Nerve pain in Parkinson’s, called neuropathy, is often treated with medications, physical therapy, supplements, or a combination of these treatments.

Close to one million people in the United States are living with Parkinson’s disease (PD), according to the Parkinson’s Foundation. An estimated 90,000 people are newly diagnosed with this neurological disorder each year.

The main symptoms of PD involve trouble with movement, such as slow movement, tremors, and rigid muscles. However, it’s not uncommon for people with PD to have other symptoms, such as pain.

Researchers have found that pain is reported in about 60% of people with PD. Compared to those without PD, people with PD are also 2 to 3 times more likely to experience pain.

Musculoskeletal joint and muscle pain due to the movements of PD is the most common type of pain associated with PD. But nerve pain, also called neuropathic pain, can also be a part of PD. Keep reading to learn more about neuropathic pain in PD and how it’s treated.

Neuropathic pain happens when nerves become damaged or inflamed. The sensation of neuropathic pain can be described in several ways, including:

  • sharp or shooting
  • electric
  • burning
  • coolness
  • numbness and tingling (“pins and needles”)

Neuropathic pain is estimated to impact 5%–30% of people with PD. Its exact cause isn’t known.

It’s possible that nerves may become damaged or compressed due to posture changes or to involuntary muscle contractions (dystonia) associated with PD. Nutritional deficiencies may also play a role.

Additionally, peripheral neuropathy is a separate condition that can coexist with PD, even when they aren’t causing each other.

Central pain in Parkinson’s disease

Another subtype of nerve-related pain observed in PD is called central pain. This happens when the pathways in your body that control pain sensations aren’t working as they should.

About 10% of people who have PD will have central pain at some point. The exact cause of central pain isn’t known. It’s generally believed to be associated with the neurodegenerative effects of PD.

The experience of central pain can vary. Some may describe it as “pain all over,” while others may have a constant painful sensation in certain areas of the body. It may also occur with other symptoms like abdominal pain or shortness of breath.

Central pain is poorly understood and can be difficult to treat. In some situations, it can be managed by starting on levodopa treatment if you haven’t already. It’s also possible that other drugs may help with severe central pain, such as:

  • anticonvulsants
  • certain antidepressants
  • narcotics

The following treatments can be used to treat neuropathic pain in PD.

Medications

There are a few different medications that may be used to ease neuropathy pain. These include:

  • Anticonvulsants: While anticonvulsants are seizure drugs, they can also help with neuropathic pain. Some examples of anticonvulsants that may be used in people with PD are gabapentin (Neurontin) and pregabalin (Lyrica).
  • Antidepressants: Some antidepressants can also help with neuropathic pain. Examples of antidepressants that may be used for neuropathic pain in people with PD are:
    • duloxetine (Cymbalta), a serotonin-norepinephrine reuptake inhibitor (SNRI)
  • Topical medications: Topical medications are applied directly to your skin. Some topical medications, such as lidocaine or capsaicin, may also help to relieve neuropathic pain localized to a certain area of the body.

A 2019 review notes that other medical treatments may be used if the ones above aren’t effective at managing neuropathic pain. These include narcotics, cannabinoids, or other seizure medications.

B12 supplements

Levodopa is one of the most common drugs used to treat PD. It helps to boost dopamine levels in the brain, which can improve the movement-related symptoms of PD.

Levodopa is associated with neuropathy. One 2019 review found that the prevalence of peripheral neuropathy was 30.2% and 42.1% in those taking oral levodopa or receiving gastrointestinal infusions of levodopa, respectively.

Levodopa-associated neuropathy may be due in part to low levels of some vitamins, particularly B12. Indeed, older studies have found that individuals who’ve taken levodopa for a long time have lower levels of vitamin B12 and an increased risk of neuropathy.

It’s possible that B12 supplementation may help prevent PD-related neuropathy, although more studies are needed. A 2019 study found a trend toward a lower risk of sensory symptoms in people with PD who took a multivitamin or a multivitamin plus B12 supplement. However, this wasn’t statistically significant.

Physical therapy and exercise

Physical therapy is an important part of PD treatment. Additionally, there’s evidence that exercise may also impact some of the pain-related processes associated with PD.

Engaging with a physical therapist may help with your neuropathic pain. This is particularly important since neuropathy is associated with a higher fall risk and trouble with gait.

For example, if changes in posture are contributing to your neuropathy, a physical therapist can work with you to reduce posture instability. This may help prevent posture or pressure-related nerve damage.

Some people with PD develop neuropathy. This happens when nerves become damaged or inflamed and can lead to sensations of shooting pains, burning, or numbness and tingling.

There are a few ways that neuropathy due to PD may be treated. These include medications, supplements, and physical therapy. If you have PD and neuropathy, your doctor may use one or a combination of these to help ease your symptoms.

Be sure to let your doctor know if you have any questions about your neuropathy treatment or find that it’s not effectively managing your symptoms.