Parkinsonism and Musculoskeletal Disorders
Musculoskeletal problems are comparatively higher in people with Parkinsonism than in the normal population. However, not all orthopaedic disorders are more prevalent – only certain conditions like frozen shoulder, osteoporosis, neck pain and back pain affect Parkinsonism patients more frequently. Let us understand the reason for these disorders so that the steps to prevent or decrease the incidence can be followed effectively.
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Meal TimingsMenu
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Osteoporosis
- Bone mineral density (BMD) in Parkinsonism patients is less compared to age-matched normal individuals which are due to restricted mobility and loss of muscle strength and weight.
- Micronutrients like vitamins D & B12 and folic acid are also deficient in these people which attributes to osteoporosis as well as worsening of Parkinsonism symptoms.
- Levodopa usage also indirectly plays a role by means of altered homocysteine metabolism
- More frequent osteoporosis screening
- Calcium and vitamin D supplements
- Regular drug monitoring
- Anti-osteoporotic medications (depending on BMD value)
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Frozen Shoulder
- Muscle stiffness and tremors – accelerated degenerative changes in the rotator cuff of the shoulder.
- Rigidity – decreased movements lead to contracture of the shoulder joint capsule.
- Regular physical activity
- Rotator cuff strengthening and range of movement exercises should be a routine in the physiotherapy regimen.
- Early intervention with intra-articular injections and manipulation prevents long-term sequelae.
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Spine Disorders
- Altered walking pattern with forward stooping posture results in low back and neck pain.
- Muscle weakness and wasting around the spine can lead to posture imbalance and in advanced cases, structural scoliosis (side bending) or kyphosis (forward bending).
- Arthritis of the spine can occur prematurely due to abnormal posture.
- Back strengthening exercises and gait training
- Walking aids (crutches) – as and when indicated
- Spinal braces have a very little role
- Spinal deformity correction surgery – considered only when activities of daily living are profoundly affected.
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Fracture Risk
- Gait imbalance due to Parkinsonism itself, secondary spinal deformity and joint stiffness
- Osteoporosis
- Reduced muscle mass and strength (sarcopenia)
- Optimization of living area
- Walking aid
- Fall prevention clinics
- Osteoporosis management
