Pain in Parkinson's disease is heterogeneous. When the presentation is nociceptive in character — and neuropathic pain has been ruled out as the predominant mechanism — a distinct, structured management pathway applies.
The patient has Parkinson's disease and presents with nociceptive pain. Neuropathic pain has been excluded. This specific combination calls for an evidence-based approach tailored to nociceptive mechanisms, separate from protocols used for neuropathic pain in Parkinson's disease.
Management in this setting involves optimising the underlying Parkinson's disease medication as a foundational step, combined with an analgesic strategy drawn from the first tier of a recognised, structured pain treatment framework.
The complete evidence-based regimen — including agent selection, sequencing, and escalation criteria — is available in the full protocol below.