Clinically reviewed by What is parkinson
Parkinson's disease is a slow, progressive condition of the brain. Cells that make dopamine are lost, and dopamine is what lets the body produce movement at the right size and speed. So movements become smaller and slower without the person meaning them to.
In Urdu the shaking is called raasha, and families notice that first. But the tremor is not what takes away independence. The stiffness, the slowness and the small shuffling steps are.
It cannot be cured and it does get worse over years. What can be changed, a great deal, is how well the person moves at any given stage.
Symptoms you might have
- Shaking that is there when the hand rests in the lap, and settles when the hand is used
- Symptoms starting on one side and staying worse on that side for years
- Stiffness in the arm, leg or trunk, often mistaken for arthritis at first
- Small shuffling steps, little arm swing, and a stooped posture
- Freezing: the feet stick to the floor in doorways, at turns, and when starting to walk
- Handwriting getting smaller, voice getting quieter, difficulty turning over in bed
Why it happens
- In most people the cause is not known. It is not caused by worry or weakness
- Age is the main risk. Most cases begin after 60
- A family history, in a small number of cases
- Long term exposure to certain pesticides and industrial solvents
- Some medicines, including certain anti-vomiting and psychiatric medicines, cause a very similar picture. Only the prescribing doctor can review that
- Small strokes in the brain can produce slow, stiff walking that looks like Parkinson's and is managed differently
When you should see a physiotherapist
Start physiotherapy at diagnosis, not when walking has already become unsafe. People who begin exercise early keep their walking, balance and confidence for longer, and they fall less.
Come in also if freezing has started, if there have been near misses on turning, or if getting out of a chair has become a struggle. Dr. Zahra sees patients at home where travelling is difficult.
Go to a hospital the same day after a fall if the hip or leg cannot bear weight, or the leg looks shorter or turned outwards. Sudden confusion, a fever, or a sharp worsening over days is not normal Parkinson's progression and needs a doctor the same day, because an infection or a medicine problem is usually behind it.
Al-Shama Physiotherapy Clinic
Ask about an appointment
اپائنٹمنٹ کے بارے میں پوچھیںAppointment ke liye poochein
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یہ فارم پُر کریں؛ واٹس ایپ پر آپ کی تفصیلات کے ساتھ پیغام تیار ہو جائے گا۔Yeh form bharein, WhatsApp aap ki tafseel ke saath khul jaye ga.
How it is treated
Physiotherapy does not replace Parkinson's medication. Levodopa and the other drugs are the neurologist's part and they are not optional. Physiotherapy works on top of them, and exercise has the strongest evidence of anything outside medication.
- Big movement training, the core of the work. The brain under-sizes every movement, so we practise deliberately large steps, reaches and turns until normal size feels normal again
- Cueing for freezing: counting out loud, a marching beat, or stepping over a line on the floor. An outside rhythm replaces the one the brain has stopped supplying
- Balance and falls prevention training, including turning in a wide arc instead of pivoting on the spot
- Exercise therapy for strength and stamina, worked hard enough to raise the breathing rate
- Posture and stretching work for the chest, hips and spine, which stiffen into a stoop if left
- Bed mobility, chair transfers and walking aid selection, taught as a repeatable sequence
There is no surgery for Parkinson's itself. Brain stimulation surgery suits a small number of selected patients, and that is a neurologist's decision.
Exercises, and what to avoid
What helps
- Marching on the spot and then along a corridor, counting one two one two out loud, knees high
- Sit to stand from a firm chair, ten times twice a day, with a loud count and a deliberate push
- Large reaching: arms up high, out wide, then across the body, standing beside a counter
- Exercise when the medicine is working best, usually an hour or so after a dose
What to avoid
- Carrying a cup of tea while walking in the early weeks of retraining. Two tasks at once triggers freezing
- Turning sharply on the spot, especially in a doorway or beside the bed
- Deep soft sofas and low beds, which make standing up far harder than it needs to be
- Loose chappals and backless slippers. The toes catch and the shuffle gets worse
What you can do at home
Clear the doorways. Freezing happens at thresholds, so take up the loose rugs and leave nothing on the floor in the path to the bathroom.
