May 29, 2026
I realized how tiring it is to be reminded that people see you differently now
Written by Crystal Onyema | May 27, 2026
As you probably know by now if you’ve been reading my column, my late uncle Brandon liked to stay on the move.
His career involved hands-on work, building things from the ground up, and figuring out problems on his own. That hardworking mentality wasn’t just part of his job. It was part of his personality. He liked feeling capable, useful, and active. Sitting still for too long just wasn’t him.
So when his Parkinson’s disease began to progress, one of the hardest adjustments for him wasn’t just the physical changes. It was when he realized that people were starting to treat him differently. And one of those people was me.
It wasn’t out of cruelty. I loved my uncle and wanted to protect him. But as his tremors and movement devolved, I started being extra careful around him. I spoke more gently, rushed to help before he could finish things himself, and sometimes watched him too closely instead of just being there with him.
One evening, we were standing outside talking when I noticed his tremors acting up more than usual. Without really thinking about it, in a soft tone, I immediately asked him if he was OK and whether he needed help.
His response caught me off guard. He snapped and told me he was cold and didn’t want people treating him like he was fragile. For a moment, the mood shifted completely. And honestly, I understood why.
May 28, 2026
Medically reviewed by Susan W. Lee, DO — Written by Erica Hersh — Updated on July 17, 2025
A pill rolling tremor is an early symptom of Parkinson’s disease. You will want to consult a doctor, because early diagnosis and treatment can help control your Parkinson’s symptoms and reduce complications.
If you have a pill rolling tremor, it looks like you are trying to roll a pill or another small object between your thumb and index finger. It’s a resting tremor, meaning that it is most likely to happen when your body is relaxed rather than when you’re using your hands.
A pill rolling tremor is one of the most common tremors associated with Parkinson’s disease. It’s usually one of the earliest symptoms.
What causes it?
Tremors are caused by problems in the parts of the brain that control movement, including the cerebellum and basal ganglia.
Some types of tremors can be inherited, Others are caused by factors such as:
- neurological disorders, such as multiple sclerosis (MS) and stroke
- excessive caffeine consumption
- an overactive thyroid
- liver or kidney failure
- anxiety, stress, and fatigue
Tremors in general are one of the major symptoms of Parkinson’s disease, occurring in approximately 75% of all cases.
In Parkinson’s disease, nerve cells in a part of the brain called the basal ganglia degenerate and produce less of a neurotransmitter called dopamine. The basal ganglia use dopamine to form connections and communicate between neurons. When there’s less dopamine, there aren’t proper connections and communication.
The basal ganglia are responsible for making sure your body movements are smooth. When there aren’t as many connections in this area of the brain, they can’t do their job as well, leading to tremors and the other movement symptoms of Parkinson’s disease.
The conditions that can cause pill rolling tremors are all serious conditions, so if you have developed a pill rolling tremor, it’s important to see your doctor as soon as possible.
May 27, 2026
Medically reviewed by Heidi Moawad, M.D. — Written by Jill Seladi-Schulman, Ph.D. on February 6, 2023
Parkinson’s disease is a neurological condition that can affect several areas of the brain. The area it affects the most is known as the substantia nigra, which is involved with movement. Nerve activity in other areas of the brain can also be affected, contributing to motor and nonmotor symptoms.
Parkinson’s disease (PD) is a neurological condition that can cause problems with movement, coordination, and balance. It’s estimated to affect almost 1 million people in the United States.
PD affects the nervous system. In this article, we’ll look at the ways it impacts the nervous system, what treatments can help, and the general outlook for PD.
In Parkinson’s disease, nerve cells in the brain become damaged and start to die. What exactly causes PD is still unknown. Generally speaking, it’s believed to develop due to a complex combination of genetic and environmental factors.
Indeed, some people with PD show genetic changes that are known to be associated with the condition. However, most people with PD don’t have these genetic changes.
People with PD do have accumulations of abnormal proteins called Lewy bodies in certain nerve cells. The formation or presence of Lewy bodies appears to contribute to PD, likely by disrupting certain processes within these cells, resulting in cell death.
Parkinson’s disease can have a variety of effects on the nervous system. This contributes to the types of symptoms associated with PD.
Motor symptoms
PD can affect several areas of the brain. The area that’s most significantly affected is called the substantia nigra, which is involved in movement.
