--- title: "Parkinson's disease: Symptoms & Treatment | HealthAnswers" description: "Parkinson" url: https://healthanswers.co.uk/conditions/parkinsons-disease/ robots: noindex --- # Parkinson's disease: Symptoms & Treatment | HealthAnswers Health A–Z Parkinson's disease — tremor, slowness, stiffness, diagnosis, and NHS treatment with levodopa and specialist support. Written by HealthAnswers editorial team Medically reviewed by [HealthAnswers UK doctor review panel](https://healthanswers.co.uk/our-doctors/) Reviewed 3 July 2026 ## Quick answer What is Parkinson's disease? Parkinson's disease is a progressive neurological condition caused by loss of dopamine-producing cells in the brain — causing tremor (often resting), slowness of movement (bradykinesia), muscle stiffness, and balance problems. Usually develops after age 60 but young-onset occurs. No cure but levodopa and other medicines control symptoms for years. Physiotherapy, speech therapy, and exercise help. See a GP if you notice persistent tremor, smaller handwriting, or difficulty starting movements. ## Who is this page for? This page is for people in the UK who want a plain-English overview of Parkinson's disease, including when to seek help and what NHS care usually involves. It explains general information, not what is wrong with you personally. ## Who should skip this page? Skip this page if you need a diagnosis, a prescription, or emergency care. It cannot replace a GP, pharmacist, NHS 111 or 999. If you are in immediate danger, call 999; for urgent advice that is not life-threatening, call 111 in England, Scotland or Wales, or use your GP out-of-hours service in Northern Ireland. On this page 7 sections ## Key facts about Parkinson's disease - Parkinson's affects about 145,000 people in the UK — second most common neurodegenerative disease after dementia. - Resting tremor, bradykinesia, and rigidity are cardinal features — diagnosis is clinical by specialist. - Levodopa with carbidopa remains most effective symptom treatment — motor fluctuations develop after years. - Non-motor symptoms — constipation, smell loss, depression, sleep behaviour disorder — often precede motor signs. - Exercise may slow progression — physiotherapy and staying active strongly recommended. ## Parkinson’s disease — dopamine deficiency movement disorder **Parkinson’s disease (PD)** is **progressive neurodegeneration** of **dopaminergic neurons** in **substantia nigra** — **motor circuit dysfunction** — **tremor, bradykinesia, rigidity, postural instability**. **~145,000 UK** — **incidence rising** with **ageing population**. **Average onset ~60** — **young-onset <50** — **10%** — **often genetic**. ## Cardinal motor features **TRAP:** - T remor — 4–6 Hz , resting , pill-rolling , asymmetric onset - R igidity — cogwheel - A kinesia/bradykinesia — slowness , reduced amplitude — most disabling - P ostural instability — later — falls **Gait:** **shuffling**, **festination**, **freezing** ## Non-motor symptoms (often earlier) - anosmia — loss of smell - constipation - REM sleep behaviour disorder — act out dreams - depression , anxiety - cognitive decline — PD dementia later - autonomic — orthostatic hypotension , urinary urgency ## Diagnosis **Clinical** — **neurologist** — **UK Parkinson’s Disease Society Brain Bank criteria** **DaTscan SPECT** — **if uncertain** — **not routine** **Exclude:** - drug-induced parkinsonism — antipsychotics , metoclopramide - vascular parkinsonism - essential tremor — action tremor , no bradykinesia - progressive supranuclear palsy , MSA — atypical parkinsonism — poor levodopa response ## Treatment ### Medicines **Levodopa + carbidopa** — **gold standard** — **best motor control** **Dopamine agonists** — **ropinirole, pramipexole** — **younger onset** — **delay levodopa** — **impulse control disorder risk** **MAO-B inhibitors** — **selegiline, rasagiline** — **mild early benefit** **COMT inhibitors** — **entacapone** — **wearing off** **Anticholinergics** — **rare now** — **tremor** — **cognitive side effects** ### Advanced **Apomorphine** — **rescue injection/infusion** **Duodopa** — **intestinal gel** **DBS** — **subthalamic nucleus/globus pallidus** — **motor fluctuations**, **dyskinesia** ### Non-drug **Physiotherapy**, **speech and language**, **occupational therapy** **Exercise** — **forced rate cycling**, **LSVT BIG/LOUD** ## Motor complications (chronic levodopa) - wearing off - on-off fluctuations - dyskinesias — involuntary movements **Specialist titration** — **fractionate doses**, **agonist**, **DBS** ## Prognosis **Progressive** — **individual rates vary** **Not Alzheimer’s** — **many independent years** **Advanced** — **dysphagia**, **falls**, **dementia** — **palliative input** **Persistent one-hand rest tremor + slowness** — **neurology** — **levodopa trial diagnostic and therapeutic**. ## ! When to see a GP about Parkinson's disease See a GP if persistent resting tremor, slowness, shuffling walk, reduced arm swing, masked facial expression, or micrographia (small handwriting). Referral to neurology or Parkinson's nurse specialist. Seek urgent help for sudden immobility, confusion with medication changes, or falls with injury. Parkinson's UK helpline supports patients and carers. ## Common questions about Parkinson's disease What are the early signs of Parkinson's disease? Tremor at rest — often one hand — slowness doing buttons or walking, reduced facial expression, softer voice, smaller handwriting, stiffness, shuffling gait, reduced arm swing when walking. Loss of smell and constipation can precede diagnosis by years. What causes Parkinson's disease? Loss of substantia nigra dopamine neurons and Lewy body protein deposits — cause multifactorial — age, genetics (minority familial), environmental factors debated. Not contagious. Parkinsonism from drugs (antipsychotics) or vascular causes — different management — exclude. Is there a cure for Parkinson's? No cure — medicines replace dopamine (levodopa) or mimic/stabilise it (dopamine agonists, MAO-B inhibitors). Deep brain stimulation for selected patients with motor fluctuations. Research into disease modification ongoing — exercise and multidisciplinary care improve quality of life. What is levodopa? Most effective Parkinson's drug — converted to dopamine in brain — combined with carbidopa to reduce peripheral side effects. Sinemet brand common. Motor complications — wearing off, dyskinesias — after 5–10 years — managed by specialist dose adjustment, agonists, or DBS. How long can you live with Parkinson's? Normal or near-normal lifespan — Parkinson's not directly fatal — complications — falls, aspiration pneumonia, frailty — contribute in advanced disease. Many live well 15–20 years after diagnosis with treatment and support. ## Sources - [NHS — Parkinson's disease](https://www.nhs.uk/conditions/parkinsons-disease/) - [NICE — Parkinson's disease](https://www.nice.org.uk/guidance/ng71) - [Parkinson's UK](https://www.parkinsons.org.uk/)