Parkinson Disease and Pain - diagnostic and therapeutic approaches to a challenging non-motor symptom

Pain affects 40 %-95 % of patients with Parkinson disease (PD) and reduces their quality of life but is often underdiagnosed and treated unsystematically. Pain aetiology and pain characteristics can be very heterogeneous, and although the optimisation of antiparkinsonian medication is essential for pain treatment, in most cases, additional therapies for sufficient treatment of pain are necessary. This paper describes the epidemiology and pathophysiology of pain in PD, delineates pain characteristics, highlights the methods of pain management in PD and how patients assess the effectiveness of the therapies. Based on the limited data available and expert consensus, practice-oriented suggestions for diagnosis and therapy of pain in PD are provided. Neurologists should be sensitised to the topic of pain in PD. Due to the complexity of the neurodegenerative disease itself, neurologists should be involved in the interdisciplinary pain therapy of PD and provide their patients with more sophisticated treatment options than has been done so far.