How does Parkinson’s disease progress?

Parkinson’s disease does not affect everyone the same way. Symptoms of the disorder and the rate of progression differ among people with the disease. Early symptoms of Parkinson’s disease are subtle and occur gradually. For example, affected people may feel mild tremors or have difficulty getting out of a chair. They may notice that they speak too softly or that their handwriting is slow and looks cramped or small. This very early period may last a long time before the more classic and obvious symptoms appear.

As the disease progresses, symptoms may begin to interfere with daily activities. The shaking or tremor may make it difficult to hold utensils steady or read a newspaper. Tremor is usually the symptom that causes people to seek medical help.

People with Parkinson’s often develop a so-called parkinsonian gait that includes a tendency to lean forward, small quick steps as if hurrying forward (called festination), and reduced swinging of the arms. They also may have trouble initiating or continuing movement, which is known as freezing.

Symptoms often begin on one side of the body, or even in one limb on one side of the body. As the disease progresses, it eventually affects both sides. However, the symptoms are often less severe on one side than on the other.