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Parkinson's disease can cause a variety of symptoms.

Parkinson's disease is a chronic ailment that slowly destroys brain cells that produce a chemical called dopamine.

Dopamine helps the brain direct muscles and limbs to move purposefully and smoothly.

The decrease in dopamine can result in symptoms such as trembling, stiff limbs, slow movement, impaired posture, and poor balance and coordination.

Early warnings

Before these clear signs appear, however, there may be more subtle indications that something is wrong. A person's handwriting may become small and cramped. They may feel shaky and have difficulty moving or walking. They may notice that their speech is too soft for others to hear.

Also, a person's face may lack expression and animation. This is sometimes called "mask face."

Progression of symptoms

Parkinson's progresses more rapidly in some people than others, according to the National Institute of Neurological Disorders and Stroke (NINDS).

The symptoms and their intensity vary as well. Not all people experience the same symptoms or in the same order. Some people become quite disabled, while others experience minor tremors and stiffness. 

Here is a more detailed look at the four main symptoms:

Tremors

Trembling movements usually start in the hand and sometimes the jaw or foot, according to NINDS.

They become more obvious when the hand is at rest or if the person is under stress. Early in the disease, tremors and other movement problems typically affect one side of the body only.

Tremors usually go away when a person is asleep or improve with intentional movements.

Rigidity

Most people with Parkinson's experience stiffness and resistance to movement, NINDS says.

Because of the disease's effects on the brain and the disrupted signals it sends to muscle groups, muscles can become constantly tensed up, resulting in stiffness and achiness.

Bradykinesia

Bradykinesia is the slowing down and loss of movements the body performs automatically.

The symptoms are unpredictable. Sometimes a person can move normally, but then he or she can't move at all. Simple activities such as washing or dressing can become extremely difficult or even impossible.

Also, a person's face may lack expression and animation. This is sometimes called masked face.

Impaired posture and balance

People with Parkinson's often develop a forward lean, lose their sense of balance and can fall easily. Their gait may consist of quick, small steps.

Parkinson's may also cause people to develop a slouched or hunched appearance, with shoulders drooped and head hanging down. As the disease progresses, some people may not be able to walk easily. They may freeze midstep or fall over.

Emotional and other symptoms

Other symptoms, according to NINDS, can include:

Depression. A person should discuss his or her feelings with a doctor. An individual may lose motivation and become dependent on family members. Medicines for depression can help.

Emotional changes. People with Parkinson's can also become insecure, afraid to travel or socialize, or angry or pessimistic.

Memory loss, slow thought. Some people have difficulty focusing their thoughts and have memory loss. Mental skills such as reasoning and social judgments may be affected.

Difficulty swallowing and chewing. In later stages of the disease, muscles used for chewing and swallowing work less efficiently. People may choke or drool. However, medications can help offset these problems.

Soft or monotone speech, slurring and talking too fast. Speech problems affect about 50% of people with Parkinson's. Speech therapy can help people overcome some of these problems.

Constipation or urinary problems. The loss of automatic movements that comes with Parkinson's can result in incontinence, constipation or difficulty urinating. A person should discuss any of these problems with a doctor.

Oily or dry skin. Improper function of the brain can lead to oily or very dry skin.

Sleeplessness. People with Parkinson's may experience nightmares, restless sleep, emotional dreams and daytime drowsiness. Researchers haven't determined whether these symptoms are related to the disease or to the medicines used to treat it. NINDS warns that people shouldn't take over-the-counter sleep aids without consulting a doctor.

Reviewed 10/18/2023

Sources

• National Institute of Neurological Disorders and Stroke. "Parkinson's Disease." https://www.ninds.nih.gov/health-information/disorders/parkinsons-disease.
• Parkinson's Foundation. "10 Early Signs." https://www.parkinson.org/understanding-parkinsons/10-early-signs.