered.
Department of Neurology, Columbia University, New York, NY, USA.
Munazza
M
Sophie
Blair
B
Ford
D000700:Analgesics / Q000008:administration & dosage / Q000627:therapeutic use; D000529:Complementary Therapies; D004298:Dopamine / Q000378:metabolism; D015259:Dopamine Agents / Q000008:administration & dosage / Q000627:therapeutic use; D005081:Exercise Therapy; D006801:Humans; D010146:Pain / Q000188:drug therapy* / Q000209:etiology / Q000378:metabolism; D059408:Pain Management / Q000379:methods*; D058748:Pain Perception / Q000187:drug effects; D010300:Parkinson Disease / Q000150:complications / Q000378:metabolism / Q000628:therapy*
D000700:Analgesics; D015259:Dopamine Agents; D004298:Dopamine