Treatment for Parkinson’s requires a nuanced and integrated approach
When the line between back problems and Parkinson's symptoms blurs
Living with Parkinson’s disease is an intricate dance of challenges. For me, pain has been a persistent partner on this journey.
For years, my coping strategy was to try to push the pain out of my mind, summoning internal strength to accept it as an enigmatic facet of life with Parkinson’s disease. However, a recent spine MRI has unveiled a new layer of complexity, leading me to question whether the pain stems solely from the intricate web of Parkinson’s or if there’s a separate contributor in the form of back problems.
Both my neurologist and movement disorder specialist have periodically prescribed spine MRIs to investigate pain, numbness, and issues related to walking. Previous results hinted at spinal stenosis, a narrowing of the spinal canal, but nothing more severe. The latest imaging review, triggered by worsening symptoms of foot drop, left-calf dystonia, and gait disturbance, revealed a new twist: herniated disks and a pinched nerve.
Initially, the revelation brought a surge of relief. Concrete evidence pinpointing the source of pain seemed like a breakthrough. I dared to dream of a clear-cut separation between the fixable back problems and the unsolvable intricacies of Parkinson’s. Spine rehabilitation, including physical therapy, decompression, pain management, and the prospect of surgery, became a beacon of hope to alleviate the pain and regain a semblance of normalcy.
A collaborative effort
Yet, as I delve deeper into this newfound clarity, the lines between back problems and Parkinson’s blur. The symptoms of Parkinson’s cannot be separated from spinal problems; stooped posture, back rigidity, forward trunk tilt, and muscle inflexibility — all emblematic of Parkinson’s — directly implicate the spine. The dream of a tidy separation dissipates, giving way to the realization that the relationship between these two conditions is more entwined than initially perceived.
I must admit that this complexity is pivotal for effective management. Of course, the coexistence of back problems and Parkinson’s necessitates an integrated approach. While spine rehabilitation offers potential relief, it cannot be a stand-alone solution. Parkinson’s-specific interventions, such as targeted exercises to improve posture and flexibility, must be seamlessly woven into the treatment tapestry.
I realize that pain management strategies must be delicately tailored to accommodate the nuances of both conditions. The allure of painkillers and steroid injections must be tempered with caution, considering their potential impact on Parkinson’s symptoms and my overall well-being.
The journey ahead requires navigating a nuanced path, understanding that addressing back problems doesn’t equate to solving the overarching challenges posed by Parkinson’s. It calls for a collaborative effort between my neurologists, movement disorder specialists, spine specialists, and me to craft a holistic and personalized approach.
Contemplating the possibility of spine surgery introduces a complex decision-making process. The risks and benefits must be weighed meticulously, considering the potential impact on Parkinson’s symptoms and overall quality of life. An honest conversation with myself and an open dialogue with healthcare providers becomes imperative, fostering an ongoing process that balances acute and chronic therapy.
As I grapple with this newfound layer of complexity in my Parkinson’s journey, it serves as an essential reminder of the resilience required to navigate uncertainties. Living with Parkinson’s demands an ongoing adaptation to the ever-evolving landscape of challenges, striking a delicate balance between addressing specific issues and embracing the broader context of the condition.
This interplay between back problems and Parkinson’s calls for an integrated approach to healthcare. It prompts a recognition that these two conditions are intricately intertwined, and their management requires a collaborative effort that transcends isolated interventions. As I continue to chart the best course of action for my situation, I am reminded that resilience and adaptability are invaluable companions on this journey with Parkinson’s.
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.
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Comments
Benjy TX
“Doc Irish” I VERY rarely comment on a post. I am sure more than a few of us can relate to your dilemma . I have found teasing out the source of chronic pain from spinal issues are next to impossible. In simple terms my spinal problems as imaged are clear cut - cervical spinal cord compression- and one emergent surgery / fusion(s) and a revision surgery- because of reoccurring cord compression - the surgeries were not considered optional. I had no choice of conservative treatments. As my “Parkinsonism” rigidity/ dystonia advances, my physicians/ surgeons cannot with certainty separate the pain source which is more than difficult to treat. I have had an MDS tell me that PD is not a painful condition - UGH.
I SINCERELY HOPE you find a surgeon you can trust and get durable relief - it my be a considered risk worth taking- Also the stress of surgery/ anesthesia can exacerbate PD progression for some. although not all - nuanced indeed!
David Strahl
Long before I was diagnosed with PD I had spinal trouble. I have had 2 cervical laminectomies and 1 in my lower back. Each left me with much needed relief and I never regretted it. I never associated this with PD. I was diagnosed with PD at a followup exam by my neurosurgeon.
JANE SCHORE
I HAVE COMPLETE CONFIDENCE YOU WILL PREVAIL ON THIS MULI-FACETED "DISEASE" AND WILL OVERCOME YOUR ISSUES. YOUR DETERMINATION IS UPLIFTING!!
John Humphreys
Very intriguing. I too have bad knee and back problems along with my PD. I suppose it is obvious that years of crouching over has greatly exacerbated my pain and bone damage. Where to proceed from here?
Lewis Elbinger
Excellent, eloquent article. I particularly appreciate this observation: "Living with Parkinson’s demands an ongoing adaptation to the ever-evolving landscape of challenges, striking a delicate balance between addressing specific issues and embracing the broader context of the condition."
Shay
I too have back pain and some sciatica. I also have Parkinson's. It was suggested that I have back surgery. My PT said surgery would not help. I control my symptoms with spinning and yoga and I go to a functional neurologist. Doing all this stuff helps. Good luck to you.
Jim Lohr
I was diagnosed in September 2022. In the last 8 months I have suffered from back pain that is so severe that it stops me from walking….and my walking was already poor to begin with. I saw a specialist at Stanford Spine Clinic who told me that I have a spine of a young man and that any pain I have is related to my “Parkinson’s posture”. My instincts tell me that the pain that I am experiencing is far greater than strained muscles can cause. I hope more research is directed to this quality of life affecting problem.
Alexa Barr
Your plea for a collaborative effort between neurologists, movement disorder specialists, spine specialists and you to craft a holistic personalized approach really resonated with me. Only last week was I suggesting to my physio that I really need a team that actually talks to each other to manage my PD rather than them sitting in their own silos. It doesn't help when I have to travel 200 km to see the neurologist. I hate pain being my constant companion but for me it is the disease of the moving pain. For a few weeks it will be a hip, then a wrist or shoulder and I feel such a hyperchondriac when I raise it with my kids. Thanks for your grounded articles.