Factors Affecting Pain in Parkinson's Disease

Article type: Research Article

Authors: Rana, Abdul Qayyum | Khan, Adeel | Uppal, Russell | Galange, Patrick | Yosuf, Muhammad Saad | Siddiqui, Ishraq | Jesudasan, Ajantha | Rana, Afshan Nazli | Abounaja, Mohammad | Hafez, Kevin | Rana, Mohammed Abdullah

Affiliations: Director Parkinson's Clinic of Eastern Toronto and Movement Disorders Centre, Toronto, ON, Canada | Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada | Faculty of Neuroscience, University of Toronto, Toronto, ON, Canada | Parkinson's Clinic of Eastern Toronto and Movement Disorders Centre, Toronto, ON, Canada | Department of Medicine, The Scarborough Hospital, Toronto, ON, Canada | Rouge Valley Hospital, Toronto, ON, Canada | Department of Family Medicine, University of Calgary, Calgary, AB, Canada | Faculty of life Sciences, York University, Toronto, ON, Canada

Note: [] Correspondence to: Abdul Qayyum Rana, MD, FRCPC, 741 Broadview Ave, B-3, Toronto, ON, M4P 2P6 Canada. Tel.: +1 416 461 0183; E-mail: ranaaq@yahoo.com

Abstract: Background: Despite being an important non-motor symptom of PD, pain remains largely understudied in PD patients. Experiencing symptoms of pain is highly disruptive of general functioning, as it may hinder both physical prowess and psychological well-being. Although pain is prevalent in the otherwise healthy geriatric population, its increased presence in PD, and the difficulty it poses when combined with other hallmark motor symptoms necessitates further investigation. An improved understanding of factors that aggravate pain, and methods that alleviate discomfort may provide significant insight on the basis of pain in PD. Such information may ultimately allow healthcare professionals to achieve the goal of improved PD patient management. Objective: To study the associations between various factors and pain in a Parkinson's disease (PD) patient population. Methods: This study investigated 121 PD patients, of which 80 reported to have pain in at least one area of the body. Exclusion criteria included patients suffering from external causes of pain, such as trauma and patients with cognitive impairment whose accounts may not have been reliable. Further inquiry determined the etiology of pain, as well as aggravating and alleviating factors. The efficacies of pharmacological or non-pharmacological therapies were assessed through additional questioning. Individuals were also asked whether their pain was unintentionally affected by other measures, such as prescribed PD medications. Results: Multiple linear regression analysis with a Wald test value of 4.070 (p = 0.044) demonstrated a statistically significant relationship between the administration of analgesics in patients with high reported pain and their pain relief. However, patients who experienced moderate pain did not exhibit any statistically significant levels of pain relief with the use of analgesics (Wald = 2.097, p = 0.148). Similarly, non-pharmacological therapies, PD medicine, and comorbidities showed no statistically significant correlations with pain relief. Conclusions: Physicians should be aware of the physiological and psychological factors that form major components of pain relief, and that patient education and support are critical to successful treatment programs.

Keywords: Parkinson's disease, pain, health policy and practice, medicine, movement disorders

DOI: 10.3233/JPD-2012-012125

Journal: Journal of Parkinson's Disease, vol. 2, no. 4, pp. 273-279, 2012