Around 13,000 people have a diagnosis of Parkinson’s in Scotland. And this number is growing.

Around 13,000 people in Scotland have a diagnosis of Parkinson’s- the fastest-growing neurological condition in the world.

But with more than 40 different symptoms, the condition is easily misunderstood. Parkinson’s develops when brain cells that produce dopamine, a neurotransmitter which plays a crucial role in motor control, stop working.

Dr Bal Athwal, a consultant neurologist at The Wellington Hospital (part of HCA Healthcare UK) said: “As a progressive condition, Parkinson’s can significantly impact quality of life and may reduce life expectancy, but with treatment, the likelihood of it impacting life expectancy can be reduced.”

But what are the tell-tale signs of Parkinson’s disease?

Ahead of World Parkinson’s Day on April 11, experts have shared ten early symptoms of the disease. Here’s the full list of early Parkinson’s signs to look out for.

1. Pain

A wide variety of pain can be an early symptom of Parkinson’s, and Athwal said: “Some patients develop pain, which often goes unexplained for some time before the diagnosis is made.”

Jennifer Taylor, helpline service manager at Parkinson’s UK, explains that such pain may include musculoskeletal pain affecting bones, muscles, ligaments, tendons or nerves, when pathways controlling sensation and pain in the brain, brainstem, and spinal cord aren’t working properly.

2. Anxiety

Anxiety can occur in the early stages of Parkinson’s. Taylor says: “Feelings of constant worry can lead to social avoidance and sometimes anxiety attacks.”

3. Trouble with balance

Postural instability, or difficulty balancing, can be a challenging movement symptom associated with Parkinson’s. “It can cause falls and people may lose their confidence as a result, with worries about going out in public,” says Taylor.

4. Stiffness

People with Parkinson’s often report tightness in their limbs, says Taylor, who explains this stiffness can occur on one or both sides of the body, contributing to a decreased range of motion.

5. Losing your sense of smell

A reduced sense of smell is often an early sign of Parkinson’s, and Taylor says you might lose your sense of smell several years, or even decades, before a Parkinson’s diagnosis.

6. Trouble sleeping and fatigue

Athwal says: “There can be problems with sleep such as insomnia, restless leg syndrome, and REM sleep behaviour disorder – a condition in which an individual seems to act out dreams by making movements or noises.”

Fatigue also affects up to half of people with Parkinson’s, and Taylor says: “You may feel quite energised one day and then too fatigued to do much the next, regardless of how much you rest.”

7. Tremor

Taylor says: “Tremor occurs mostly at rest, and it lessens during sleep or when the body part is actively in use. For example, your hand might tremble while sitting still, but this symptom can disappear when you shake hands with someone.”

Tremor usually starts asymmetrically and tends to occur in the hands, but can also appear in other parts of the body, including the lower lip, jaw or leg.

8. Depression

A person with Parkinson’s may experience depression at any time, even before diagnosis.

Taylor says: “Depression symptoms may come and go but can also intensify both the movement and cognitive symptoms of Parkinson’s.”

9. Smaller handwriting and slowness of movement

Micrographia – small, cramped handwriting – is often an early symptom of Parkinson’s, say the experts.

“Words can become crowded together while the size of your handwriting might get progressively smaller as you continue to write,” explains Taylor.

And Athwal adds: “There is also slowness of movement – this can be quite subtle at first, but people might complain of their handwriting becoming smaller, or might find it harder to do small fine tasks such as fastening buttons and zips.”

10. Diminished facial expressions

Facial masking, also called hypomimia, is an early Parkinson’s symptom that can make it hard for others to interpret your mood.

“People might assume you’re depressed or upset and it can be frustrating to constantly be asked what’s wrong when you’re feeling fine,” says Taylor.

“Stiff or slow facial muscles make it hard to smile, raise your eyebrows or otherwise express your feelings, an important part of how we communicate.”