Parkinson’s disease is a gradually worsening condition that predominantly impacts the nervous system and changes a person’s movement. The most notable feature of Parkinson’s for most people is the shaking of the hands; however, the disease can start with more subtle and easy-to-miss changes.
Decreased sense of smell, decreased movement, disrupted sleep, constipation, and a softer speaking voice can happen before Parkinson’s begins to show major shaking. These can all be mistaken for normal aging, stress, or just being tired; however, being aware of the signs can help you catch them early.
Being aware of the signs of Parkinson’s early does not mean the person for sure has the disease; however, it can help avoid further damage as it does happen slowly, and if multiple signs are present and worsening, a doctor can provide early help and guidance.
What is Parkinson’s disease?
Parkinson’s will begin to develop when nerve cells in the brain begin to die or become damaged. The nerve cells that create and help with the movement of the neurotransmitter ‘dopamine’ are lost.
Once the levels of dopamine in a person are low, they can experience symptoms such as stiffness, shaking, and being slower to respond or complete tasks. Parkinson’s can also impact sleep, digestion, symptoms of depression, and control of the bladder and everyday tasks.
Most symptoms are slow to begin and can present differently for everyone.
The Early Signs of Parkinson’s Disease That Are Commonly Missed
1. A Small Shaking of the Hand While Resting
The first sign of Parkinson’s that is most likely to be noticed is a small shaking of either the fingers, hands, chin, or leg. Typically, the shaking will occur when the body part is at rest and not being used.
Occasional tremors after stress, exercise, or due to certain medications are often not a cause for concern. A persistent tremor should be evaluated by a doctor, especially if the tremor is on one side of the body.
2. Decrease in Size of Handwriting
Handwriting may become smaller or more difficult to read. This is called micrographia and may be an early sign of Parkinson’s disease.
This may occur gradually, with handwriting getting smaller toward the end of a sentence. A person may also feel an increased difficulty in the act of writing itself.
3. Decreased Sense of Smell
Decreased or loss of smell is an early sign of Parkinson’s disease that is often overlooked. A person may find difficulty in their ability to smell their favorite food, spices, flowers, and perfume.
While a cold or flu may cause a temporary loss of smell, a persistent, unexplained change in a person’s ability to smell may be a cause for concern.
4. Physical Actions of Dreams During Sleep
An early sign of Parkinson’s disease may be a person acting out their dreams during sleep. This sign is more often reported by a person’s family members than the person.
While occasional restless sleep is not a cause for concern, frequent sleep disturbances may also be a sign of Parkinson’s disease when combined with other symptoms.
5. Stiffness in the Arms, Legs or Shoulders
Shoulders, arms, hips, legs, and other body areas may feel stiff, tight, or uncomfortable. These sensations may simply be perceived as muscle strain, arthritis, or part of the normal aging process.
You may be noticing that your arms do not swing at your sides as they should while you walk, or there may be a noticeable delay in your ability to get out of a chair or turn in bed or complete other daily tasks, like getting dressed.
6. Slower Daily Movements
Parkinson’s disease, especially, is characterized by bradykinesia, or slowness of movement. Bradykinesia is the reason why everyday tasks like walking and buttoning a shirt may be perceived as harder to do because you are moving slower.
Also, when a person has Parkinson’s disease, the person’s gait, or the distance covered in each step, becomes shorter.
7. Constipation Without a Clear Reason
A person may become constipated for a number of different reasons. Some of those reasons may include taking a certain medication, not drinking enough fluids, or eating a poor diet. But long-term constipation with no clear reason may be a symptom of Parkinson’s disease.
There may also be digestive changes that can occur before any of the other, better known, more visible symptoms of Parkinson’s disease.
8. A Softer or Low Voice
A person’s voice may gradually become softer, quieter, breathy or less expressive. Family members may feel that the person is speaking too slowly or too quietly, even though the person does not notice the change.
If voice changes continue without a throat infection or another clear reason, it is worth discussing with a doctor.
9. Less Expressiveness
People with Parkinson’s disease can appear sad or serious. Sometimes it looks like they have no emotions. People may refer to this as a ‘masked face’.
Family members may see that people with Parkinson’s may not smile as much or have as many facial expressions when they speak to people.
10. Changes in Posture or Balance
People may start standing or walking in a slouched way. People may also appear to have a poor sense of balance when they begin to walk. While a lack of balance is usually a later symptom of Parkinson’s, small changes in posture may begin sooner.
People may also experience frequent dizziness that requires an evaluation, especially when combined with other symptoms.
Does Parkinson’s Disease Affect Urinary Health?
Parkinson’s disease can affect the bladder. Some common urinary symptoms can be:
Going to the bathroom frequently.
Having to go to the bathroom suddenly.
Waking up multiple times during the night to go to the bathroom.
Not being able to control going to the bathroom.
Not being able to fully empty the bladder.
These urinary symptoms may be related to other conditions such as a urinary infection, prostate issues, diabetes, kidney disease, and other illnesses. A urologist can assess bladder symptoms and provide the appropriate treatment.
Some patients may need an evaluation at a nephrology hospital, especially when there are kidney concerns, frequent infections, and other renal assessments. Nephrologists in Kerala can help patients with kidney disease and help them with issues that are separate from neurological concerns.
However, symptoms that are suggested to be Parkinson’s should be evaluated mainly by a neurologist.
When Should You See a Doctor?
Having one isolated symptom does not mean that you have Parkinson’s disease. Stiffness, a soft voice, and even constipation can happen for other reasons as well.
You should seek medical advice when:
There is more than one early sign
Symptoms worsen or develop gradually over time
Tremors occur at rest
There are changes to walking, writing, or speaking
Sleep movements are more common
There are frequent urinary concerns that disrupt daily activities or sleep
A doctor can evaluate your symptoms, provide a history, and refer you to a specialist when necessary.
Why Early Evaluation Matters
There may not be a guaranteed permanent cure for Parkinson’s, but there is significant value in supporting early treatment as there is control for managing symptoms. This can support individuals to maintain mobility and even improve their functional independence.
This assistance is essential as Parkinson’s is one of many medical conditions that have an overlapping of symptoms. With therapy support, and the right treatment, many individuals can continue to engage in meaningful activities.
Conclusion
The beginning stages of Parkinson’s does not mean you will have to wait to see the onset of tremors. Reduced sense of smell, softer voiced speech, more weakness, lack of control of movements, changes to sleep, constipation, and frequent issues of a urinary nature can all be warning signs.
These changes are not reasons for panic, but they should be evaluated when they are persistent or when they appear together. A medical consultation can provide answers and support to the right care.
For possible Parkinsonism symptoms, see a neurologist. For toilet issues, a urologist may help. For kidney issues, see nephrologists or a nephrology hospital in Kerala.