The nerve cells in this area make a neurotransmitter called dopamine. Neurotransmitters are chemical messengers that allow nerve cells to communicate with each other.
Dopamine is important for controlling certain aspects of movement. It’s also involved in many other functions like attention, memory, and mood, just to name a few.
In PD, as the nerve cells that make dopamine die, less dopamine is produced. This leads to the characteristic motor symptoms that are associated with PD, such as:
- tremors
- slow movement, known as bradykinesia
- rigid muscles
- trouble with coordination and balance, which affects gait and increases the risk of falls
In late-stage PD, the corpus callosum and corticospinal tracts of the brain are sometimes involved. It’s thought that this is due to the chronic changes in motor activity that PD causes. Changes in these areas of the brain can also contribute to motor symptoms.
May 26, 2026
Medically reviewed by Heidi Moawad, M.D. — Written by Erica Roth — Updated on April, 6, 2026
Key takeaways
- Subtle changes in motor skills, such as handwriting becoming smaller (micrographia), can be an early indication of Parkinson’s disease. This happens because of changes in the brain affecting movement control.
- Early symptoms of Parkinson’s can include sleep disturbances, such as insomnia and restless leg syndrome, which can make it difficult to fall and stay asleep.
- Besides obvious tremors, Parkinson’s disease can cause rigidity, slow movement, voice changes, a rigid facial expression, and changes in posture.
Parkinson’s disease (PD) is a neurological movement disorder that affects approximately 500,000 people in the United States.
Some early symptoms include:
- cramped handwriting or other writing changes
- tremor, especially in the finger, hand, or foot
- uncontrollable movements during sleep
- slow movement (bradykinesia)
- voice changes
- rigid facial expression or masking
- stooped posture
PD starts with the brain cells, called neurons, which control movement. The neurons affected by Parkinson’s disease produce a substance called dopamine. PD sets in when specific neurons die and dopamine levels in the brain decrease. Experts think the lack of dopamine causes symptoms that affect how you move.
Early signs of Parkinson’s disease can be easy to miss, especially if they occur sporadically. It may be time for you or a loved one to see a doctor if you notice recurring symptoms.
A change in the size of your handwriting may be an early indicator of Parkinson’s disease. People with PD have a hard time controlling movement because of the changes in the brain. This can affect many different motor skills, including writing.
“Micrographia” is the medical term for small handwriting. People with Parkinson’s disease often have handwriting that looks cramped. Individual letters tend to be smaller than typical, and words are spaced closely.
A person with PD may be able to write in the size they intend for a short time, but as they relax, the writing usually becomes smaller after a few minutes.
Tremor is perhaps the most recognizable sign of Parkinson’s disease. A slight shaking of a finger, hand, or foot is common.
The person experiencing the tremor is likely to be the only one who notices it in the early stages of PD. However, the shaking will worsen and become noticeable to others as the condition progresses. The tremor is usually most noticeable at rest.
May 25, 2026
Medically reviewed by Heidi Moawad, M.D. — Written by Jill Seladi-Schulman, Ph.D. on August 31, 2023
Dystonia causes involuntary muscle contractions that lead to unintended movements and changes in posture. It’s estimated to affect over one-third of people with Parkinson’s disease.
Parkinson’s disease (PD) is a neurogenerative disorder that affects movement. People with PD have symptoms like tremors, muscle rigidity, and slow movements.
If you have PD, you may also experience dystonia. This is a condition that leads to involuntary muscle contractions that can cause changes in posture and movement.
Keep reading to learn more about PD-related dystonia. We’ll cover how dystonia is associated with PD, ways to manage it, and more.
Dystonia is a condition that causes unintended, sometimes painful, muscle contractions. Dystonia can affect one or many different muscle groups in your body.
Dystonic movements are irregular and can last for a few seconds or minutes. They may occur once in a while or very often. They usually happen more frequently as PD progresses.
The effects of dystonia lead to unusual movements and shifts in posture. For example, dystonia affecting your toes can cause them to curl involuntarily, making walking difficult or painful.
Dystonia can sometimes occur on its own due to genetics or unknown causes. But, it may result from another condition or factor, including:
- other neurological conditions like Parkinson’s disease and Wilson’s disease
- birth injury, such as a lack of oxygen to the brain
- head injuries
- stroke
- brain tumors
- infections
- drug reactions
- exposure to environmental toxins
Recent Comments