Low Back Pain Common in the Progression of Parkinson Disease
Of the total participants, 79.6% had arthritic changes, 38.8% were diagnosed scoliosis, and 24.1% had spondylolisthesis with instability observed.
Patients with Parkinson disease experience a higher risk for low back pain related to the disease progression symptoms, according to a study published in the European Spine Journal.
Researchers of this observational study analyzed 97 patients with Parkinson disease and 97 healthy controls. Researchers used self-reported questionnaires to collect data on pain intensity in lumbar spine, pain intensity down legs, and functional disability. They also used disease-specific information to collect data on Hœhn and Yahr stage, disease duration, and motor function. In addition, 54 patients with low back pain had X-rays performed to evaluate instability.
Results indicated significantly more cases of low back pain in patients with Parkinson disease when compared with healthy controls (87.6% vs 64.9%, respectively; P =.000), and the duration of pain lasted significantly longer (16.0 ± 13.2 years vs 11.8 ± 12.1 years, respectively; P =.025). Patients with Parkinson disease also experienced significantly more frequent and higher intensity lumbar region pain (both P =.000). Both patients with Parkinson disease and healthy controls were comparable between leg pain intensity, pain qualities, and Oswestry Low Back Pain Disability Questionnaire scores.
For the patients with Parkinson disease, there were no differences found between low back pain and disease-specific data, but those patients who had higher Oswestry Low Back Pain Disability Questionnaire scores had a higher Hœhn & Yahr stage (P =.002) and Unified Parkinson's disease rating scale part III score (P =.007). Patients who had hypokinetic symptoms had higher pain intensity in lumbar spine than those patients who had tremor symptoms (P =.021). Of the patients who underwent X-rays, 79.6% had arthritic changes, 24.1% had instabilities with spondylolisthesis, and 38.8% had scoliosis, which was associated with lateralization of parkinsonian symptoms (P =.011).
In conclusion, the progression of Parkinson disease can lead to degeneration of the lumbar spine, and this can lead to low back pain for 88% of this population. Researchers note that, “the knowledge about musculoskeletal conditions in [Parkinson] disease is important for an interdisciplinary conservative or operative treatment decision.”
Galazky I, Caspari C, Heinze HJ, Franke J. The prevalence of chronic low back pain and lumbar deformities in patients with Parkinson's disease: implications on spinal surgery. [published online September 8, 2018]. Eur Spine J. doi: 10.1007/s00586-018-5748-0