Dystonia causes involuntary muscle contractions that lead to unintended movements and changes in posture. It’s estimated to affect over one-third of people with Parkinson’s disease.

Parkinson’s disease (PD) is a neurogenerative disorder that affects movement. People with PD have symptoms like tremors, muscle rigidity, and slow movements.

If you have PD, you may also experience dystonia. This is a condition that leads to involuntary muscle contractions that can cause changes in posture and movement.

Keep reading to learn more about PD-related dystonia. We’ll cover how dystonia is associated with PD, ways to manage it, and more.

Dystonia is a condition that causes unintended, sometimes painful, muscle contractions. Dystonia can affect one or many different muscle groups in your body.

Dystonic movements are irregular and can last for a few seconds or minutes. They may occur once in a while or very often. They usually happen more frequently as PD progresses.

The effects of dystonia lead to unusual movements and shifts in posture. For example, dystonia affecting your toes can cause them to curl involuntarily, making walking difficult or painful.

Dystonia can sometimes occur on its own due to genetics or unknown causes. But, it may result from another condition or factor, including:

People with PD can experience dystonia as a symptom of their PD. This is likely due to the neurodegenerative effects of PD, which cause damage to nerves in different areas of the brain, particularly those involved with movement.

Treatment with levodopa can often improve dystonia but can also sometimes cause dystonia. Dystonia is a less common side effect of levodopa than dyskinesia, but it can occur.

Dystonia due to levodopa may resolve with dosage adjustment or discontinuing the medication. However, it can be permanent and may remain even after stopping the drug.

How common is dystonia in Parkinson’s disease?

It’s estimated that dystonia affects 30% or more of people with PD. Dystonia can happen at any stage of PD and is often seen in more advanced stages. However, it’s often a common early symptom in people with young-onset PD.

What is dystonia like in Parkinson’s disease?

When dystonia happens, it can feel like a sustained muscle spasm or cramp. This can cause your body to twist or turn in an uncomfortable and potentially painful way.

Some types of dystonia may be brought on by movement. For example, walking may lead to twisting or curling of the ankle, foot, or toes in people with dystonia of the foot.

Generally speaking, people with PD have dystonia on the side of the body where they have the most PD symptoms. The foot is the most commonly affected area in people with PD. Other areas that may be affected include the:

  • muscles surrounding the eyes
  • jaw
  • neck
  • vocal cords
  • swallowing muscles
  • arms and hands
  • abdominal wall

What’s the difference between parkinsonism and dystonia?

Parkinsonism is a term that refers to conditions that have symptoms similar to those of PD, including tremors, slow movement, and muscle rigidity. In addition to PD, several other conditions can cause parkinsonism. Examples include:

Dystonia can be present in some types of parkinsonism, such as MSA and PSP. However, it’s important to note that dystonia can also happen by itself without any signs of parkinsonism.

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If your dystonia symptoms are relieved by taking levodopa, your doctor can work with you to adjust the timing or dosing of your levodopa.

For example, your doctor may recommend taking a controlled-release dose of levodopa to help maintain sufficient levels of levodopa in your body.

There are also other potential treatments for PD-associated dystonia. These include:

What medications should be avoided with dystonia?

Certain medications, such as antipsychotic and antiemetic drugs, can induce dystonia. Some of these medications can also interact with certain PD medications or can worsen the movement symptoms of PD.

As such, it’s important to avoid these medications if you have PD and dystonia. Your doctor can also give you a more individualized list of medications to avoid or use with caution.

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Dystonia and dyskinesia are two similar symptoms. However, there are some differences to be aware of.


Dystonia involves sustained muscle contractions that can cause unintended movements and changes in posture. One or many muscle groups in the body may be affected. Dystonia can sometimes be painful.

Dystonia may happen due to the effects of PD on the nervous system. Dystonia may also be a side effect of PD treatment, though this is rare.


Dyskinesia typically causes erratic involuntary movements of your face, torso, or limbs. These movements are generally more fluid and have a writhing quality to them. Dyskinesia is typically not painful.

Dyskinesia is a side effect of levodopa treatment. People who have dyskinesia can experience it at different times. For example, it can happen when your levodopa dose is at its peak or when levodopa levels rise or fall.

Dystonia can affect many people with PD. It often happens in the later stages of PD but is a common early symptom in people with young-onset PD. If you have dystonia, you can have involuntary muscle contractions that affect your posture.

Dystonia can happen due to the effects of PD itself or may be a rare side effect of levodopa treatment. Sometimes, adjusting the timing and dose of your levodopa can help ease dystonia.

Other treatments for PD-associated dystonia include medications, physical therapy, or Botox injections. If you have PD and dystonia, talk with your doctor about treatment options that may suit you.