At the most basic level, Parkinson’s disease affects the dopamine levels in the brain, causing problems with motor function or movement of the body.
While movement can include everything from walking to the mailbox to swallowing your morning coffee, the three classic movement problems that define Parkinson’s disease are tremor, rigidity, and bradykinesia (slowness of movement).
Different people exhibit different symptoms: some people have tremors and problems with rigidity, while others might have bradykinesia and rigidity but no tremor at all.
Symptoms of Parkinson’s disease usually show up on one side of the body. Over time, most people develop symptoms on both sides, but for most of us one side remains more symptomatic than the other.
The symptoms of Parkinson’s disease can be quite unpredictable. they vary from hour to hour and day to day. many people with Parkinson’s have good days, when they have very few active symptoms, but inevitably they also experience bad days when they tremble and freeze throughout the day.
Most people with Parkinson’s find that when their medication is in balance, their movements are basically normal—and, conversely, when their medication wears off or when they are tired or stressed, the Parkinson’s symptoms become more active.
When I’m exhausted or unhappy, my body lets me know by making my Parkinson’s worse; this is a way of reminding me that I need to slow down and take care of myself.
Gary, 50, experienced many minor symptoms that went unnoticed by most people, although his wife noticed that something was wrong. “I had problems with my gait; I took short steps and my arms didn’t swing much when I walked. I lacked expression in my face, and I had lots of mood swings. My wife noticed the symptoms before anyone else did, and she noticed that they seemed to come and go.”
Rigidity
Rigidity is a tightening or stiffening of the muscles. Typically, our muscles work in opposing pairs—the bicep paired with the tricep, for example—and one muscle contracts as the other relaxes. when someone has Parkinson’s disease, the communication between the opposing muscles can be disturbed, and one set of muscles tenses, causing stiffness.
There are two basic types of rigidity: lead-pipe rigidity (the body won’t move; it’s stiff, like a lead pipe) and cogwheel rigidity (the body moves in a jerky motion, similar to the cogs in a wheel). in both types of rigidity, the body does not move smoothly, and there can be a great deal of pain.
Some people with Parkinson’s have severe rigidity, while others don’t experience it at all. My rigidity started early, but I didn’t recognize what it was. My legs felt very stiff, they hurt, and they didn’t operate right. was I overusing them—or was I out of shape? did I need to rest, or did I need to get more exercise?
Typically, rigidity occurs more on one side than on the other and involves the arms, legs, neck, and back. Once I experienced a bout of full-body rigidity: I couldn’t move for 45 minutes. It was as if my entire body was tied up in a knot. I sat until the episode passed, and then I was gradually able to move again.
Bradykinesia
Bradykinesia is a general term referring to slowness of movement or speech. The term akinesia refers to absence of movement, which can also be a sign of Parkinson’s disease; in most cases, akinesia shows up as an arm that does not swing when you walk or a similar inability to move voluntarily.
Most people with Parkinson’s disease experience some type of bradykinesia, which can be expressed in a number of ways—from freeze attacks to difficulty dressing, from difficulty walking to difficulty swallowing.
The symptoms of bradykinesia come and go, but when they are active, the person may feel weakness, although the muscles are completely normal. Parkinson’s disease affects the communication between the brain and the muscles, creating slowness and stiffness, but the muscles themselves are healthy and strong.
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