Pain is a very frequent symptom with influence on the quality of life in Parkinson's disease (PD), but is still underdiagnosed and commonly treated only unsystematically. Pain etiology and pain character are often complex and multi-causal, and data regarding treatment recommendations are limited. Pain can be primarily related to PD but frequently it is associated with secondary diseases, such as arthrosis of the spine or joints. However, even basically PD-unrelated pain often is amplified by motor- or non-motor PD symptoms, such as akinesia or depression. Beyond an optimization of anti-parkinsonian treatment, additional pain treatment strategies are usually needed to properly address pain in PD. A careful pain history and diagnostic work-up is essential to rate the underlying pain pathophysiology and to develop a targeted therapeutic concept. This review gives an overview on how pain is treated in PD patients and how patients assess the effectiveness of these therapies; here, the manuscript focuses on pathophysiology-driven suggestions for a multimodal pain management in clinical practice.

中文翻译：

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帕金森病疼痛的管理。

疼痛是一种非常常见的症​​状，会影响帕金森病 (PD) 的生活质量，但仍然未被充分诊断并且通常只是不系统地进行治疗。疼痛病因和疼痛特征通常是复杂的和多原因的，关于治疗建议的数据是有限的。疼痛可能主要与 PD 有关，但通常与继发性疾病有关，例如脊柱或关节的关节病。然而，即使基本上与 PD 无关的疼痛也经常被运动或非运动 PD 症状放大，例如运动不能或抑郁。除了优化抗帕金森病治疗外，通常还需要额外的疼痛治疗策略来正确解决 PD 中的疼痛问题。仔细的疼痛病史和诊断检查对于评估潜在的疼痛病理生理学和制定有针对性的治疗概念至关重要。本综述概述了如何治疗 PD 患者的疼痛以及患者如何评估这些疗法的有效性；在这里，手稿的重点是病理生理学驱动的临床实践中多模式疼痛管理的建议。