BACK PAIN IN PARKINSONISM: EXPLORING PAIN GENERATORS AND INTERVENTIONAL MANAGEMENT: A CASE SERIES

Ismi Hamdani
Department of Neurology, Rumah Sakit Umum Daerah KH Idham Chalid, Ciawi, Bogor, Indonesia , Department of Neurology, Universitas Tarumanagara, Jakarta, Indonesia , Fellowship MIN KNI, Rumah Sakit Umum Pusat Nasional Cipto Mangunkusumo, Jakarta, Indonesia , Department of Neurology, Rumah Sakit Umum Pusat Nasional Cipto Mangunkusumo, Jakarta, Indonesia , Department of Neurology, Universitas Indonesia, Jakarta, Indonesia
Lie Anto
Department of Neurology, Rumah Sakit Umum Daerah Kabupaten Bintan, Riau, Indonesia , Department of Neurology, Universitas Maritim Raja Ali Haji, Tanjungpinang, Riau, Indonesia , Fellowship MIN KNI, Rumah Sakit Umum Pusat Nasional Cipto Mangunkusumo, Jakarta, Indonesia , Department of Neurology, Rumah Sakit Umum Pusat Nasional Cipto Mangunkusumo, Jakarta, Indonesia , Department of Neurology, Universitas Indonesia, Jakarta, Indonesia
Irma Savitri
Fellowship MIN KNI, Rumah Sakit Umum Pusat Nasional Cipto Mangunkusumo, Jakarta, Indonesia , Department of Neurology, Rumah Sakit Umum Pusat Nasional Cipto Mangunkusumo, Jakarta, Indonesia , Department of Neurology, Universitas Indonesia, Jakarta, Indonesia
Tiara Aninditha
Fellowship MIN KNI, Rumah Sakit Umum Pusat Nasional Cipto Mangunkusumo, Jakarta, Indonesia , Department of Neurology, Rumah Sakit Umum Pusat Nasional Cipto Mangunkusumo, Jakarta, Indonesia , Department of Neurology, Universitas Indonesia, Jakarta, Indonesia
Nurul Fadli
Fellowship MIN KNI, Rumah Sakit Umum Pusat Nasional Cipto Mangunkusumo, Jakarta, Indonesia , Department of Neurology, Rumah Sakit Universitas Indonesia, Depok, Indonesia , Department of Neurology, Universitas Indonesia, Jakarta, Indonesia
Yusak Mangara Tua Siahaan
Department of Neurology, Siloam Hospitals Lippo Village, Karawaci, Tangerang, Indonesia
Dyah Tunjungsari
Department of Neurology, Rumah Sakit Umum Pusat Nasional Cipto Mangunkusumo, Jakarta, Indonesia , Department of Neurology, Universitas Indonesia, Jakarta, Indonesia
Henry Riyanto Sofyan
Fellowship MIN KNI, Rumah Sakit Umum Pusat Nasional Cipto Mangunkusumo, Jakarta, Indonesia , Department of Neurology, Rumah Sakit Umum Pusat Nasional Cipto Mangunkusumo, Jakarta, Indonesia , Department of Neurology, Universitas Indonesia, Jakarta, Indonesia
https://doi.org/10.32539/kfdtz052
Keywords:
Pain, Parkinsonism, Pain Intervension

Abstract

Text size

Pain is a common non-motor symptom in parkinsonism, often overlooked despite its significant clinical impact. The most common form is Parkinson's disease (PD), followed by secondary and atypical parkinsonisms such as PSP. Two cases presented with musculoskeletal-spinal pain as the chief complaint: a PD patient with upper back pain that improved after an erector spinae nerve block, and a PSP patient with lumbar facet pain that improved after an intra-articular steroid injection. Pain in parkinsonism can originate from muscles, bones, joints, discs, ligaments, fascia, or nerves, requiring careful evaluation. Both cases demonstrate the effectiveness of pain injection interventions in patients unresponsive to conservative therapy. Appropriate pain assessment and management are crucial to improving the quality of life of parkinsonism patients.

References

Beiske AG, Loge JH, Rønningen A, Svensson E. Pain in Parkinson’s disease: Prevalence and characteristics. Pain [Internet]. 2009;141(1):173–7. Available from: https://journals.lww.com/00006396-200901000-00027

Broen MP, Braaksma MM, Patijn J, Weber WE. Prevalence of pain in Parkinson's disease: a systematic review using the modified QUADAS tool. Mov Disord [Internet]. 2012;27(4):480-4. Available from: https://doi.org/10.1002/mds.24054

Shrimanker I, Tadi P, Schoo C, et al. Parkinsonism. [Updated 2024 Mar 13]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025. Available from: https://www.ncbi.nlm.nih.gov/books/NBK542224/

Ford B. Pain in Parkinson’s disease. Movement Disorders [Internet]. 2010;25(S1). Available from: https://movementdisorders.onlinelibrary.wiley.com/doi/10.1002/mds.22716

Buhmann C, Kassubek J, Jost WH. Management of Pain in Parkinson’s Disease. Bloem BR, Brundin P, editors. J Parkinsons Dis [Internet]. 2020;10(s1):S37–48. Available from: https://journals.sagepub.com/doi/10.3233/JPD-202069

Tai YC, Lin CH. An overview of pain in Parkinson’s disease. Clin Park Relat Disord [Internet]. 2020;2:1–8. Available from: https://linkinghub.elsevier.com/retrieve/pii/S2590112519300301

Defazio G, Berardelli A, Fabbrini G, Martino D, Fincati E, Fiaschi A, et al. Pain as a Nonmotor Symptom of Parkinson Disease. Arch Neurol [Internet]. 2008;65(9). Available from: http://archneur.jamanetwork.com/article.aspx?doi=10.1001/archneurol.2008.2

