The clinical characteristics of lower back pain in Parkinson's Disease

ABSTRACT

BACKGROUND: Lower back pain (LBP) in Parkinson's disease (PD) is common but frequently overlooked, due to the tendencies of focusing on the management of the motor symptoms and signs by most neurologists. Uncontrolled LBP may impact on the activities of daily living of the PD patients. However, study on the LBP in PD has been rarely reported. METHODS: Sixty three PD patients with LBP were included, between October 2004 and April 2005. We investigated the clinical characteristics of LBP and response to the management prospectively. RESULTS: Eleven male and 52 female patients were included and the mean age was 64.4 years. On lumbar MRI and/or X-ray, degenerative spondylosis was detected in 22 patients, bulging discs in 30, and fractures in 9. Fourteen patients reported improvement of LBP after levodopa therapy. Young age at onset and abnormally flexed posture correlated with the responsiveness of LBP to levodopa therapy (p<0.05, respectively). These responders were more frequently experiencing motor fluctuation and dyskinesia than the non-responders (p<0.05, respectively). CONCLUSIONS: LBP in PD has diverse etiologies and clinical features. Some PD patients with LBP show response to levodopa therapy. We suggest that the prudent evaluation and proper management of LBP are important to achieve the better activities of daily living in PD patients.