We see varied cases at our Clinic, some within our boundaries, and some not. A lady came in hoping we could provide an alternative treatment for her Parkinson’s, since medication is all she has been on since being diagnosed six years ago. The disease came on as a trigger from another ailment. A critical element in dealing with any ailment or disease is being proactive, mixed with having the right spirit. In her case, she was also bothered by a few other issues.

The big question is – What is Parkinson’s Disease? Many people would say, I know, “is where older people hands start to shake plenty!” While one of the terms used to describe the disease is “Shaking Palsy”, there’s a lot to learn regarding the genesis of the disease. For example, the symptoms one should look for; understanding the role that genetics can play; and, appreciating the fact that like most diseases, younger persons can be affected too. Michael J. Fox, a successful Hollywood star was diagnosed at 30.

Parkinson’s Defined

Parkinson’s disease, or PD as it is sometimes referred to, is a progressive, neurological condition. It is predominantly characterised by problems with body movements, known as ‘motor symptoms’ – the most identifiable, perhaps, being tremor. Other difficulties that are not related to movement can also occur, such as pain, sleep disturbance and depression – known as ‘non-motor symptoms’.  About 10-20%  of persons with Parkinson’s are diagnosed before age 50; only half of these people are diagnosed before age 40, with slightly more men than women affected. This is called Juvenile Parkinson’s, the category into which Michael J. Fox fell.

Causes

Our movements are controlled by nerve cells in the brain. To prompt a movement, the cells pass messages to one another – and to the rest of the body – using neurotransmitters. In healthy people, these messages are carried efficiently. But, in people with Parkinson’s, the messages are disrupted and are not transmitted smoothly to the muscles. This is when difficulties controlling movement arise.

Symptoms

They may be mild at first. For instance, you may have a mild tremor or a slight feeling that one leg or foot is stiff and dragging. Symptoms may affect one or both sides of the body, and could include:

• Slow blinking
• Constipation
• Difficulty swallowing
• Drooling
• Problems with balance and walking
• No expression in the face (like you’re wearing a mask)
• Muscle aches and pains
• Movement problems, which include:
  • Difficulty starting movement, such as standing to walk, or getting out of a chair
  • Slow movements
  • Loss of small or fine hand movements; writing may become small and difficult to read; eating becomes difficult
• Rigid or stiff muscles, often beginning in the legs
• Shaking, called tremors
  • Usually occurs in the limbs at rest, or when the arm or leg is held out
  • Goes away when you move
  • Eventually may be seen in the head, lips, tongue, and feet
  • May be worse when tired, excited, or stressed
  • Finger-thumb rubbing (pill-rolling tremor) may be present
• Slowed, quieter speech and monotone voice
• Stooped position
• Low blood pressure when getting up, sweating, drooling, lack of body temperature control. These problems are due to something called autonomic dysfunction.

Other symptoms may include:

• Anxiety, stress, and tension
• Confusion
• Dementia
• Depression
• Fainting
• Hallucinations
• Memory loss

What foot problems can people with Parkinson’s experience?

• There are a number of general foot problems such as corns, bunions and plantar warts (fish eyes) to name a few. People with Parkinson’s are faced with further difficulties arising mainly from rigidity, muscular contractions and altered gait pattern. Rigidity and/or contraction, particularly in the area of the calf muscles, can reduce a person’s ability to flex their ankles, affecting the body’s ability to absorb the shock of ground contact. This in turn can lead to pressure problems such as excess callus on the soles of the feet.
• Loss of balance, poor posture, as well as gait problems are among the most commonly recognised features of Parkinson’s. In general, the stride length shortens, and the amount of time both feet remain in contact with the ground increases. A ‘normal’ walking action is to strike the ground firstly with the heel, and then finally push off with the toes – commonly described as a ‘heel-to-toe’ gait.
• Because of the rigidity within the ankle, the person with Parkinson’s can often begin to lose this normal heel-to-toe type of gait, and a more shuffling action can begin to predominate.
• This more flat-footed type of gait can produce foot, leg and even knee pain, and can significantly reduce the foot’s ability to adequately absorb the shock of ground contact. In the long term, this type of flat-footed stance can seriously impact an individual’s mobility.
• In contrast, some people with Parkinson’s will complain of ‘walking on their toes’. This is a common problem, and it is usually associated with the accompanying rigidity of the disease. The rigidity can affect the ankle joint and, in particular, its ability to bend the foot up. Due to this rigidity, the foot can then assume a downward-pointing position, resulting in the feeling that the person is ‘toe-walking’.

Look out next week for a continuation on the categories of Parkinson’s, foot care options, general treatment options, and other associated ailments like edema (swelling), and exercise.

Your feet mirror your general health . . . cherish them!