Rigidity of movement

Stiffness related to degenerative brain conditions

Rigidity is an increased resistance to movement, causing muscles to feel stiff and tight. It is one of the core motor features of Parkinson’s disease and often causes morning stiffness, aching and reduced flexibility.

Key points

• Patients with Parkinson’s disease can experience resistance to passive movement of joints, known as rigidity. For example, when someone else moves your arm or leg, it may feel stiffer and harder to move than usual, even when trying to relax. The stiffness will often feel ‘ratchety’, like cogs turning (known as ‘cogwheeling’). It is one of the three core motor features of Parkinson’s disease, together with tremor and slowness of movement (bradykinesia).
• Rigidity commonly begins on one side of the body, before spreading over time. It can contribute to stooped posture, reduced arm swing and aches or pain in the neck, shoulders and back.
• Morning stiffness can involve feeling tight or ‘locked up’ on waking or after sitting for long periods. Patients taking medication for the treatment of their Parkinson’s symptoms may report this happens because the effect of the previous day’s medication has worn off overnight. Discussing the timing of your first morning dose with your neurologist can sometimes help reduce this early-morning stiffness.
• Rigidity generally improves with dopamine-based medication, though the degree of improvement varies between people.

Next steps:

• book a GP visit
• request an assessment for Parkinson’s disease.

Stiffness and rigidity are common, non-specific symptoms, and Parkinson’s disease is only one of many possible causes. Other contributors include:

• age-related joint and muscle conditions, such as osteoarthritis or a frozen shoulder
• atypical parkinsonian disorders
• drug-induced parkinsonism
• vascular parkinsonism
• general inactivity, poor sleep or muscular tension unrelated to a neurological condition.

The pattern of stiffness helps distinguish these possibilities, including whether it is:

• accompanied by other symptoms
• associated with tremor or slowness
• one-sided.

New or worsening stiffness should be properly assessed rather than assumed to be Parkinson’s disease.

When to consider specialist review

Speak with your neurologist or GP if your stiffness is:

• worsening (including if you already take Parkinson’s medications)
• significantly affecting daily activities or sleep
• accompanied by features such as:
  • marked one-sided clumsiness
  • early falls
  • eye movement changes that might suggest a condition other than typical Parkinson’s disease.

When to seek urgent help

Seek urgent medical attention if you experience:

• a fall with injury or loss of consciousness
• a sudden or rapidly worsening inability to move
• any new confusion accompanying worsening stiffness
• any new weakness (rather than stiffness) in a limb.

These symptoms may indicate an acute problem requiring prompt assessment rather than a routine review.