The classic three motor symptoms of Parkinson’s - tremor, slowed movement and muscle stiffness - are well known. However, less well-known, but increasingly recognized, non-motor symptoms include sleep disturbance, constipation and a reduced sense of smell. The good news is that there are many less serious reasons for these. Read on for some other possibilities.
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Other possible causes of tremor: Essential tremor (ET). Usually affects hands, head, legs, body or voice and is worse when you move unlike a Parkinson’s tremor which is worse at rest. Small quantities of alcohol usually steady ET whereas they have no effect on a Parkinson’s tremor. ET also often runs in families. Finally ET does not improve in response to levodopa the main medication used to treat PD. Alcohol, some medications and other diseases affecting the nervous system can also cause tremor.
Symptom: Slowness of movement (bradykinesia)
Other possible causes of slow movements: Normal slowing down of reflexes due to changes in nerve fibres as we get older mean that messages to move are slower to reach the muscles.
Sarcopenia – loss of muscle mass and power as we age – can also make it harder to move fast as can certain medications such as certain sleeping pills.
Prevent muscle loss
Symptom: Muscle stiffness (rigidity)
Other possible causes of muscle stiffness: Being inactive or overweight, sleeping in a poor position can all cause muscles to be stiff or less flexible as can DOMS – delayed onset muscle soreness – caused by unaccustomed activities such as running, walking, weights, cycling or swimming. In this case the stiffness usually eases over a few days.
Symptom: Sleep problems
Other possible causes of sleep problems: Idiopathic Rapid Eye Behaviour Disorder (iRBD) which causes sufferers to act out dreams now increasingly recognised as a potential early sign of PD and other neurodegenerative disorders can be also caused by withdrawal from alcohol or sleeping tablets and/or antidepressants. In 55 per cent of cases, it has no known cause.
Insomnia and waking in the night can be caused by indigestion, anxiety, respiratory problems, lack of exercise, pain from arthritis or sleep apnoea, which causes brief interruptions in breathing.
Symptom: Reduced sense of smell (hyposmia)
Other possible causes of reduced sense of smell: Common culprits include allergies, such as hay fever and allergic rhinitis most usually triggered by a reaction to house dust mites, growths in the nose (nasal polyps), viral infections such as flu and head injury. Other neurological diseases such as Alzheimer’s disease and other types of dementia can less often be another possible cause.
Learn more about treatments for loss of smell
Other possible causes of constipation: The most usual causes are a poor diet, with not enough fibre-rich vegetables, fruit, pulses and wholegrains, dehydration and lack of exercise. Constipation can also be a result of poor bowel habits, for example holding on when you need to ‘go’, certain prescription drugs, prolonged bed rest, and overuse of laxatives.
See the doctor if… you have any or all of the above symptoms. They may be able to reassure you that your symptoms are caused by something other than Parkinson’s or refer you to a specialist to rule out Parkinson’s or other more serious disease.