hand tremours — a symptom of parkinson's disease

Spot Parkinson’s Early: 23 Symptoms of Parkinson’s Disease To Look Out For

The earlier you receive medical intervention for Parkinson's disease, the better the long-term outcomes might be. Learn how to spot the early signs of Parkinson's here.

by Lorraine Bunag, R.N.

A Little Background on Parkinson’s Disease

Parkinson’s Disease (PD) is a brain disorder that manifests into physical and cognitive symptoms. Hallmark signs include involuntary tremors, muscular rigidity, and slowed movements. PD has several stages and symptoms tend to get worse as the condition progresses.

Symptoms of Parkinson’s Disease

The earlier you receive medical intervention for Parkinson’s Disease, the better the long-term outcomes might be. For this reason, it is crucial to spot the symptoms of PD as soon as possible.

In this section, we will categorise the symptoms of Parkinson’s disease into two categories:

  1. Physical symptoms
  2. Cognitive and mental signs

Physical Symptoms

According to experts, individuals with Parkinson’s Disease usually experience tremors, slow movement, rigidity and stiffness, in addition to other physical and cognitive symptoms. While some symptoms develop due to the condition itself, others arise as a result of other symptoms

1. Tremors

Perhaps, the most well-known sign of PD is involuntary tremors or trembling.

These shakings typically start in one limb — hand, arm, foot, or leg — and then affect both sides of the body. You may also observe the trembling in the tongue, mouth, chin, and jaw. Sometimes, the person may also experience pill-rolling tremors, where they rub their index finger and thumb together.

What is characteristic about the tremors is that they usually happen when the limb is at rest, but stops when the person is busy (using the limb) or asleep. 

It is also possible for the individual to have what we call “internal tremors,” meaning that they can feel the tremors, but it is actually not visible to others.

2. Bradykinesia

Next on our list of Parkinson’s symptoms is bradykinesia or slow movement; it results from slowed transmission of instructions from the brain to specific parts of the body.

As the disease progresses, bradykinesia might make even simple tasks like getting up from the bed or buttoning clothes more difficult and time-consuming. This sign also affects how the person walks: they may take unusually small steps (shuffling their feet) or drag their feet across the floor.

Despite the high possibility of bradykinesia worsening over time, experts emphasise that this symptom can be quite unpredictable. One moment you can be moving as easily as before, and then suddenly, you may need help performing daily tasks like taking a bath. For this reason, bradykinesia can be quickly disabling and it may be helpful to have a caregiver at home to help with activities of daily living.

3. Rigidity

Parkinson’s may also cause muscle stiffness or rigidity, which can result in pain and limit your range of motion. Any muscle in the body can experience rigidity, but with Parkinson’s disease, it is most common in the neck, shoulders, and arms.

Tremors, bradykinesia, and rigidity make up the main physical symptoms of Parkinson’s (Parkinsonism). However, they may also be caused by other conditions. If they are indeed caused by PD, chances are, they will also give rise to the following symptoms:

4. Posture and Balance Issues

Individuals with Parkinson’s disease may develop issues with their posture and balance.

Posture and balance are interrelated. The inability to stand upright (stooped posture) often makes a person vulnerable to impaired balance, which may or may not result in accidents such as falls. For instance, a slight shove or push could cause the person to uncontrollably move forward and bump into something or fall.

5. Loss of Automatic Movements

Did you know that PD may lead to the loss of movements which we do subconsciously? Case in point, an individual may stop blinking or swinging their hands naturally as they walk. In some cases, they even stop smiling.

6. Changes in Speech

Generally, Parkinson’s symptoms also include changes in speech; although, the way one’s speech changes varies depending on the individual.

For instance, a person may speak faster or slower than usual; others, on the other hand, may show significant hesitation before talking. Some may also assume an unusually monotonous way of expressing themselves.

7. Changes in Writing

Parkinson’s disease may also affect or change how a person writes. As the condition progresses, individuals may find it more difficult to write, so their penmanship may appear smaller or harder to understand.

8. Chewing or Swallowing Concerns

People with Parkinson’s disease might experience drooling, and/or difficulties in swallowing and chewing. These symptoms are concerning because they interfere with eating and increase the risk of choking. Should you experience these symptoms, speech therapy can help.

9. Skin Concerns

Since many people are focused on the signs of PD that involve movement, they might miss the skin changes brought about by the condition.

Reports indicate that Parkinson’s disease may lead to changes in the skin like increased oil production, the appearance of flakes, or the development of inflammation with redness and itching. They may also have dandruff on their scalp.

10. Reduced Ability to Smell

Reduced ability to smell, called hyposmia, is one of the early symptoms of PD; in fact, some people experience hyposmia years before a Parkinson’s diagnosis. However, please note that not everyone who experiences a loss of smell will develop Parkinson’s disease.

11. Bladder Problems

One of the common symptoms of Parkinson’s disease is urinary incontinence. Often, individuals report an urgent and frequent need to urinate even when the bladder is not full yet.

At one glance, urinary incontinence may not seem like a big concern; but when it occurs frequently, it can negatively impact one’s day-to-day life and confidence.

12. Gastrointestinal Symptoms

The brain changes that cause muscle stiffness and slowed movements also influence the muscles in our digestive system. This makes it difficult for the food to pass through the gastrointestinal tract, resulting in bowel symptoms, more commonly, constipation (having less than three bowel movements in a week).

Nausea (feeling sick) may also occur because of the slow emptying of the food from the stomach to the small intestine.

