Not Your Usual Neck and Back Pain

There are many ways to get a backache. This is new for me — lower back pain that leads to spasms and literally drives me to my knees.

It doesn’t feel like the pain from overdoing it in the garden. Every gardener knows that exquisite twinge from too much lifting or shoveling. After all the years I have gardened, I know that pain well. This is not my usual lower back pain.

An article published in 2018 in the European Spine Journal found significantly more cases of low back pain, with longer durations, in patients with Parkinson’s disease than in healthy controls. Parkinson’s patients also experience more frequent and intense lumbar pain. Researchers concluded that Parkinson’s progression can lead to degeneration of the lumbar spine, and this leads to low back pain for about 88% of this population.

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According to an article published in 2018 in Frontiers in Neurology, both low back pain and Parkinson’s are associated with impaired proprioceptive function, sensory orientation during standing balance, anticipatory postural adjustments, automatic postural responses, and striatal-cortical function.

All of those are present as I wobble and weave through my “off” periods. Neck and back pain are more intense on the right side, but it’s subtle and hard to distinguish when the spasms are happening.

The authors of the Frontiers in Neurology article go on to suggest that “it may not be so implausible to consider [low back pain] as an axial parkinsonism, rendering it the most prevalent parkinsonism in the world.” Axial parkinsonism symptoms include gait freezing, postural instability, and trunk posture alterations and can have a significant impact on patients’ quality of life. Moreover, these symptoms are poorly responsive to dopaminergic drugs and surgical therapies.

In a 2008 article published in The Journal of the Canadian Chiropractic Association, a chiropractic doctor noted how early Parkinson’s without tremor imitated mechanical back pain. During a follow-up visit with the patient after the official Parkinson’s diagnosis, the provider noted that “something” started to change about a year earlier.

The article’s author wrote:

“In retrospect, … diagnosis may not have been able to be made any sooner as the patient’s symptoms were very subtle, non-specific, and common; … If it were not for the absence of significant objective back pain symptoms one day which caused the case re-evaluation, one may not have been alerted to an atypical set of symptoms developing and dialing into the diagnosis of PD may have been even further delayed.”

My lower back pains feel like my muscles are commanded by my broken Parkinson’s brain to tighten and “be ready.” Once I’m through the off period, the broken brain pain commands stop. I don’t have the sequelae of injury-related back pain — muscles that twinge as a reminder not to move in a certain position because it will make the pain worse. My off-period back pain seems to be an entirely different phenomenon.

For self-management, I lost 20 pounds to relieve mechanical stress on my body. I use massage and it helps, as do exercise and stretching. But my neck and back pain occur episodically — a “flicker effect.” If I attend immediately to the flickering surges of neck and back pain, then the consequences are diminished. The pain is not as intense, doesn’t last as long, and the spasms don’t occur.

When the flicker effect occurs, I apply the “sideways viewing” technique. Since the pain doesn’t appear to be injury-related, tied instead to abnormal “get ready, muscle” brain signals, sideways viewing helps. Sideways viewing allows me to witness that broken brain relationship and then meditate around the brain noise toward calm. It took a while to learn, but it works quite well if I am at rest.

I offer up this new perspective on neck and back pain associated with Parkinson’s. I see it as another manifestation of my favorite nonmotor culprit, homeostasis dysregulation. Parkinson’s causes dysregulation and abnormal flight-or-fight responses during off periods, which antagonize the back and neck muscles by triggering them to “get ready.” By using this to intervene, the pain lessens considerably, and I find relief.

This is still all new to me. I have not yet figured out how to walk around in the world with the pain present while simultaneously implementing sideways viewing, but I’m working on it. I am still failing more than succeeding, but with enough success thus far in applying sideways viewing to this unusual neck and back pain to encourage me.

Note: Parkinson’s News Today is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or another qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of Parkinson’s News Today or its parent company, Bionews, and are intended to spark discussion about issues pertaining to Parkinson’s disease.