Medically reviewed by Brenda B. Spriggs, M.D., MPH, FACP — Written by Yvette Brazier — Updated on July 15, 2025
Key takeaways
- Parkinson’s disease can start with subtle symptoms like sleep disturbances, loss of smell, slight tremor, small handwriting, difficulty moving, constipation, reduced facial expression, or a soft voice.
- The primary motor symptoms of Parkinson’s disease involve slow movement, tremor, muscle stiffness, and impaired balance, typically starting on one side of the body.
- Beyond motor skills, Parkinson’s can also cause changes to the autonomic nervous system, leading to issues like constipation, urinary problems, and blood pressure fluctuations, as well as affecting emotions, thinking, and senses.
The symptoms of Parkinson’s disease (PD) usually begin gradually, and they affect each person differently. The symptoms a person has will vary widely, regardless of how severe they are or how quickly they develop.
Read on to find out more about the different types of symptoms and how to recognize the early symptoms of PD.
The symptoms of PD affect individuals differently, but some can be an early sign of the disease.
These are:
- REM sleep disorder and other sleep problems
- the loss of the sense of smell
- tremor, especially in one hand
- a smaller size of handwriting
- difficulty moving or walking or a stooping gait
- constipation
- loss of facial expression, that may make the person look emotionless
- a low or soft voice
Primary motor symptoms
The four main signs and symptoms include:
- slow physical movements, known as bradykinesia
- shaking, or tremor
- muscle stiffness, or rigidity
- problems with balance and coordination, known as postural instability
Symptoms often start on one side first.
Slow physical movement
The person finds it hard to start moving. Starting to get up from a chair can become more difficult, for example. It takes longer than before to do physical tasks. A lack of coordination can cause the person to fall or drop things.
The difficulty is not only with carrying out the movement itself, but also with planning and starting it.
Many people may experience slower movements and attribute these to older age, but sometimes they are a sign of PD.
Tremor
Tremor is a familiar symptom of PD to many people. The shaking often starts in one hand.
It may start in one foot, or the person may begin rubbing their forefinger and thumb together, back-and-forth. Less commonly, it starts in the jaw or face. Many people do not have a severe tremor.
It is usually more likely to happen when the affected part of the body is resting. Stress or anxiety may make it more noticeable.
Other conditions that may lead to tremor include:
- multiple sclerosis
- encephalitis, an inflammation of the brain
- alcohol use disorder
The presence of tremor is not necessarily a sign of PD.
However, according to the Parkinson’s Disease Foundation, around 70 percent of people with PD experience a slight tremor at some time during the disease.
Rigidity
The muscles feel stiff, and this can make some everyday tasks troublesome, such as getting out of a chair, rolling over in bed, using body language appropriately, or making fine finger movements.
Stiffness is most common in the limbs and neck. Severe stiffness can reduce a person’s range of movements. Sometimes there is pain.
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