Parkinson’s disease is a condition that leads to problems with movement, sleep, mental health and more. There is no cure for it, but there are therapies and medicines to reduce symptoms such as tremors, difficulty in speaking and painful muscle contractions. There are certain things or habits that can make the symptoms of Parkinson’s disease even worse. The list also includes medications that may be used in managing some of the symptoms in people with this health condition. On World Parkinson’s Day, which falls place on April 11, we tell you the things that can worsen Parkinson’s disease symptoms.

What is Parkinson’s disease?

Parkinson’s disease is a progressive neurodegenerative disorder that mostly affects movement. It occurs when nerve cells in the brain, specifically in the substantia nigra, gradually break down or die, shares neurosurgeon Dr Aditya Gupta. These cells produce dopamine, a neurotransmitter that is crucial for coordinating movement. As dopamine levels decrease, people with Parkinson’s experience tremors, rigidity, slowness of movement, and impaired balance and coordination.

The exact cause of Parkinson’s disease is not fully understood, but it is believed that genetic factor can play a role. Also, age is a significant risk factor, with most people being diagnosed after the age of 60, says the expert.

What are the signs of Parkinson’s disease?

The signs of Parkinson’s disease can vary from person to person but commonly include:

• Tremors, especially in the hands, arms, or legs.
• Stiffness or rigidity of the muscles.
• Bradykinesia or slowness of movement.
• Postural instability leading to balance problems.
• Changes in speech, writing, or facial expression.
• Depression.
• Anxiety
• Sleep disturbances.

What can worsen the symptoms of Parkinson’s disease?

The following can make the symptoms worse:

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1. Stress

The body’s natural response to stress involves heightened muscle tension and increased heart rate, which can aggravate tremors and rigidity in people with Parkinson’s disease, says the expert. Stress management techniques such as mindfulness, meditation, and relaxation exercises may help mitigate these effects by promoting a calmer nervous system.

2. Lack of sleep

Inadequate or poor quality sleep disrupts the body’s natural rhythms, leading to increased fatigue and worsening motor symptoms in people with Parkinson’s disease. Establishing good sleep hygiene practices and addressing underlying sleep disorders with the help of a doctor are crucial for managing Parkinson’s symptoms.

3. Illness or infection

Any illness or infection can put additional stress on the body, leading to a temporary worsening of Parkinson’s symptoms. The immune response mounted by the body to fight off infections can exacerbate inflammation, potentially affecting dopamine levels in the brain and aggravating motor symptoms. It is important for people with Parkinson’s disease to promptly address any illnesses or infections and to stay vigilant about overall health maintenance.

4. Medication timing or dosage

Proper timing and dosage of medications are essential for managing Parkinson’s symptoms effectively. Fluctuations in symptom control can occur if medications are not taken as prescribed, leading to periods of worsening symptoms known as “off” episodes, says Dr Gupta.

5. Poor nutrition

Malnutrition or dehydration can impact medication absorption and overall health, potentially worsening Parkinson’s symptoms. Maintaining a balanced diet consisting of nutritious foods can support overall health and enhance the effectiveness of Parkinson’s medications.

6. Inactivity

Lack of physical activity can contribute to muscle stiffness and weakness, worsening motor symptoms in people with Parkinson’s disease. Regular exercise, and stretching, can help improve mobility, balance, and overall physical function. Engaging in physical activity also promotes the release of endorphins, which can help alleviate symptoms of depression and anxiety commonly experienced by people with Parkinson’s disease.

7. Certain medications

Some of the medications can exacerbate Parkinson’s symptoms. Medications such as antipsychotics, antiemetics, and some antidepressants can interfere with dopamine levels or exacerbate motor symptoms. For instance, Citalopram, which is often used in the treatment of depression. According to a 2000 study published in the Parkinsonism & Related Disorders journal, a person with Parkinson’s disease experienced a worsening in the motor status soon after including citalopram to her medication list.

How to manage Parkinson’s disease symptoms?

The management of Parkinson’s symptoms typically involves a combination of medications, physical therapy, speech therapy, and lifestyle modifications, says the expert.

• Medications aim to increase dopamine levels in the brain or mimic its effects, helping to alleviate motor symptoms.
• Physical therapy and exercise programs can improve mobility, flexibility, and balance.
• Speech therapy can help in dealing with speech and swallowing problems.
• Support groups and counselling can provide emotional support and practical advice for coping with the challenges of living with Parkinson’s disease.

Regular monitoring by a doctor is essential to adjust treatment plans as and when needed, and address any emerging symptoms or complications related to Parkinson’s disease.