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Medication-Free Ways to Treat Parkinson’s Disease

US News & World Report - Health logo US News & World Report - Health 1/11/2019 Heidi Godman
Senior Asian woman (60s) practicing Tai Chi.: People with Parkinson's disease may practice tai chi to help reduce body stiffness and improve balance. © (Getty Images) People with Parkinson's disease may practice tai chi to help reduce body stiffness and improve balance.

People with Parkinson’s disease, the incurable neurodegenerative disorder that affects movement, have few options for medical treatment. Prescription medications can help manage symptoms, and an implantable device (a deep brain stimulator) can help control tremors – the hallmark of the condition. But many Parkinson’s patients don’t know about additional complementary or alternative treatments that can make a difference.

“Parkinson’s disease is a whole-body disease. You can’t just treat it with one modality. Medicines work well but they don’t address all of the other problems we see,” explains Dr. Dean Sutherland, a neurologist and Parkinson’s disease specialist in Sarasota, Florida.

What Is Parkinson’s?

Parkinson’s disease occurs when dopamine-producing cells in the brain stem die off. It’s unclear what causes the condition. Sutherland says some cases (fewer than 10 percent) may be genetic. The majority of cases are believed to be triggered by environmental exposure, like contact with chemicals, including pesticides, herbicides or fungicides.

What is clear is that without dopamine – a neurotransmitter or brain chemical needed to initiate movement throughout the body – symptoms of Parkinson’s start to show up.

Parkinson’s disease motor symptoms (affecting movement) include:

  • Involuntary tremors that occur at rest.
  • Stiffness throughout the body.
  • Slowed movement (bradykinesia).
  • Stooped posture.
  • Problems with walking and balance.
  • Lack of facial expression (often referred to as the “mask of Parkinson’s”).
  • Muscle freezing that suddenly causes a patient to feel glued to the floor.

Nonmotor Parkinson’s symptoms include:

  • Gastrointestinal problems such as slowed stomach emptying, constipation or both.
  • Mood disorders such as depression or anxiety.
  • Cognitive impairment.
  • Sleep disorders that may involve thrashing movements.
  • Orthostatic hypotension, a drop in blood pressure when standing.
  • Problems swallowing.
  • Loss of voice volume.
  • Drooling.
  • Unexplained pain.
  • Loss of smell.
  • Changes in urinary function (increases in frequency and urgency).

Exercise Is Medicine

In addition to medication, exercise is considered crucial to help manage symptoms of Parkinson’s disease. “Exercise releases dopamine into the same parts of the brain that are stimulated by taking medication. That helps with motor issues like stiffness, tremors and muscle freezing,” Sutherland explains.

Since dopamine is also important for helping to regulate mood, exercise is effective for mild to moderate depression. Some evidence even suggests that three weekly sessions of vigorous exercise can help slow or delay the progression of Parkinson’s disease.

“But we have lots of studies that show any form of exercise helps reduce symptoms to some degree,” Sutherland says.

For example, tai chi and yoga have been found to help reduce body stiffness and improve balance and well-being. And special boxing classes tailored to people with Parkinson’s have been shown to improve gait, endurance, balance and quality of life.

Forced Exercise

Increasing evidence suggests that riding a stationary bicycle at a high speed can help manage many Parkinson’s symptoms. Jay Alberts, a Parkinson’s researcher and vice chair of innovations at Cleveland Clinic's Neurological Institute, has found that Parkinson’s patients who can pedal at a speed of 80 revolutions per minute or more, in three 40-minute sessions per week, can improve brain connections, boost dexterity, reduce or eliminate tremors, improve walking speed and heighten their sense of smell.

Many Parkinson’s patients are unable to pedal at a high speed, so Alberts has patients hop onto stationary tandems (a bicycle built for two), with another rider who keeps the RPMs at a high rate. It’s known as “forced exercise.”

“Symptoms are reduced for about eight weeks after [patients] stop exercising. This won’t cure them, but we are slowing the progression of the disease,” Alberts says.

Don’t buy a motorized stationary bicycle to attempt forced exercise on your own, however. There are only direct-drive motorized cycles currently on the market, and Alberts says using such equipment may provide an aerobic workout but won't replicate the results of his research.

"A direct drive has no mechanism to process feedback. It is either on or off. We know from our studies and other studies that there has to be an active contribution from the patient. If there’s no active movement from the patient, it will not result in any changes in cortical activity. You can’t just let your legs get jiggled around rapidly. In our approach, the motor is providing a helping hand," Alberts says.

However, there are cycling classes at YMCAs throughout the country designed to help people with Parkinson’s disease reach 80 RPMs. The program is called Pedaling for Parkinson’s, and Alberts helped create it in 2008.

Other Pill-Free Parkinson's Treatments

Exercise is just one component of adjunct Parkinson’s treatment. Others include:

  • Massage therapy. “Therapeutic massage has been shown to help with stiffness and pain in Parkinson’s,” Sutherland says. “Massage releases neurotransmitters in the brain.”
  • Acupuncture. “In some people, acupuncture appears to help reduce tremors, stiff muscles and pain,” Sutherland says.
  • Singing. “We know from anecdotal reports that singing helps improve voice volume and even social interactions. When you have better voice volume, you’re more likely to go out with friends and spend time with people,” Sutherland notes. There are also speech therapy programs that help improve voice volume.
  • Physical therapy. This can help improve flexibility, balance and gait. Some programs are designed specifically for people with Parkinson’s to learn to take bigger steps to reduce common walking problems such as shuffling.
  • Occupational therapy. Therapists can help you improve your ability to perform the activities of daily living, such as dressing or brushing your teeth. You may learn to use adaptive tools, such as a gadget to pull up a zipper or button a shirt.
  • Swallowing therapy. Speech therapists can help you improve swallowing ability, or at least help you learn to live with swallowing challenges caused by Parkinson’s disease.
  • Aqua therapy. Taking a physical therapy class in a pool helps relieve the worry about falling and enables a person with Parkinson’s disease to move more freely than he or she would out of the water.

Where to Find Help for Parkinson’s

Your primary care doctor or neurologist may be able to refer you to programs that help treat Parkinson’s disease, especially physical, speech or occupational therapy.

You can also check with national nonprofit groups that support Parkinson’s patients, such as the Parkinson’s Foundation or the American Parkinson’s Disease Association, or turn to nonprofits in your area. Examples of local nonprofit Parkinson’s groups include PD Active in Berkeley, California, and the Hope Parkinson Program in Fort Myers, Florida. All of these groups can connect you to resources that provide classes or therapy designed for people with Parkinson’s.

You may also find Parkinson’s-related exercise classes at your local gym or YMCA. But keep in mind that before participating, you should get a green light from your doctor. It’s also important to seek out classes that are tailor-made for people with Parkinson’s disease, since the disease affects ability and balance.

Another point: You’ll probably need to practice an adjunct therapy on a regular basis. “We would never prescribe medication just once a week and then stop. Exercise [like medicine] is something you have to integrate into your life,” Alberts says.

And the biggest mistake may be doing nothing at all and relying only on medication.

“I clearly see a difference in people who are proactive about exercise and alternative therapies versus people who are sedentary,” Sutherland says. “Being sedentary with Parkinson’s is like poison. It contributes to disability down the road.”

Related Video: Parkinson's Patient Finds Healing, Strength Through Boxing (Provided by KETV Omaha)

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