Pain in Parkinson’s

This article is taken from Progress 2026, our research magazine. To view the full magazine, visit this page.

Pain in Parkinson’s can be unpredictable, persistent and make daily life very challenging. Despite this, options to help manage pain in Parkinson’s are very limited. In fact, around half of those who feel pain aren’t provided with any treatments at all.

A major challenge to understanding pain and providing relief is the complexity of pain itself. If we all received the same pin prick to a finger, none of us would feel the pain in the same way. That’s because pain is a totally personal experience, and this can make it very tricky to define, measure and treat.

Alan shared: “I would describe the pain I feel as a burning sensation, similar to cramp, which starts in the neck and spreads across the shoulders and chest. It can last anywhere from 10 minutes to an hour and often wakes me in the night.

"There are things now that I don’t do, that I would like to do, but I’m scared to do them. I live in a coastal village and one of the things I used to do regularly was walk down to the bay. I haven’t done that now for over a year.”

What types of pain do people with Parkinson’s experience?

• Musculoskeletal pain - this refers to pain in the muscles, often an ache, and can be caused by rigidity and stiffness.
• Dystonic pain - this refers to pain caused by uncontrolled muscle movements, like spasms, and can feel like cramp.
• Neuropathic pain - this refers to pain caused by damage to part of the nervous system and isn’t well understood in Parkinson’s. It’s sometimes described as a stabbing, shooting, burning or prickling feeling

In general, pain can be categorised into acute and chronic pain. Acute pain usually gets better once the underlying cause has been removed, treated or healed. If pain lasts longer than 3 months or is recurring, it becomes chronic pain and can start to have a severe impact on daily life.

One of the largest studies to investigate chronic pain in Parkinson’s, involving over 10,000 people, found that it affected 1 in 3 people. It was even more common in women.

Wendy shared: “Even 9 years since I was diagnosed, I don’t have balance issues and I can still do most things, but the pain I feel is horrendous. I first noticed pain in my leg, which I thought was sciatica. Gradually it turned into full blown dystonia. The pain is excruciating. If I have a bad dystonia attack, I can’t walk.”

Pain in Parkinson’s can make associated symptoms worse

Research has shown that people with Parkinson’s who experience severe, persistent pain with their condition can also have a harder time with other symptoms.

Dr Kirsty Bannister and Dr Anna Fieldwalker at King’s College London compared people with Parkinson’s with and without pain. Those experiencing pain were significantly more affected by a wide range of Parkinson’s symptoms, such as tremor, stiffness, sleep and memory challenges.

Anna shared: “We also found that all people with Parkinson’s had a harder time naturally managing pain, not just those who experienced persistent pain. This suggests that for some people, pain is linked to the development of their Parkinson’s. This knowledge will help inform future studies exploring how the condition may begin.”

Parkinson’s may increase sensitivity to pain

Studies show that people with Parkinson’s may be more sensitive to painful triggers, such as temperature and touch, reacting earlier than those without the condition. It suggests that Parkinson’s itself changes how pain is processed and felt in the body.

What can cause pain in Parkinson’s?

Understanding what causes pain in Parkinson’s is critical to developing better treatments. But it’s a big challenge. Many factors are likely involved and the causes may vary from person to person. Take a look at the research that’s ongoing to improve our understanding of what’s behind different types of pain in Parkinson’s.

Brain and nerve changes

Our nervous system has a clever ability to alter the levels of pain that we feel. When we’re in pain, particularly when we’re highly stressed or emotional, a system of inhibitory pathways carry signals down from the brain to the spinal cord to reduce the pain that we feel.

Dr Kirsty Bannister is now leading research to explore whether Parkinson’s affects how well these inhibitory pathways function. It builds on a previous study which showed that, in an animal model of Parkinson’s, the inhibitory system responsible for blocking pain did not work. 

Now, we’re funding an ongoing study to explore whether these pain-blocking signals are also affected in people with Parkinson’s.

Kirsty shared: "We investigated the way that people with Parkinson’s detect and respond to sensory stimulation. Surprisingly, we found that the pathways that block pain didn’t always work properly. This was the case regardless of whether the person experienced chronic pain as a major symptom of their Parkinson’s.

"Our findings suggest that problems with pathways that block pain could be a  feature of Parkinson’s, and a potential target for new treatments."

Low levels of dopamine

A key feature of Parkinson’s is a lack of dopamine in the brain. As dopamine levels reduce, we start to see symptoms of Parkinson’s, including stiffness and slowed movement. These symptoms can cause pain in the muscles, but new research suggests the lack of dopamine could also play a more direct role.

A study, involving 53 people with Parkinson's, found that not only could musculoskeletal pain be directly linked to low levels of dopamine in the brain, the muscle pain that participants experienced also wasn’t affected by the severity of their Parkinson’s symptoms. Therefore, muscle pain might be down to more than just Parkinson’s symptoms themselves, opening up the possibility for new, targeted treatments.

How can we treat pain in Parkinson’s?

Improving how we measure pain

An important step in finding better treatments is developing tools that can accurately monitor and measure pain. In 2015, researchers at King’s College London developed the King’s Parkinson’s Pain Scale (KPPS). This is the first globally validated scale that helps identify and measure pain in Parkinson’s.

Dopamine-boosting medication

For pain that fluctuates over the day and is worse during off-periods (when a person’s Parkinson’s medication has worn off) dopamine-boosting medication, such as levodopa, can be a positive first step to helping reduce the pain. This can certainly be the case for pain that may be related to muscle cramps, dystonia and unwanted movements.

One small study, published in 2025, explored whether taking MAO-B inhibitors (medication that helps levodopa work even more effectively) could reduce pain in Parkinson’s. The study involved 40 people with Parkinson’s and results showed that MAO-B inhibitors, particularly safinamide and rasagiline, appeared to restore pain thresholds and improve quality of life.

Keeping active

Keeping active helps muscles stay strong and reduces strain on the body, which can alleviate pain. Starting small with short bursts of exercise throughout the day, called ‘exercise snacking’ can be a great way to start, especially if pain makes movement challenging. This could be climbing the stairs or walking at a faster pace.

Bhanu shared: "Exercise is an ideal and perfect way to combat most pain. If you experience pain, the thought of exercising can be a daunting one. But, as long as a health clinician has assessed the safety and need for exercise, the initial discomfort is far outweighed by the positive impact regular exercise can have on persistent pain and your general wellbeing."

Developing a pain toolkit fit for the future

Jenni aims to learn from people with lived experience, including people with Parkinson’s, carers, and healthcare professionals. She'll use this knowledge to co-develop a Parkinson’s pain management toolkit for people with Parkinson’s and a training package for healthcare professionals. Once developed, the toolkit will be trialled by people with Parkinson’s.

Jenni shared: "Understanding pain and how it affects people with Parkinson's is the first step to better pain management.

"These resources aim to raise awareness of pain in Parkinson’s, help people to understand their pain, and support clinicians to understand pain and its management in the context of Parkinson’s. Due to the variable nature of pain, understanding people’s experiences and the impact of pain on their lives is key."

Pain management for Parkinson’s has come a long way. Researchers across the UK continue to push for answers, striving to identify the causes of pain and find better management strategies to help people with Parkinson’s live without pain and the challenges it brings.

Find out more about pain in Parkinson’s and how to manage it in our free booklet or call our helpline on 0808 800 0303.