Small Handwriting and Other Early Symptoms of Parkinson’s

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.

1. Small handwriting

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.

2. Tremor

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.