Choi SM, Kim BC, Jung HJ, Yoon GJ, Kang KW, Choi KH, et al. Impact of pain and pain subtypes on the quality of life of patients with Parkinson’s disease. Journal of Clinical Neuroscience [Internet]. 2017;45:105–9. Available from: https://doi.org/10.1016/j.jocn.2017.08.002

Li J, Zhu BF, Gu ZQ, Zhang H, Mei SS, Ji SZ, Liu SY, Han C, Chen HZ, Chan P. Musculoskeletal Pain in Parkinson's Disease. Frontiers Neurology Sec. Movement Disorders [Internet]. 2022;12:756538. Available from: https://doi.org/10.3389/fneur.2021.756538

Ha AD, Jankovic J. Pain in Parkinson’s disease. Movement Disorders [Internet]. 2012;27(4):485–91. Available from: https://movementdisorders.onlinelibrary.wiley.com/doi/10.1002/mds.23959

Defazio G, Antonini A, Tinazzi M, Gigante AF, Pietracupa S, Pellicciari R, et al. Relationship between pain and motor and non‐motor symptoms in Parkinson’s disease. Eur J Neurol [Internet]. 2017;24(7):974–80. Available from: https://doi.org/10.1111/ene.13323

Tinazzi M. Pain and motor complications in Parkinson’s disease. Journal of Neurology, Neurosurgery & Psychiatry [Internet]. 2006;77:822–5. Available from: https://doi.org/10.1136/jnnp.2005.079053

Lin CH, Chaudhuri KR, Fan JY, Ko CI, Rizos A, Chang CW, et al. Depression and Catechol-O-methyltransferase (COMT) genetic variants are associated with pain in Parkinson’s disease. Scientific Reports [Internet]. 2017;7:6306. Available from: https://doi.org/10.1038/s41598-017-06782-z

Pagonabarraga J, Tinazzi M, Caccia C, Jost WH. The role of glutamatergic neurotransmission in the motor and non-motor symptoms in Parkinson’s disease: Clinical cases and a review of the literature. Journal of Clinical Neuroscience [Internet]. 2021;90:178–83. Available from: https://doi.org/10.1016/j.jocn.2021.05.056

Chaudhuri KR, Rizos A, Trenkwalder C, Rascol O, Pal S, Martino D, et al. King’s Parkinson’s disease pain scale, the first scale for pain in PD: An international validation. Movement Disorders [Internet]. 2015;30(12):1623–31. Available from: https://doi.org/10.1002/mds.26270

Defazio G, Tinazzi M, Berardelli A. How pain arises in Parkinson’s disease?. European Journal of Neurology [Internet]. 2013;20(12):1517–23. Available from: https://doi.org/10.1111/ene.12260

Rana AQ, Kabir A, Jesudasan M, Siddiqui I, Khondker S. Pain in Parkinson’s disease: Analysis and literature review. Clinical Neurology and Neurosurgery [Internet]. 2013;115(11):2313–7. Available from: https://doi.org/10.1016/j.clineuro.2013.08.022

Nardelli D, Gambioli F, De Bartolo MI, Mancinelli R, Biagioni F, Carotti S, et al. Pain in Parkinson’s disease: a neuroanatomy-based approach. Brain Communications [Internet]. 2024;6(4). Available from: https://doi.org/10.1093/braincomms/fcae210

Cattaneo C, Jost WH. Pain in Parkinson’s Disease: Pathophysiology, Classification and Treatment. Journal of Integrative Neuroscience [Internet]. 2023;22(5). Available from: https://doi.org/10.31083/j.jin2205132

Rana AQ, Qureshi ARM, Shamli Oghli Y, Saqib Y, Mohammed B, Sarfraz Z, et al. Decreased sleep quality in Parkinson’s patients is associated with higher anxiety and depression prevalence and severity, and correlates with pain intensity and quality. Neurological Research [Internet]. 2018;40(8):696–701. Available from: https://www.tandfonline.com/doi/full/10.1080/01616412.2018.1462880

Su D, Cui Y, He C, Yin P, Bai R, Zhu J, et al. Projections for prevalence of Parkinson's disease and its driving factors in 195 countries and territories to 2050: modelling study of Global Burden of Disease Study 2021. BMJ [Internet]. 2025;388:e080952. Available from: https://doi.org/10.1136/bmj-2024-080952

Wijaya VO, Pinzon RT. Pain Characteristics as Non-Motor Symptom in Parkinson Disease. Neurona [Internet]. 2018;35(4):296-301. Available from: https://doi.org/10.52386/neurona.v35i4.31

Download this PDF file

pdf

Published:

2026-01-24

Issue

Vol. 13 No. 1 (2026): Jurnal Kedokteran dan Kesehatan : Publikasi Ilmiah Fakultas Kedokteran Universitas Sriwijaya

Section

Articles

License

Creative Commons License

This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.

How to Cite

Hamdani, I., Lie Anto, Irma Savitri, Tiara Aninditha, Nurul Fadli, Yusak Mangara Tua Siahaan, Dyah Tunjungsari, & Henry Riyanto Sofyan. (2026). BACK PAIN IN PARKINSONISM: EXPLORING PAIN GENERATORS AND INTERVENTIONAL MANAGEMENT: A CASE SERIES. Jurnal Kedokteran Dan Kesehatan : Publikasi Ilmiah Fakultas Kedokteran Universitas Sriwijaya, 13(1), 119-127. https://doi.org/10.32539/kfdtz052