13. Pain

Pain ultimately becomes a part of Parkinson’s symptoms as the condition progresses.

As mentioned earlier, muscular rigidity or stiffness can result in pain; however, it is not the only source of aches and pain in PD.

Painful sensations may be musculoskeletal, especially due to changed posture or accidents such as falls. It can also be neuropathic, resulting from damage to the nerves that carry signals from the different parts of the body to the brain and spinal cord.

14. Changes in Vision

It is not surprising for individuals with PD to report changes in their vision after diagnosis.

For one, the slowed movements of their eye muscles can make reading difficult. They may also experience dry eyes due to an imparied blinking reflex, or face difficulty opening their eyes.

15. Sleep Disturbance

While the condition itself may result in difficulty sleeping, a lot of factors come into play as it progresses.

Case in point, urinary incontinence can wake an individual with Parkinson’s in the middle of the night, while constipation may make them feel too uncomfortable to sleep well. Furthermore, slowed movement can also cause difficulty in finding a comfortable position.

16. Weight Issues

In most cases, PD and its symptoms cause people to lose weight. For instance, nausea and constipation can result in a loss of appetite, while slowed movement and rigidity can lead to difficulties in eating. However, with medication, the risk of weight gain increases.

17. Fatigue

The stress of everything, from finding out about their condition to the signs and symptoms like sleep disturbances, can be draining and contribute to fatigue (or the feeling of severe tiredness) even when not doing anything strenuous.

18. Low Blood Pressure and Dizziness

People with Parkinson’s disease may develop orthostatic hypotension or low blood pressure after changing positions too quickly. This often results in dizziness.

19. Sexual Dysfunction

Symptoms of Parkinson’s can affect sexual health like decreased libido or sex drive. Some males also develop erectile dysfunction or the inability to achieve or maintain an erection.

Cognitive and Mental Symptoms

The changes occurring in the brain that affect movement and muscle tone can also influence how a person thinks, affecting our cognitive functions. Furthermore, the weight of the physical symptoms and the uncertainties of the prognosis can trigger mental health concerns.

Below are some of the cognitive and mental health symptoms that people with Parkinson’s might experience.

20. Anxiety and Depression

The cognitive changes happening in someone with PD bear similarities to those with anxiety and depression. On top of that, the stress and concerns that come with medication, therapy, and not being able to do things like before can increase the risk of anxiety and depression.

21. Memory Problems and Cognitive Changes

A reduced ability to recall things and difficulty in focusing may not appear until the later stages of Parkinson’s, but experts say the risk is there. In fact, many individuals with PD tend to develop dementia towards the later stages.

22. Hallucinations and Delusions

Previously, experts believed that psychotic symptoms, particularly hallucinations and delusions, mainly arise from long-term use of PD medications; now, though, they found that these could be related to the disease itself.

23. Apathy

Because of their physical symptoms like pain and reduced ability to move, individuals often develop a lack of interest in daily activities (apathy). People around them may also notice changes in their personality and behaviour.

What To Do Next

Detecting Parkinson’s disease as early as possible is crucial — it gives the affected individual and their medical team more time to manage the symptoms and increases the chance of staving off debilitating symptoms for as long as possible.

If you have any of the above-explained symptoms, talk to your doctor right away. They would be the ones to tell you if you have PD or another health condition. Do you want to be assessed by a doctor in the privacy and comfort of your home? Consider booking an appointment with one of our house call doctors or consult a doctor online. 

References
  1. Non-movement symptoms. (n.d.). Parkinson’s Foundation. Retrieved April 4, 2021, from https://www.parkinson.org/Understanding-Parkinsons/Non-Movement-Symptoms
  2. Parkinson’s disease – Symptoms and causes. (2018, June 30). Mayo Clinic. Retrieved April 4, 2021, from https://www.mayoclinic.org/diseases-conditions/parkinsons-disease/symptoms-causes/syc-20376055
  3. Parkinson’s disease – Symptoms. (2017, October 23). nhs.uk. Retrieved April 4, 2021, from https://www.nhs.uk/conditions/parkinsons-disease/symptoms/
  4. Parkinson’s disease and dementia. (n.d.). Johns Hopkins Medicine, based in Baltimore, Maryland. Retrieved April 4, 2021, from https://www.hopkinsmedicine.org/health/conditions-and-diseases/parkinsons-disease/parkinsons-disease-and-dementia#:~:text=Parkinson%20disease%20causes%20physical%20symptoms,it%20hard%20to%20maintain%20relationships
  5. Parkinson’s disease. (n.d.). National Institute on Aging. Retrieved April 4, 2021, from https://www.nia.nih.gov/health/parkinsons-disease
  6. Parkinson’s disease – Symptoms, diagnosis and treatment. (n.d.). American Association of Neurological Surgeons. Retrieved April 4, 2021, from https://www.aans.org/en/Patients/Neurosurgical-Conditions-and-Treatments/Parkinsons-Disease
  7. Parkinson’s disease: Causes, symptoms, stages, treatment, support. (n.d.). Cleveland Clinic. Retrieved April 4, 2021, from https://my.clevelandclinic.org/health/diseases/8525-parkinsons-disease-an-overview#symptoms-and-causes
  8. Parkinson’s psychosis. (n.d.). PubMed Central (PMC). Retrieved April 4, 2021, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3045857/

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About the Writer
Lorraine Bunag, R.N.
Lorraine is a registered nurse who spends most of her time writing informative articles on health and wellness. At the end of the day, she relaxes by reading a book or watching documentaries about unsolved mysteries.
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