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Sinemet and Fatigue (more!) Thanks Brian, your advice seems to cover the point. I know about referred pain, which occurs in locations oddly removed from the one that is stressed. I think in my case though it is merely spasm caused by any kind of nervous tension. I recall now that for years before presenting with PD I used to get this upper back pain on long driving trips. As a side issue, I also know about trapped nerves, I have one that causes permanent numbness on one side of one thigh. Oddly, I can sense touch in that area normally but not temperature. Ice cube or coffee cup, it's all the same. All this chat about muscles, pain, and fatigue raises some interesting questions, that perhaps the MDs can answer; the medical texts I've glanced at don't have much to say: 1. Why exactly do "tired" muscles hurt? What's happening chemically to cause the pain and how does it work? 2. Why is troublesome fatigue (which I prefer to view as lack of physical endurance) mentioned so often by PWP and so seldom by any of the literature on PD? 3. Why is Sinemet, which supposedly works only in the CNS, so quick to abate this muscle fatigue (assuming it's not spasm from dyskinesia)? Cheers, Joe J. R. Bruman (818) 789-3694 3527 Cody Road Sherman Oaks CA 91403 On Sat, 22 Mar 1997, Brian Collins wrote: > On Sat 22 Mar, J.R. Bruman wrote: > > Sinemet And Fatigue (more) 21 Mar 97: > > Thanks for your advice, Brian, but you overlook two things I > > mentioned: > > (1) The intense pain is in the 'upper' thoracic region, i.e., > > center of back just below shoulder blades, and not the lumbar > > region, which one might expect to be affected by lifting,, posture, > > or shovel work. It appears during mental activity as well, even > > when leaning back in a comfortable chair. > > (2) The pain disappears promptly on lying supine (so it is clearly > > of muscular origin) but just as promptly after taking a Sinemet, > > even without lying dosn. In fact I can just continue working. > > > > As you know, dopamine occurs widely in the body, and not all the > > levodopa of Sinemet reaches the brain, since the carbidopa isn't > > 100% effective in preventing its conversion to dopamine. I wonder > > if there might be some connection in PD, between DA produced in the > > SN and DA produced outside the brain, elsewhere in the body. > > Cheers, > > Joe > > > > > > > > > > J. R. Bruman (818) 789-3694 > > 3527 Cody Road > > Sherman Oaks CA 91403 > > > > > Hello Joe, You are right; your symptoms are not consistent with back > pain due to bending over too much. As you describe it above, my > second guess would be that it is more likely to be pain induced by a > trapped nerve than real muscular strain. If the muscles really were > strained, I would have thought that a dull ache would be about as good > as you could achieve by lying down. > I know about trapped nerves, because I suffer from it myself. In > my case, the pressure occurs due to some collapsed pads between the > upper vertebrae in my neck, but the pain is in my upper arm. Pain > induced by this means really is switchable. The collapsed pads are > caused in my case by the constant pressure caused by the loss of > muscle tone due to Parkinsons. It is either that, or the extreme > stress caused by dyskinesias due to excess sinemet. It has been > brought under control by taking one of the anti-inflammatory drugs > used for treating arthritis called Naprosyn (in the UK). The Sinemet > comes into the act because of its beneficial effect in relieving any > muscular spasm which may be occurring, giving 'Instant Cure' for > the pain. > Now all it needs is for someone who knows more than I do to advise > if pain in the area indicated by Joe can be caused, like my shoulder/ > arm pain, by a trapped nerve. A physiotherapist perhaps?, or better > yet a chiropractor? > Regards > -- > Brian Collins <[log in to unmask]> >