Are you alright there Ray? It’s just the pain It’s taking my breath at the moment so I can’t breathe properly The pain I’ve got is where the coccyx is Bend your knees Does that make it better? Both knees Yes it does It’s quite surprising to me that a lot of people with Parkinson’s don’t actually know that pain is a symptom That’s absolutely right I think a lot of people don’t report pain unless you ask them It’s kind of an afterthought It’s not one of the core symptoms of Parkinson’s Quite a lot of older people have got Parkinson’s Not you There’s a more stoicism about a certain generation that just doesn’t volunteer pain How would you describe your pain Ray? I would say that I’m constantly affected by my lower back We’ve seen you in the past unable to move at all You came in and I don’t even think you could lie down on the bed he was in such pain There’s five different reasons why people get pain or five different types of pain but one of them is stiffness from the Parkinson’s the rigidity and if we start by getting muscles moving more they’re more likely to relax more and then the pain the stiffness and the lack of movement is more negated So for Ray lying down completely straight is difficult It’s quite painful That’s nice, this is nice How do you sleep in bed? I don’t sleep in bed What do you mean you don’t sleep in bed? I found with Parkinson’s it got more difficult in bed to turn You sort of stick It took me an hour and five minutes to get from one side of the bed to the other an hour and five minutes! Do you sleep in a chair every night? Yea And I don’t think that’s helping I think I’m bringing some of my own pain on I’m afraid I think I would agree When it’s really been bad for a sustained period it wears on you you just feel totally down In Parkinson’s the lack of dopamine actually affects your perception of pain So you can have a heightened perception of pain that you wouldn’t have had before Not everybody but some people do It’s quite difficult because your body has changed in how much pain you can bare Some people say they’ve got high threshold Some people it’s lower but again that might alter with a diagnosis Is it important for people to acknowledge what they’re experiencing ? Yes and to talk to the Parkinson’s nurse, the doctor the physiotherapist Somebody about it You can be in denial In this position the best thing that you could also do is bring your knees a little bit closer and just start letting them gently rock from side to side Very gently This is a good exercise because it helps get you a bit more rotation in your trunk Now Ray is lying with his legs straight That’s amazing You are obviously physically in a different position there Ray but in terms of pain There isn’t any That’s amazing That’s crazy And that’s why people need advice Yea because how would you know how to do this? Are there things that people can do to prevent? Well exercise! This is the thing that I would recommend Exercise is absolutely one of the best things that people can do Well, the best thing that they can do Well done Does that feel easier? Ooh you stood up better then as well A lot better, straight off See now I’m totally loose Just being able to do that Is there pain anywhere? Nowhere This is actually crazy to me because I’m not used to seeing this A couple of minutes of simple exercise Yes, that’s the difference that exercise makes! That’s where the job satisfaction is immense Is just seeing seeing somebody’s life made easier Maybe Ray will go to bed tonight Will you go to bed tonight Ray? You’ll have to have a chat with my wife

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