A study of the effect of musculoskeletal pain on patients with idiopathic Parkinson’s disease

Introduction 
Aims: To explore the ‘lived experience’ of musculoskeletal pain in patients with idiopathic Parkinson’s disease. 
Background: Research has shown the prevalence of musculoskeletal pain in idiopathic Parkinson’s disease is high. However, the actual detailed experience of it has not been studied. 
Methods 
Design: Cross-sectional mixed methodology study of people with idiopathic Parkinson’s disease and musculoskeletal pain. Qualitative semi-structured interviews were used with interpretive phenomenology methodology. Patients also completed questionnaires on pain, Parkinson’s and anxiety & depression. 
Setting: Participants were recruited from acute and community NHS Trusts in the East of England.
Participants: Purposive sample of 15 people with idiopathic Parkinson’s disease & musculoskeletal pain. Patients with dementia were excluded. 
Procedure: Two hour home interview and questionnaire session. The interviews were semi-structured around 8 questions. The researcher used her insider clinical experience to guide the interview and talk through the questionnaires. 
Main outcome measures: Thematic analysis was used with the interview data. Pain scores included Visual Analogue Scale. Parkinson’s scores included Parkinson’s Disease Questionnaire-39. Anxiety and depression score was Hospital Anxiety & Depression Score. 
Results 
Nine themes were developed from the interviews: musculoskeletal pain, other symptoms, activities affected, well-being, sleep, carers, expense, healthcare professionals involved, and management.
Discussion 
Impact of the two conditions (Parkinson’s and pain) varied from mild to severe. All participants were affected in some way in terms of their ability to do activities. This could challenge their well-being.
Conclusions 
Patients should be reassured of the benefits and low risk of step 1 analgesics. Pacing, comfort, and sleep hygiene contributed to self-management. Best coping was enabled by both acceptance of their condition and advanced management techniques. Patient’s unique experience of pain and their personal expertise in its management should be respected by professionals.