Parkinson's Disease Explained

The main symptoms

Parkinson's has three classic movement symptoms. The first is tremor — a shaking that often starts in one hand and is most noticeable at rest. The second is slowness of movement (bradykinesia), which can make everyday tasks like doing up buttons, writing or walking harder and smaller in scale. The third is stiffness (rigidity) of the muscles, which can be uncomfortable. Not everyone has all three, and the tremor is not always present. There are also many non-movement symptoms that can appear, sometimes years before the shaking: a reduced sense of smell, constipation, disturbed sleep, low mood, and tiredness. Recognising this wider picture helps people and doctors understand the full impact of the condition.

What causes it

Parkinson's develops when nerve cells in a part of the brain called the substantia nigra are gradually lost. These cells produce dopamine, a chemical that helps send signals to control smooth, coordinated movement. As dopamine levels fall, the movement symptoms appear. Exactly why these cells are lost is not fully understood. Most cases are not directly passed down through families, although a small number are linked to specific genes, and having a close relative with Parkinson's slightly raises the risk. Age is the biggest risk factor, and it is more common in people over 60, though younger people can be affected too. Research continues into environmental and genetic factors, but for most people no single cause can be identified.

How it is diagnosed

There is no single test that confirms Parkinson's. Diagnosis is mainly clinical, meaning it is based on a careful history and examination by a specialist, usually a neurologist or a doctor who specialises in Parkinson's. UK guidance recommends that people with suspected Parkinson's are referred quickly and untreated to a specialist to confirm the diagnosis. The specialist looks for the typical pattern of symptoms and how they respond to treatment over time. Sometimes a brain scan is used to help rule out other conditions that can look similar, but scans do not diagnose Parkinson's on their own. Because several conditions can mimic Parkinson's, an expert assessment and review over time are important to get the diagnosis right.

Treatments that help

Treatment aims to control symptoms and keep people active and independent, as there is no cure yet. The main approach is medicine that boosts or mimics dopamine in the brain, which can greatly improve movement. Different medicines suit different people and stages, and a specialist tailors the plan, adjusting it as the condition changes. Over time, symptoms can fluctuate and treatment may need fine-tuning. Beyond medicine, physiotherapy helps with movement, balance and preventing falls; occupational therapy helps with daily tasks; and speech and language therapy helps with speech and swallowing. For some people with more advanced symptoms, specialist options such as deep brain stimulation may be considered. A Parkinson's specialist nurse is often a valuable point of contact for advice and support.

Living well with Parkinson's

Parkinson's is a marathon, not a sprint, and living well is very possible. Regular exercise is one of the most helpful things people can do; activities that challenge balance, strength and flexibility can improve movement and wellbeing. A healthy, high-fibre diet with plenty of fluids helps with common problems like constipation. Support for mood and sleep matters as much as movement, so it is worth mentioning these to the care team. Practical planning around the home, staying socially connected, and using local support groups all help. The charity Parkinson's UK offers information, a helpline and local networks. With good specialist care and support, many people manage the condition well and keep doing the things that matter to them.