Movement Disorders Program
Rhode Island Hospital

Parkinson’s Disease Symptoms

We all experience movement problems at times: tremors, muscle spasms, or an occasional loss of balance. But unusual or persistent symptoms could be an indication of Parkinson’s disease, or another movement disorder. Movement disorders range from mild to severely debilitating, and many have very similar symptoms. It is vitally important to get a correct diagnosis.

Early Signs of Parkinson's

When it comes to the early signs of Parkinson’s disease, it can be hard to tell what’s normal and what’s not. Some early signs of Parkinson’s can also be very similar to the warning signs of other movement disorders. A single sign isn’t always a concern, but if you have more than one of these common signs, you should talk to your physician about the possibility of Parkinson’s disease.


Having difficulty moving your bowels without straining can be an early sign of Parkinson's disease.

Is it normal? A diet low in water or fiber can cause constipation. Some medications, especially pain medications, can also cause constipation. If there is no clear reason that would cause you to have constipation, you should speak with your doctor.

Change in voice

If a change in voice is so significant that your friends begin to notice, you should speak with your doctor. A voice becoming softer or more hoarse can be a sign of Parkinson’s.

Is it normal? Your voice can change due to things like a chest cold or other virus. However, if your voice doesn’t return to normal after your illness has passed, you should see your doctor.

Difficulty moving around

Stiffness in your arms or legs or not swinging your arms when you walk could be a sign of Parkinson’s. Stiffness or pain in your shoulder or hips can be an early sign as well.

Is it normal? Stiffness in certain body parts can be normal, but it should go away as you move. An injury to your arm or shoulder may cause stiffness until it is healed, and certain conditions like arthritis might cause difficulty moving around. But if there is no clear reason for the stiffness and if the symptoms are persistent, you should speak with your doctor.

Dizziness, fainting, or loss of balance

Feeling dizzy or unbalanced, such as when standing up, or fainting can be a sign of low blood pressure, which is linked to Parkinson’s.

Is it normal? Feeling dizzy from time to time can be normal, but if it occurs on a regular basis, you should bring it to your doctor’s attention.

Facial masking

Appearing to have a serious, angry, or depressed expression on your face, even when you are not in a bad mood, is called facial masking. If you have been told you frequently have this look, it may be an early sign of Parkinson’s disease.

Is it normal? Certain medications can cause a similar serious or staring expression, but this should stop after stopping the medication. If facial masking persists, you should speak with your doctor.

Loss of smell

Not smelling certain foods as well as you used to or having trouble smelling foods that have a particularly strong scent can be a sign of Parkinson’s.

Is it normal? Your sense of smell can be changed by illnesses, such as a cold, flu or stuffy nose, or even by certain medications. If your sense of smell hasn’t returned after an illness has passed or after stopping the medication, you should see your doctor.

Small handwriting

 If your handwriting has changed, such as letter sizes getting smaller or words becoming more crowded together, it may be a sign of Parkinson's disease called micrographia.

Is it normal? Handwriting can change as you get older, particularly if you have stiff hands or fingers or poor vision. However, if there is no obvious reason for a change in writing, you may want to speak with your doctor.

Stooping or hunching over

Stooping, leaning, or slouching when you stand and having difficulty standing up straight can be an early sign of Parkinson’s disease.

Is it normal? Some things like pain from an injury or illness may cause you to have trouble standing straight. Certain bone conditions can also make you hunch over. If there is no clear reason for slouching or leaning, bring it to your doctor’s attention.


A tremor or slight shaking in the hand, finger, or chin while at rest is a common early sign of Parkinson’s.

Is it normal? Tremors or shaking can also occur for normal reasons such as intensive exercise, stress, or injury. Shaking can also be a side effect of certain medications.

Trouble sleeping and muscle spasms

Thrashing around in bed, sudden movements, or muscle spasms while sleeping may be signs of Parkinson’s disease. 

Is it normal? It’s normal to have a night of tossing and turning and difficulty sleeping. Muscle spasms and sudden jerks of the body are also normal when first falling asleep or in lighter sleep. However, if these movements and trouble sleeping are persistent, you may want to see your doctor.

Parkinson's Disease Causes and Risk Factors

There is no clear cause of Parkinson’s disease. However, doctors believe it is likely a blend of genetics and environmental or other unknown factors.

Parkinson’s occurs with the loss of certain brain cells that produce a substance called dopamine. Dopamine is essential for smooth and coordinated muscle movement throughout the body, in addition to other functions. As we age, it’s normal for these cells to die and it usually happens at a very slow rate. However, for some people, the loss happens rapidly. When 50 to 60 percent of the cells are gone, the symptoms of Parkinson’s appear. 

There are some risk factors that may make Parkinson’s more likely:

  • Age - Parkinson’s mostly affects people 60 and older.
  • Family history - Individuals with a parent or sibling with Parkinson’s are more likely to also have it.
  • Gender - Men are more likely to develop Parkinson’s disease than women.
Woman in kitchen smiling

Treatment for Parkinson's

Treatment for Parkinson’s is based on each individual’s symptoms. Parkinson’s disease treatment ranges from medication to surgical intervention to lifestyle modification. 

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What is Life Like with Parkinson's Disease?

Life with Parkinson’s disease can be a challenge. However, by taking an active role in treatment, adhering to a medication schedule, and making healthy lifestyle choices, people with Parkinson’s can live their lives to the fullest.

If you have Parkinson’s, speak with your doctor about creating a plan to stay as healthy and active as possible. Some ways to do this may include:

  • Seeing a neurologist who can provide specialized treatment
  • Receiving rehabilitation therapy or speech therapy
  • Starting a regular exercise routine to maintain activity and delay worsening symptoms
  • Using assistive devices to make walking, eating, getting dressed, and writing easier
  • Meeting with a social worker to discuss how Parkinson's will affect your life
  • Making adaptations to the home to make daily life easier and safer
  • Talking with family and friends to get the support you need

Whichever stage of Parkinson’s disease you are in, our team is here to help you achieve and maintain your best possible quality of life. 

Learn more about the Norman Prince Neurosciences Institute (NPNI) at Lifespan