Korean J Pain.  2025 Jan;38(1):43-50. 10.3344/kjp.24245.

Characterizing pain in Parkinson's disease: types, predictors, and management implications

• Alis C
• Demirelli DS
• Ay E
• Genc G

• KMID: 2563870
• DOI: http://doi.org/10.3344/kjp.24245

Abstract

Background
Pain impacts quality of life (QoL) in Parkinson's disease (PD) patients, yet it is often overlooked. This study aims to comprehensively evaluate pain in PD, particularly focusing on differences between neuropathic pain (NP) and other types.
Methods
We conducted a cross-sectional study involving PD patients, assessing the prevalence and characteristics of pain. Various scales were employed to evaluate anxiety, depression, and QoL. We investigated associations between pain, demographic, and clinical variables to determine predictors and pain-related factors. Additionally, factors related to NP were explored.
Results
During the study period, a total of 109 patients were examined. Sixteen patients were excluded due to various reasons. The final analysis included 93 patients (34 females and 59 males). Pain was reported by 80.6% of PD patients, with no significant demographic or clinical differences between those with and without pain. However, longer disease duration predicted NP, and musculoskeletal pain was more prevalent in females. Anxiety was common in patients with central parkinsonian pain (CPP). Patients taking amantadine reported less radicular/ neuropathic pain (RNP), suggesting a therapeutic role.
Conclusions
Our findings underscore the high prevalence of pain in PD and its impact on QoL. NP appears to be associated with disease progression, while sex-specific differences highlight the need for personalized pain management strategies. The association between anxiety and CPP emphasizes the importance of addressing psychological factors in PD pain management. Further research on amantadine's benefits in reducing RNP is warranted, emphasizing the importance of tailored pain management strategies for PD patients.

Keyword

Anxiety; Cross-Sectional Studies; Disease Progression; Musculoskeletal Pain; Neuralgia; Pain Management; Parkinson Disease; Quality of Life

Figure

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  Fig. 1 Comparison of EQ-5D-3L scores between Parkinson’s disease patients with and without pain. EQ-5D-3L: 3-level version of EQ-5D (EQ-5D-3L) by the EuroQol Group.

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  Fig. 2 Receiver operating characteristic (ROC) curve for predicting neuropathic pain based on Parkinson’s disease (PD) duration. AUC: The area under curve.

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  Fig. 3 Distribution of pain types according to sex. RNP: radicular/neuropathic pain, MSP: musculoskeletal pain, DRP: dystonia-related pain, CPP: central parkinsonian pain.

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  Fig. 4 Distribution of GAD-7 scores across different pain types. GAD-7: General Anxiety Disorder-7 scale, RNP: radicular/neuropathic pain, MSP: musculoskeletal pain, DRP: dystonia-related pain, CPP: central parkinsonian pain.

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  Fig. 5 Distribution of MDS-UPDRS III scores across different pain types. MDS-UPDRS III: The Movement Disorders Society-Unified Parkinson’s Disease Rating Scale part III, RNP: radicular/neuropathic pain, MSP: musculoskeletal pain, DRP: dystonia-related pain, CPP: central parkinsonian pain.

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