Pain syndrome in Parkinson’s disease: unresolved issues of classification, park-pain, and the “blind spot” in diagnosis

Pain is one of the most common non-motor symptoms of the Parkinson’s disease (PD), affecting up to 85% of patients at different stages of the disease. Despite its high prevalence, pain syndrome often remains in the “blind spot” of both diagnosticians and patients themselves, who have adapted to persistent discomfort. One of the reasons for the insufficient attention to pain in PD is the lack of a unified classification and, consequently, the absence of a diagnostic tool that would allow a systemtatic and objective assessing of all aspects of pain syndrome in PD patients. In this review, we present leading theories on the pathogenesis of pain syndrome in PD, evaluate their reflection in existing classifications, and analyze the practicality and effectiveness of scales and questionnaires used for pain assessment in PD. Particular attention is paid to key pain subtypes, including nociceptive, neuropathic, and nociplastic pain, and their significance in clinical practice. A fundamentally new aspect, not covered in earlier reviews, is the concept of “Park-pain” — a specific course of PD in which pain becomes the dominant non-motor symptom, accompanied by pronounced psycho-emotional disturbances. Our findings indicate current trends in the understanding of pain in PD patients to be not adequately reflected in existing classifications, highlighting the need for a new diagnostic paradigm that incorporates modern perspectives on the nature of pain and its impact on the quality of life.

Contributions:
Smirnova E.V. — research concept, manuscript writing;
Zhukova N.G. — manuscript writing, text editing.
All co-authors — approval of the final version of the manuscript, responsibility for the integrity of all parts of the manuscript.

Funding. The study had no sponsorship.

Conflict of interest. The authors declare no conflict of interest.

Received: June 27, 2025
Accepted: July 7, 2025
Published: October 31, 2025

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