• Symptoms of Parkinson's disease

  • Motor symptoms
  • Non-motor symptoms
  • Constipation
  • Sweating
  • Pain
  • Speech and facial expression
  • Sleep and fatigue
  • Sense of smell
  • Mood and behaviour
  • Apathy
  • Anxiety
  • Thought and memory

• Treatment Options

• PD: What you need to know

Motor symptoms

As described below, the main motor (i.e., movement-related) symptoms of Parkinson’s disease (PD) are slowness of movement (bradykinesia), stiffness (rigidity), tremor, and loss of balance (postural instability).

Most people with PD will experience three or more of these symptoms.

Slowness of movement (bradykinesia)

Bradykinesia literally means slow movement. The general effect of bradykinesia is that it takes more time and effort to complete daily tasks.

To begin with, bradykinesia affects small, precise movements such as those needed for fastening buttons and writing. Problems with rising from a chair or turning over in bed are also common. Later on in PD, starting to walk may become difficult, or a person may unexpectedly ‘freeze’ to the spot for a short time while walking. For tips on the use of cueing strategies to help overcome ‘freezing’, visit the ‘Curing and cognitive movement strategies’ section of the website.

Stiffness (rigidity)

Rigidity in PD is a stiffness of the muscles.

To test for rigidity, the examining doctor moves the relaxed body part slowly and gently, and tests for any resistance to movement.

Tremor

The type of tremor seen in PD is a shaking motion that mainly occurs at rest, and may become less during activity (although in some people, tremor can disappear during sleep, and appear with certain actions or postures).

Initially, tremor usually affects the arm, hand or fingers on one side of the body, and may begin as a slight twitch. The most common tremor movement in PD is a back and forth motion of the thumb and first finger known as ‘pill rolling’.

A tremor isn’t present in all cases of PD, but it can be a troubling symptom for some people. It is not usually disabling since the tremor is mainly present at rest.

Loss of balance (postural instability)

The ability to maintain posture and balance may be affected in people with PD. This can lead to unsteadiness when walking, turning or standing, or when performing actions such as rising from a chair or bending over. Any of these unsteady movements may lead to a fall, which is a major cause of injury in people with PD.

There are many practical devices such as handrails, walking sticks, and walking frames that can help with stability and can prevent falls. A physiotherapist will be able to identify the right walking device for each person.