Session Title: Virtual Poster Hall
Session Time: None. Available on demand.
Disclosures: Benjamin C. Miller, DO: No financial relationships or conflicts of interest
Case Description: This is a 72 year old man with a remote history of back pain 20 years prior who was referred to our clinic by a spine surgeon for new low back pain. His pain started insidiously over the previous 8-9 months. He underwent physical therapy initially with only mild relief of his pain and so was referred to physiatry for further management. He was treated with directed physical therapy, and later interlaminar epidural spinal injections that provided only temporary relief. On exam he was noted to have general rigidity especially in his low back and hamstrings, which only mildly improved with stretching. He had a slow gait with a shortened stride and minimal upper body movement.
Setting: Outpatient resident physiatry continuity clinic
Patient: A 72-year-old man with low back pain not improved with physical therapy Assessment/
Results: After failed physical therapy, pharmacologic treatment, and injections, he was referred to a movement disorders specialist who confirmed the diagnosis of Parkinson’s disease and began treatment with carbidopa/levodopa. Upon follow up with physiatry after initiation of treatment for Parkinson’s, his low back pain had completely resolved.
Discussion: While low back pain is well-known sequelae of Parkinson’s disease, there is a paucity of literature about it as a primary presenting symptom. In patients with low back pain refractory to usual treatment, the provider should take care to examine the patient for any other parkinsonian features. Additionally, while there is sparse reference in the literature, carbidopa/levodopa can be an effective treatment for low back pain in these cases.
Conclusion: Low back pain can be a presenting symptom, and successfully managed with treatment, of Parkinson’s disease.
Level of Evidence: Level V
To cite this abstract in AMA style:Miller BC, Murtaugh BT. Low Back Pain as a Presentation of Undiagnosed Parkinson’s Disease: A Case Report [abstract]. PM R. 2020; 12(S1)(suppl 1). https://pmrjabstracts.org/abstract/low-back-pain-as-a-presentation-of-undiagnosed-parkinsons-disease-a-case-report/. Accessed April 16, 2021.
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PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/low-back-pain-as-a-presentation-of-undiagnosed-parkinsons-disease-a-case-report/