10 Early Signs of Parkinson's Disease

This short brochure describes ten symptoms that may be early signs of Parkinson’s disease. Each symptom of concern is listed along with ‘What is normal’. If you have more than one symptom, you may want to visit your doctor.

It can be hard to tell if you or a loved one has Parkinson’s disease (PD). PD is a neurodegenerative disorder that predominately affects dopamine-producing (“dopaminergic”) neurons in a specific area of the brain called the substantia nigra. Symptoms generally develop slowly over years and the progression of symptoms is often different from one person to another due to the diversity of the disease.

What follows is a list of 10 early signs of Parkinson’s disease. No single one of these signs means you should worry about having PD, but if you have more than one sign, you should consider making an appointment to talk to your doctor.

Tremor

Have you noticed a slight shaking or tremor in your finger, thumb, hand or chin? A tremor, while at rest, is a common early sign of PD.

What is normal?

Shaking can be normal after lots of exercise, if you are stressed or if you have been injured. Shaking could also be caused by a medicine you take.

Small Handwriting

Has your handwriting gotten much smaller than it was in the past? You may notice that your letter sizes are smaller and the words are crowded together. A change in handwriting may be a sign of PD called micrographia.

What is normal?

Sometimes writing can change as you get older, if you have stiff hands or fingers or poor vision

Constipation

Do you have trouble moving your bowels without straining every day? Straining to move your bowels can be an early sign of PD and you should talk to your doctor.

What is normal?

If you do not have enough water or fiber in your diet, it can cause problems in the bathroom. Also, some medicines, especially those used for pain, will cause constipation. If there is no other reason such as diet or medicine that would cause you to have trouble moving your bowels, you should speak with your doctor.

Loss of Smell

Have you noticed you no longer smell certain foods very well? If you seem to have more trouble smelling foods like bananas, dill pickles or licorice, you should ask your doctor about PD.

What is normal?

Your sense of smell can be changed by a cold, flu or a stuffy nose, but it should come back when you are better.

Trouble Sleeping

Do you thrash around in bed or act out dreams when you are asleep? Sometimes your spouse will notice or will want to move to another bed. Sudden movements during sleep may be a sign of PD.

What is normal?

It is normal for everyone to have a night when they ‘toss and turn’ instead of sleeping. Similarly, quick jerks of the body when falling asleep or when in lighter sleep are common and often normal.

Dizziness or Fainting

Do you notice that you often feel dizzy when you go from sitting down to standing up? Feeling dizzy or fainting can be a sign of low blood pressure and can be linked to PD.

What is normal?

Everyone has had a time when they stood up and felt dizzy, but if it happens on a regular basis you should see your doctor.

Stooping or Hunching Over

Are you not standing up as straight as you used to? If you or your family or friends notice that you seem to be stooping, leaning or slouching when you stand, it could be a sign of PD.

What is normal?

If you have pain from an injury or if you are sick, it might cause you to stand crookedly. Also, a problem with your bones can make you hunch over.

Trouble Moving or Walking

Do you feel stiff in your body, arms or legs? Have others noticed that one or both of your arms doesn’t swing like it used to when you walk? Sometimes stiffness goes away as you move. If it does not, it can be a sign of PD. An early sign might be stiffness or pain in your shoulder or hips. People sometimes say their feet seem “stuck to the floor.”

What is normal?

If you have injured your arm or shoulder, you may not be able to use it as well until it is healed, or another illness like arthritis might cause the same symptom.

Masked Face

Have you been told that you have a serious, depressed or mad look on your face, even when you are not in a bad mood? This is often called facial masking. If so, you should ask your doctor about PD.

What is normal?

Some medicines can cause you to have the same type of serious or staring look, but you would go back to the way you were after you stopped the medication.

A Soft or Low Voice

Have other people told you that your voice is very soft or that you sound hoarse? If there has been a change in your voice you should see your doctor about whether it could be PD. Sometimes you might think other people are losing their hearing, when really you are speaking more softly.

What is normal?

A chest cold or other virus can cause your voice to sound different, but you should go back to sounding the same when you get over your cough or cold.

What can you do if you have PD?

It is possible to have a great quality of life with PD. It is essential to work with your doctor and follow recommended therapies in order to successfully treat symptoms.

• Develop a plan with your doctor to stay healthy. This might include:

– A referral to a neurologist, a doctor who specializes in the brain, or a Movement Disorder Specialist, a neurologist with additional training in PD

– Care from an occupational therapist, physical therapist and/or speech therapist

– Meeting with a medical social worker to talk about how Parkinson’s will affect your life

• Start a regular exercise program to help manage symptoms and maintain well-being.
• Talk with family and friends who can provide you with the support you need.

The Parkinson’s Foundation is here to help. Contact the Parkinson’s Foundation Helpline for answers to your questions in either English or Spanish. Staffed by Parkinson’s disease information specialists, the Helpline is free and here to support you — and your loved ones — in any way possible, including:

• Current information about Parkinson’s
• Emotional support
• Referrals to health care professionals and community resources

A wide variety of free publications are also available. To order, call or email our Helpline: 1.800.4PD.INFO (1.800.473.4636) / Helpline@Parkinson.org.

Not ready to talk to someone about PD? Visit Parkinson.org for reliable information.