Pain and Musculoskeletal Disorders: Common Nuisances in Parkinson Disease

Parkinson disease (PD) is a widespread neurodegenerative disorder with progressive motor and nonmotor features. Pain is one of the most frequent but ignored nonmotor features of the disease. Among several different types of pain in PD, musculoskeletal pain due to rigidity, rheumatologic disease, or skeletal deformity is the most frequently reported pain. Pain assessment with a reliable and valid tool is necessary to differentiate different types of pain. The King's Parkinson's Disease Pain Scale is a reliable and valid tool for rating of various types of pain in PD. Treatment modalities for musculoskeletal pain in PD are based on a multidisciplinary approach, which includes modification of dopaminergic medications, botulinum toxin for dystonia, exercise and rehabilitative measures, and surgical options for select patients. An accurate diagnosis of pain subtype in PD is a prerequisite for optimal treatment. (C) 2020 Elsevier Inc. All rights reserved.