How to manage Parkinson's disease

Parkinson’s disease is a life-changing condition that seriously affects movement, but there are now more ways than ever to manage the symptoms

‘People tend to think Parkinson’s mainly affects older men and causes people to shake and become slow and stiff, but it affects women and some younger people too and there are more than 40 symptoms,’ says Claire Bale, associate director of research at Parkinson’s UK, about the progressive neurodegenerative disorder.

With so many possible indicators it can be hard to know what might or might not be a sign of Parkinson’s – there are many other conditions that share some of its symptoms, such as the involuntary shaking known as essential tremor. However, as it progresses it becomes easier to identify. There are now about 145,000 people in the UK who have Parkinson’s and it is thought to be the fastest growing neurodegenerative condition in the world.

Parkinson’s results from the loss of dopamine-producing cells in the brain, though what causes them to die is not known. Dopamine is a neurotransmitter that plays a vital role in co-ordinating movement.

The symptoms develop gradually over time, but the most common early ones include:

Tremors – a rhythmic shaking of the hands, feet, or head, often most noticeable when the person is at rest.

Rigidity – stiffness of the muscles, which makes it difficult to move the arms and legs freely.

Slowness of movement – everyday tasks, such as getting dressed or eating, become more difficult.

Mild memory and thinking problems.

As the disease progresses, postural instability may develop and a loss of balance and co-ordination that makes it difficult to walk. Non-motor symptoms might also develop – these can include cognitive impairment, depression, anxiety, sleep problems and constipation.

For women there is the added complication of deciding whether symptoms are due to the menopause or Parkinson’s, as fatigue, sleep problems, anxiety, muscle pains, and stiffness are common to both.    

The great unknown

While the exact cause of Parkinson’s is not known, it is widely believed that genetic and environmental factors play a part. Other indications of greater risk include:

Age: it is most common in people aged over 60.

Sex: men are slightly more likely to develop the disease than women.

Family history: having a close relative with Parkinson’s increases the chances that you will develop it.

Exposure to certain toxins: ingesting small amounts of pesticides or herbicides may also increase the risk.

There is no cure for Parkinson’s, but there are several treatment options, including medications, lifestyle adjustments and surgery. While the disease itself is not fatal, complications arising from it can be serious. The first step to living with it is to understand the disease and its progression, because there are treatments that can help to manage the symptoms.

Fighting back

Getting regular exercise and physiotherapy are both recommended for people with Parkinson’s, but there is also a range of drugs and other treatments that can help. The most common medication is levodopa, a chemical that is converted to dopamine in the brain. People with Parkinson’s have low levels or are missing dopamine entirely, mainly due to the loss of the cells that make it. Generally, motor symptoms only become evident later in the course of the disease, after 60% to 80% of the cells have already been lost.

Some research has shown that regular exercise might reduce the risk of developing the condition. Other studies indicate that people who consume caffeine – found in coffee, tea and many fizzy drinks – are less likely to get the disease than those who don’t. Whether caffeine protects against getting Parkinson’s or works in some other way is not known.

Some of the latest treatments being investigated include:

Gene therapy: delivering genes to the brain that can help replace the dopamine-producing cells which have been lost.

Stem cell therapy: stem cells have the potential to develop into many different types of cells, including dopamine-producing neurons.

Neuroprotective therapy: using drugs or other therapies to protect the dopamine-producing areas of the brain from further damage.

Focused ultrasound: a non-invasive procedure which destroys cells in a small area of the brain that is responsible for some of the symptoms of Parkinson’s.

In cases where the disease is far advanced, there are also surgical options:

Deep brain stimulation (DBS): the implantation of a device in the brain that delivers electrical impulses to specific areas of the brain. This can help to improve motor co-ordination.

Ablative surgery: destroying cells in a small area of the brain that is responsible for some of the symptoms. This type of surgery is typically reserved for people with advanced Parkinson’s disease who do not respond well to medication or DBS.

Sound advice

Essential tremor (ET) is not the same as Parkinson’s but is also characterised by involuntary shaking. It usually affects the hands, but can also impact the head, voice, and legs. Imagine an uncontrollable shake when trying to write a note but which disappears when you rest your arm. This so-called ‘intentional tremor’ is a hallmark characteristic of ET, and is often made worse by stress or anxiety.

While medication is the first line of treatment, about half of people with ET do not obtain satisfactory relief, so a unique partnership between the renowned National Hospital for Neurology and Neurosurgery (NHNN) in London and the nearby Queen Square Imaging Centre is now providing rapid access to the latest treatment options.

The NHNN is the largest dedicated neurological and neurosurgical hospital in the UK. It provides comprehensive services for the diagnosis, treatment and care of all conditions that affect the brain, spinal cord, nervous system and muscles. Queen Square Imaging Centre offers expert comprehensive assessment for patients interested in receiving focused ultrasound treatment for essential tremor or Parkinson’s.

With no incisions or anaesthetic involved, the treatment involves minimal risk and can typically be performed as a day case procedure. This means you can return quickly to your normal life with minimal recovery required. Many patients have reported immediate and lasting improvement of their tremors.

Finding help and support

As the largest European charitable funder of research into the disease, Parkinson’s UK has invested over £100 million in studies that have delivered new medications and better care. Its many projects are at different stages of the research pipeline.

Across the country there are support groups run by volunteers who usually have personal experience of living with Parkinson’s. They organise all kinds of activities and welcome anyone with the condition, as well as their family members and carers. There really is no need to suffer in silence. 

  • Visit for details of local support groups. For information about ultrasound treatment call 020 7833 2513 or visit

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