Stick a strip of coloured tape across the floor where freezing happens. Having something to step over often releases the feet.
Teach the family one freezing routine and use the same one every time: stop, stand tall, rock the weight side to side twice, then one big step.
Raise the bed and the chairs to knee height and use chairs with arms. Keep a night light and a clear path to the toilet.
A warm shower or a hot pack before exercise loosens stiff muscles. Ice is not useful in Parkinson's.
How long it takes
Expect a difference in step length, confidence and chair rising within four to eight weeks of consistent work, three or more sessions a week.
The gains are real but not permanent. Stop for a couple of months and most of it goes. So the programme is written to be done at home for years, with a review block of treatment every three to six months or whenever the medication changes.
The disease progresses over years, usually slowly. Many people live a long time with it and stay independent for most of that time. What helps most is starting early and working at a real effort rather than going through the motions.
Urdu / Roman Urdu
Choose your reading script / اپنی پسند کا رسم الخط منتخب کریں
اردوUrdu script
پارکنسنز، جسے رعشہ بھی کہتے ہیں، دماغ کی بیماری ہے جو آہستہ آہستہ بڑھتی ہے۔ دوا نیورولوجسٹ دیتا ہے اور دوا ضروری ہے۔ فزیوتھراپی دوا کی جگہ نہیں لیتی، اس کے ساتھ چلتی ہے۔
اصل مسئلہ صرف ہاتھ کانپنا نہیں۔ اکڑن، سستی، چھوٹے قدم، اور دروازوں میں پیر جم جانا اصل مسئلہ ہے۔ علاج کا اصول یہ ہے: ہر حرکت جان بجھ کر بڑی کریں۔ بڑے قدم، اونچے گھٹنے، بلند آواز میں گنتی۔
اگر پیر جم جائے تو: رک جائیں، سیدھے کھڑے ہوں، وزن دو بار دائیں بائیں کریں، پھر ایک بڑا قدم لیں۔ گھومتے وقت چکر کاٹ کر گھومیں۔ ڈھیلی چپل نہ پہنیں اور بستر گھٹنے کی اونچائی پر رکھیں۔
Roman Urdu
Parkinson's, jise raasha bhi kehte hain, dimagh ki bimari hai jo aahista aahista barhti hai. Dawa neurologist deta hai aur dawa zaroori hai. Physiotherapy dawa ki jagah nahi leti, uske sath chalti hai.
Asal masla sirf haath kanpna nahi. Akarhan, susti, chhote qadam, aur darwazon mein pair jam jana asal masla hai. Ilaj ka usool ye hai: har harkat jaan bujh kar bari karen. Bare qadam, oonche ghutne, buland awaz mein ginti.
Agar pair jam jaye to: ruk jayen, seedhe khare hon, wazan do bar daen baen karen, phir ek bara qadam len. Ghumte waqt chakkar kaat kar ghumen. Dhili chappal na pehnen aur bistar ghutne ki oonchai par rakhen.
Treatment at the clinic, and online
INFORMATION → INDIVIDUAL CARE
A plan built around you.
Talk with Dr. Zahra Fatima, DPT. Understand your next steps, with guidance for your own symptoms and daily routine.
Talk it through
Discuss your symptoms, what you find difficult and what you want to get back to.
Understand your next steps
Use the consultation to discuss which care and exercises fit your situation.
Take your plan with you
Your online consultation includes a written plan you can refer to afterwards.
Questions people ask
Can physiotherapy cure Parkinson's disease?
Why do my feet stick in doorways?
What is the best exercise for Parkinson's?
Does exercise slow Parkinson's down?
Should my father use a walking stick?
Related conditions
- Osteoporosis and weak bones
- Bed sores, prevention and care
- Balance problems in older people
- Falls and fall prevention
- Difficulty walking