Factors affecting pain in Parkinson's disease.
BACKGROUND
Despite being an important non-motor symptom of PD, pain remains largely understudied in PD patients. Experiencing symptoms of pain is highly disruptive of general functioning, as it may hinder both physical prowess and psychological well-being. Although pain is prevalent in the otherwise healthy geriatric population, its increased presence in PD, and the difficulty it poses when combined with other hallmark motor symptoms necessitates further investigation. An improved understanding of factors that aggravate pain, and methods that alleviate discomfort may provide significant insight on the basis of pain in PD. Such information may ultimately allow healthcare professionals to achieve the goal of improved PD patient management.


OBJECTIVE
To study the associations between various factors and pain in a Parkinson's disease (PD) patient population.


METHODS
This study investigated 121 PD patients, of which 80 reported to have pain in at least one area of the body. Exclusion criteria included patients suffering from external causes of pain, such as trauma and patients with cognitive impairment whose accounts may not have been reliable. Further inquiry determined the etiology of pain, as well as aggravating and alleviating factors. The efficacies of pharmacological or non-pharmacological therapies were assessed through additional questioning. Individuals were also asked whether their pain was unintentionally affected by other measures, such as prescribed PD medications.


RESULTS
Multiple linear regression analysis with a Wald test value of 4.070 (p = 0.044) demonstrated a statistically significant relationship between the administration of analgesics in patients with high reported pain and their pain relief. However, patients who experienced moderate pain did not exhibit any statistically significant levels of pain relief with the use of analgesics (Wald = 2.097, p = 0.148). Similarly, non-pharmacological therapies, PD medicine, and comorbidities showed no statistically significant correlations with pain relief.


CONCLUSIONS
Physicians should be aware of the physiological and psychological factors that form major components of pain relief, and that patient education and support are critical to successful treatment programs.
Director Parkinson's Clinic of Eastern Toronto and Movement Disorders Centre, Toronto, ON, Canada. ranaaq@yahoo.com
Abdul Qayyum
AQ
Rana
Adeel
A
Khan
Russell
R
Uppal
Patrick
P
Galange
Muhammad Saad
MS
Yousuf
Muhammad Saad
MS
Yosuf
Ishraq
I
Siddiqui
Ajantha
A
Jesudasan
Afshan Nazli
AN
Rana
Mohammad
M
Abounaja
Kevin
K
Hafez
Mohammed Abdullah
MA
Rana
D000368:Aged; D000700:Analgesics / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000188:drug therapy / Q000453:epidemiology* / Q000209:etiology*; D010300:Parkinson Disease / Q000150:complications*; D015995:Prevalence; D012307:Risk Factors; D016896:Treatment Outcome
D000700:Analgesics