Rigidity in Parkinson's Disease: A Primary Symptom

Impact and Treatment of Rigidity in Parkinson's Disease

elderly man trying to button his shirt
What are the symptoms and impact of rigidity in Parkinson disease?. Credit: Dorling Kindersley / Getty Images

What is Parkinson's Disease Rigidity?

Rigidity—when your muscles are stiff and resist moving—is one of the primary symptoms of Parkinson's disease, affecting at least 90 percent of people with the disease at some point. It occurs when your muscles stiffen involuntarily.

Most people who have Parkinson's disease experience rigidity, usually in their shoulders, arms and leg muscles. In fact, one of the earliest symptoms of Parkinson's for some people is a stiff, painful shoulder.

Rigidity can be present on only one side of the body (unilateral) or both sides (bilateral.) Rigidity also can occur in the hips and ankles, and in the neck and trunk (rigidity in your neck and trunk is called "axial rigidity"). Unlike some neurological conditions which affect muscle tone, the rigidity in Parkinson's disease affects flexor and extensor muscles equally.

Rigidity in Parkinson's disease can prevent you from moving easily, and this lack of easy movement can lead to more stiffness in a downward cycle. This symptom can cause discomfort or pain in your muscles.

What Does Rigidity Feel Like in Parkinson's? - Symptoms

When your muscles are rigid and you're having trouble moving them, it leads to several problems:

  • You may not be able to move your arms or legs very far, which means you'll take shorter steps and may not swing your arms as you walk. This can lead to problems with balance, even if it doesn't affect the "balance centers" in the brain.
  • You might find it difficult to do things that require small, careful movements, like button a shirt.
  • When your doctor tries to move your arm or leg around, it may move in a jerky "cogwheel" manner. Rather than having your movements feel "fluid-like" it seems like they occur in several, jerky steps.
  • Axial rigidity may cause your spine to be curved, and you may stoop. Unfortunately, this stooped posture can cause more stiffness and rigidity and also increases the risk of falls.
  • You may have trouble with normal facial expressions, leading to a mask-like blank expression. This expression can, in turn, affect your relationships, as your facial expression may suggest to your loved ones that you feel differently about a situation based on body language.
  • Rigidity is worsened by voluntary movements on the other side of the body (reinforcement.) For example, stiffness in your left arm and shoulder may be enhanced when you use your right arm.
  • Pain and muscle cramps may occur on top of an already present feeling of "tightness." The constant tenseness of the muscles can lead to aching.

A person with Parkinson's may have none of these problems, or that person may have all of them. They're likely to be progressive, meaning that as your illness gets worse, these problems will get worse, too.

Impact of Rigidity in Parkinson's Disease

The muscle rigidity in Parkinson's disease can impact every area of your life. Going through a normal day, rigidity affects mobility by making it difficult walking, and turning, with the stopped posture disrupting the normal way in which landmarks are used to navigate safely.

Eating can be affected, and even getting out of a chair or turning in bed can be difficult. Rigidity can interfere with normal communication both by the masked face appearance leaving others uncertain of your emotional reaction to conversation, and by changing the appearance of your written words as well.

Thankfully, treatment can improve the quality of life for most people. Thinking about an ordinary day, however, is a good reminder that treatment goes beyond using medications to help with the symptoms, and methods to help adapt with the symptoms that cannot be controlled and education family and friends about Parkinson disease along the spectrum from the difficulty in interpreting facial expressions to the importance of fall prevention.

Similar to severe arthritis, Parkinson's disease often has effects on daily living and activity that you would not think of prior to being diagnosed.

Treatment for Rigidity

Rigidity in Parkinson's disease may be all but inevitable, but there are treatments that can improve your ability to move and ease any pain or discomfort you feel from your stiff muscles.

First, there's exercise. Regular exercise can keep your muscles more flexible and will keep you moving generally. Although it can be difficult to get motivated to exercise, especially if your muscles don't want to cooperate, it's one of the most beneficial things you can do for yourself. Before you begin, talk to your doctor about how to exercise safely with your limitations. Working with a physical therapist can be very helpful in designing a routine, as well as to learn more about how to improve your balance and reduce your risk of falls. The best exercise program will include both flexibility (range of motion) exercise and strength training.

If your face is rigid and mask-like, a speech therapist may be able to help you exercise those muscles and keep them more flexible. It's best to start this type of therapy soon after your diagnosis to have the most success with it.

Finally, some drugs prescribed for Parkinson's disease can help to reduce rigidity. Specifically, Levodopa (L-dopa), frequently used to treat the condition, can help improve rigid muscles. Other medications may also have some effect.

If you feel that your Parkinson's rigidity is interfering too much in your daily activities, or if it's causing you pain, talk to your doctor about it. There are effective treatments for it.

Adapting to Rigidity

In addition to medications, there are lifestyle adjustments that may help you cope with the physical limitations of the disease. You may wish to consider one of the mobility aids available. One common difficulty many people cope with is getting up and out of a chair. A lift chair can be particularly helpful in raising you to a level which makes this easier.

Support and Coping

In addition to medications and therapy, and aids to assist you in daily living, there is support available that is helping many people cope with Parkinson disease. You may have a support group in your community. Thankfully, with the availability of the internet and many excellent online support communities, people with Parkinson's disease now have the option to connect with others facing the same challenges 24 hours a day.

Sources:

Kasper, Dennis L., et al. Harrison's Principles of Internal Medicine. New York: McGraw Hill Education, 2015. Print.

National Institute of Neurological Disorders and Stroke. Parkinson’s Disease: Hope Through Research. Updated 06/21/16. http://www.ninds.nih.gov/disorders/parkinsons_disease/detail_parkinsons_disease.htm

Tarsey, D. Patient Education: Parkinson Disease Treatment Options — Medications (Beyond the Basics). UpToDate. Updated 06/28/16.

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