Friday, 6th November 2020
Just like putting miles on a car adds wear and tear, daily life puts stress on our bodies that can add up over the years. While this stress can take its toll on any part of the body, problems in the lower (lumbar) back and spine are particularly common with age. And, because Parkinson’s disease (PD) movement, walking and posture symptoms can put extra stress on the back and spine, these issues may be more common in people with PD.
Back Problems Are Common in People with and without Parkinson’s
The back is made up of varied structures that protect the spinal cord and nerves, which send signals from the brain to the body to move, feel and respond. When different parts of the back are affected, certain problems may occur. These issues are common in many people, both with and without PD:
Some Back Problems Are More Specific to Parkinson’s
There are certain back-related problems that are more common in people with advancing PD or similar movement disorders. Forward bending, called camptocormia, typically occurs while standing, sitting and walking and resolves when lying down. Leaning to one side, called pleurothotonus or Pisa Syndrome, is less affected by position. Both conditions can cause back pain and walking and balance problems as well as increased risk of falls and social isolation. Exactly why these conditions happen is not known, but problems in muscles or brain circuits responsible for movement may contribute. Treatment may include Parkinson’s medication and/or muscle relaxants; botulinum toxin injections; physical therapy or, in rare cases, deep brain stimulation surgery.
Evaluation Involves Exam and Imaging
To determine the cause of back symptoms, doctors perform a neurological examination and often also spine imaging, such as a CT or MRI scan. A myelogram, which involves injecting a dye into the spinal canal, also may be necessary in some cases.
Treatment Depends on the Cause
Once you and your doctor find the cause, you can create a personalized treatment plan. This may include medication or injections to treat pain and physical therapy or exercise to strengthen muscles or improve posture. It also may involve behavioural changes such as gradually increasing activity if you are sedentary, losing weight if necessary, avoiding heavy lifting or quitting tobacco use, which can limit blood and oxygen flow to the back. (These are also steps you can take to prevent back problems.) In some cases, your doctor may recommend surgery. For questions to consider and tips on preparing for a procedure, read our blog on surgery and Parkinson’s.
Article Source: The Michael J. Fox Foundation for Parkinson’s Research