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Neurologist reveals why Parkinson’s symptoms are often mistaken for other conditions
Dr. Guy Schwartz, a neurologist with Stony Brook Medicine in New York, describes how symptoms can overlap across the two conditions
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Singer Carly Simon has revealed that her Parkinson’s disease was initially mistaken for arthritis, highlighting how the two conditions can share similar symptoms, particularly in the early stages
“My health issues began with arthritis in both knees and one hip. I had all three joints replaced, and at first, I thought the difficulty I was having walking was simply part of the long recovery process,” Simon said in a statement shared with multiple media outlets on July 27
“Eventually, there were periods when I could not walk without considerable help. My family and I knew that something more was going on. After an extensive evaluation at Mayo Clinic, I was diagnosed with Parkinson’s.”
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Arthritis is far more common than Parkinson’s disease, affecting nearly 60 million U.S. adults compared with about 1.1 million Americans living with Parkinson’s, according to the Centers for Disease Control and Prevention
Even so, about 90,000 Americans are diagnosed with Parkinson’s disease each year, making it a relatively common neurological disorder despite being far less prevalent than arthritis
Singer Carly Simon (pictured in 2019) has revealed that her Parkinson’s disease was initially mistaken for arthritis, highlighting how the two conditions can share similar symptoms, particularly in the early stages
Arthritis primarily affects the joints and connective tissues, causing pain, inflammation, stiffness and structural damage, per the CDC. The most common types are osteoarthritis (wear-and-tear of cartilage) and rheumatoid arthritis (an autoimmune disease)
Parkinson’s disease is a progressive neurological disorder that mainly affects the brain and nervous system, according to the National Institute on Aging (NIA). Dopamine-producing nerve cells in the brain gradually die or become impaired, affecting movement
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Although the conditions can share mobility problems, arthritis is typically driven by painful joint inflammation, while Parkinson’s primarily affects movement through changes in the brain a neurologist with Stony Brook Medicine in New York
Overlapping symptoms
“Parkinson’s disease can sometimes be misdiagnosed as arthritis, and vice versa,” Schwartz, who specializes in Parkinson’s disease, told Fox News Digital. “The one main symptom that they share is difficulty with walking — some kind of impediment, limitation or disability.”
Arthritis is far more common than Parkinson’s disease, affecting nearly 60 million U.S. adults compared with about 1.1 million Americans living with Parkinson’s, according to the Centers for Disease Control and Prevention.(iStock)
While arthritis and Parkinson’s are fundamentally different diseases, health experts say they can share the following symptoms that can make diagnosis difficult
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- Joint or limb stiffness
- Difficulty walking or changes in gait
- Reduced range of motion
- Slower movement or trouble initiating movement
- Balance problems or feeling unsteady
- Pain or aching
- Fatigue
- Difficulty performing everyday tasks due to reduced mobility
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The two conditions can also occur in the same person, Schwartz noted, since both become more common with age. “I’ve definitely been challenged by individuals who come to me with these symptoms,” he said. “Sometimes the examination is confounded by significant arthritis.”
The two conditions can be especially difficult to distinguish because both are largely diagnosed based on a patient’s symptoms and physical examination rather than one definitive test.(iStock)
While many people may connect Parkinson’s with tremors, early signs of the disease usually include stiffness, slowness and changes in gait.Â
In older adults who have been diagnosed with arthritis or have had joint replacements, those same symptoms can easily be attributed to joint disease or surgical recovery
Parkinson’s-specific symptoms
Some Parkinson’s symptoms are not typically seen in arthritis cases. People who experience the following signs should consult a neurologist, according to the Parkinson’s Foundation
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- Resting tremor (often starting on one side)
- Smaller handwriting (micrographia)
- Reduced arm swing while walking
- Soft or quieter voice
- Mask-like facial expression
- Slowed movement (bradykinesia)
- Loss of smell
- REM sleep behavior disorder (acting out dreams)
- Constipation that predates movement symptoms
“It’s not unusual for there to be misdiagnoses.”
While tremor is often considered a hallmark symptom, Schwartz cautioned that it isn’t always present. “About a third of individuals with Parkinson’s disease do not have a tremor,” he said. “That’s when the diagnosis becomes more challenging.”
“In Parkinson’s disease, dexterity becomes compromised because of slowness and stiffness,” the expert added. “In arthritis, it’s more of a mechanical issue, where the joints don’t allow full range of motion.”
How is Parkinson’s diagnosed?
The two conditions can be especially difficult to distinguish because both are largely diagnosed based on a patient’s symptoms and physical examination rather than one definitive test
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There is no single blood test or imaging scan that can definitively confirm Parkinson’s, as “very few things in medicine are 100%,” he said
However, newer diagnostic tools have emerged, including specialized imaging and skin biopsy testing. “We’re still learning,” the neurologist said, adding that a blood test may be on the horizon
While many people may connect Parkinson’s with tremors, early signs of the disease usually include stiffness, slowness and changes in gait.(iStock)
For now, diagnoses are made based on the following factors, per the National Institute of Neurological Disorders and Stroke (NINDS)
- A detailed medical history, including the type and timeline of symptoms
- A neurological exam that identifies telltale symptoms such as tremor, slowed movement, muscle stiffness, gait changes and balance problems
- A physical exam to assess movement, coordination, reflexes and other neurological functions
- The patient’s response to Parkinson’s medications
- Additional tests to eliminate other conditions
Schwartz emphasized that early diagnostic uncertainty is not uncommon. “It’s not unusual for there to be misdiagnoses,” he said. “Sometimes seeing a patient over time helps — eventually the disease declares itself, and then it’s easier to make the diagnosis.”
Anyone experiencing persistent walking difficulties, stiffness or other symptoms that don’t seem fully explained by arthritis should discuss them with a healthcare provider, who can determine whether a neurological evaluation is appropriate
