I don't think that Dr. Michael Rezak (APDA Medical Director) will mind me posting his recent email to me. I had a question about the source of my pain (the site of the pain moves around, from my neck that has had 4 levels of cervical fusion, to my lower back where there are 5 "bulging" discs, to my shoulders. The pain has been labeled "Dystonia." And thank goodness not everyone gets it!

This was his answer to a question I had about dystonia and dyskinesia and when meds should be adjusted:

Painful dystonia is a form of dyskinesia. It can be either an ON “peak dose” phenomenon or an OFF phenomenon. If the dystonia occurs upon arising in the am or when a dose is wearing off then it suggests that it is an OFF phenomenon and meds should be adjusted upward. If it is a “peak dose” problem then meds should be decreased.

There are a few scattered case reports where a patient developed pain (without dystonia /dyskinesias) just from being on a dopaminergic. This is not well understood.


As Debi indicated. it is a form of the disease itself. Yet, it can also be a side effect of long-term L-dopa replacement therapy.

Peg