Understanding the 10 Early Signs of Parkinson's Disease

Noticing subtle changes in your body or in a loved one can be concerning, and you’ve come to the right place to find clear, reliable information. This article provides a detailed look at the 10 most common early signs of Parkinson’s disease, as described by leading public health and medical organizations.

The 10 Most Common Early Warning Signs

Parkinson’s disease is a progressive disorder of the nervous system that primarily affects movement. Its symptoms often start gradually, sometimes with a barely noticeable tremor in just one hand. While tremors are a well-known sign, there are many other indicators. It’s important to remember that having one or more of these signs does not mean you have Parkinson’s, as they can be caused by other conditions. However, understanding them is the first step toward seeking a proper evaluation.

Here are the 10 early signs, based on information from sources like the Parkinson’s Foundation and the National Institute on Aging.

1. Tremor

A tremor, or shaking, is perhaps the most recognized sign of Parkinson’s disease. This shaking usually begins in a limb, often your hand or fingers. A key characteristic is a “pill-rolling tremor,” where your thumb and forefinger rub back and forth. A crucial distinction is that a Parkinson’s tremor typically occurs when your muscles are at rest. The shaking may decrease when you perform a task. This is different from other types of tremors, like an essential tremor, which often becomes more apparent during action.

2. Small Handwriting (Micrographia)

A sudden, significant change in your handwriting can be an early indicator. People may notice their handwriting has become much smaller than it used to be, a condition known as micrographia. You might also find that the words on the page are crowded together. This happens because Parkinson’s can affect the fine motor control needed for writing, making it difficult to perform the once-automatic movements with the same size and fluency.

3. Loss of Smell

Many people with Parkinson’s report experiencing a reduced or complete loss of their sense of smell, known as anosmia. You might find it difficult to smell certain foods like bananas, dill pickles, or licorice. Because a loss of smell can be caused by a cold, flu, or a stuffy nose, it is often overlooked. However, if the change persists after you’ve recovered from other illnesses, it could be a sign to discuss with your doctor.

4. Trouble Sleeping

While everyone has a bad night’s sleep now and then, the sleep problems associated with early Parkinson’s can be more dramatic. Specifically, a condition called REM sleep behavior disorder (RBD) is a strong risk factor. In RBD, a person acts out their dreams physically and sometimes violently by thrashing, kicking, or punching in their sleep. These movements are different from the occasional tossing and turning most people experience.

5. Stiffness and Slowed Movement

Parkinson’s disease can cause stiffness in your body, arms, or legs that doesn’t go away as you move. This can limit your range of motion and may be painful. You might notice that your arms don’t swing naturally when you walk, or you may feel like your feet are “stuck to the floor,” making it hard to take the first step. This overall slowing of movement, called bradykinesia, can make simple tasks time-consuming and difficult.

6. Constipation

The digestive system is often affected in Parkinson’s disease, as the condition can slow down the autonomic nervous system, which regulates gut function. Straining to have a bowel movement is a common and early non-motor symptom. While constipation can be caused by many factors, including a low-fiber diet or certain medications, chronic constipation that doesn’t resolve with typical remedies is worth noting.

7. A Soft or Low Voice

Your voice may change in the early stages of Parkinson’s. You might start speaking very softly, a condition known as hypophonia, without realizing it. Others may comment that you are mumbling or that your voice sounds hoarse or monotone, with less of its normal inflection. This happens because the disease can affect the muscles that control speech.

8. Masked Face

Facial expressions are controlled by small, complex muscles in the face. Parkinson’s can affect the control of these muscles, leading to a condition called hypomimia, or “masked face.” This can result in a serious, depressed, or angry look on your face, even when you are not feeling that way. You might blink less often or have a blank stare. It’s often family members or friends who notice this change first.

9. Dizziness or Fainting

Feeling dizzy or fainting can be a sign of orthostatic hypotension, which is a sharp drop in blood pressure when you stand up from a sitting or lying position. This condition is common in people with Parkinson’s and can be an early symptom. While many people feel a bit lightheaded upon standing up quickly, persistent dizziness, lightheadedness, or fainting should be evaluated by a doctor.

10. Stooping or Hunching Over

A change in posture is a very common sign. You or others may notice that you are stooping, hunching, or leaning when you stand. This postural instability is caused by the disease’s impact on the automatic reflexes that control balance and posture. This can also lead to problems with balance and an increased risk of falls as the disease progresses.

Frequently Asked Questions

What should I do if I notice one or more of these signs?If you are experiencing several of these symptoms, it is important to schedule an appointment with your doctor or a neurologist. They can perform a thorough examination and discuss your concerns. Early consultation is key. This article is for informational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment.

Is there a single test for Parkinson’s disease?No, there is no single blood test or scan that can definitively diagnose Parkinson’s disease. A diagnosis is typically made by a neurologist based on your medical history, a review of your signs and symptoms, and a neurological and physical examination.

Can these symptoms be caused by something else?Yes, absolutely. Many of these signs, such as constipation, loss of smell, or stiffness, can be caused by a wide range of other conditions or are a normal part of aging. This is why a comprehensive medical evaluation is so important to rule out other possibilities and get an accurate diagnosis.