What Are The Early Signs of Parkinson’s?

Learn the first symptoms and when to get treatment

An elderly man with Parkinson's disease has his hand held by doctor.

Learn the first symptoms and when to get treatment

Parkinson’s disease is a neurological disorder that affects about 1 million people in the United States. It primarily affects neurons in the brain that produce the neurotransmitter dopamine, a chemical messenger that sends signals from the brain to cells throughout the body.

Parkinson’s is a degenerative illness, meaning it starts with mild symptoms that become worse over time. The early signs of Parkinson’s are usually subtle, but ultimately the disease can cause debilitating symptoms that disrupt both physical and cognitive abilities.

The cause of Parkinson’s is unknown, but may be a combination of genetics, lifestyle and environmental factors. The risk increases with age, but between 2 and 10 percent of people who develop the disease are diagnosed before age 50.

Early symptoms of Parkinson’s

“Parkinson’s does not affect everyone the same way. Symptoms can vary from person to person, and the disease may progress at different rates,” says Melissa Houser, MD, a neurologist at Scripps Clinic Torrey Pines. “In fact, the first signs of Parkinson’s may be vague or associated with other conditions like respiratory infections, making it difficult to know if they are caused by the disease or something else.”

According to the Parkinson’s Foundation, the following can be early symptoms. If you or a loved one has more than one of them on a regular basis, it’s a good idea to make an appointment with the doctor. 


A slight trembling or shaking in your hand or fingers while you’re at rest is one of the most common early Parkinson’s signs.

 Loss of smell

If you can no longer smell certain foods as well as you used to, such as bananas or dill pickles, let your doctor know.

Handwriting changes

People with early Parkinson’s often have handwriting that becomes smaller and more crowded than usual. This is called micrographia. It’s normal for handwriting to change with age, but if it shrinks noticeably, get it checked.

Sleeping problems

Everyone has occasional restless nights, but be aware of changes in activity during deep sleep, such as making sudden movements or acting out dreams.

Voice changes

People with early Parkinson’s may be told they are speaking very softly or they sound hoarse. If there has been a change in your voice not due to a cold or sore throat, mention it to your doctor.

Facial masking

A change in your facial expression that causes you to look angry, serious or sad when you are not is called “facial masking” and can be an early indication of the disease.

Dizziness or fainting

Feeling dizzy, lightheaded or faint can be caused by low blood pressure, often associated with Parkinson’s.

Problems with movement or walking

Symptoms may include stiffness or rigidity in the arms or legs, coordination problems, changes in how you swing your arms when walking and other movement changes. Often, other people will notice these changes first.

“Remember, having any of these signs doesn’t necessarily mean you have Parkinson’s,” says Dr. Houser. “Temporary symptoms are usually nothing to worry about, but if they persist, talk about them with your doctor.”

Diagnosis and treatment

Your primary care physician will usually review your symptoms and perform a complete medical exam to identify potential causes. Brain imaging exams may be ordered in some cases. If your doctor believes you may have Parkinson’s, they may refer you to a neurologist. In addition, you may see a movement disorder specialist or physical therapist to evaluate your symptoms and help you learn to move more easily.

While there is not yet a cure for Parkinson’s, a combination of medication and therapy can help patients manage the illness and delay symptoms. For some patients, a surgical procedure called deep brain stimulation (DBS) can help control tremors when medication is not effective.

“Parkinson’s disease varies from person to person, so we develop personalized treatment plans to address each individual’s symptoms and lifestyle,” says Dr. Houser. “Many patients are able to successfully manage their symptoms and continue their usual activities.”

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