Cogwheeling is a type of rigidity seen in people with Parkinson’s disease. It’s often an early symptom of Parkinson’s, and it may be used to make a diagnosis.

Cogwheeling, also known as cogwheel rigidity or cogwheeling, can affect any limb, but it’s most common in the arms. It can affect one or both arms.

With any type of muscle rigidity, your muscle might feel “tight.” You might not be able to move the muscle fully. This can be painful and uncomfortable. You might also experience tremors in the same muscle when it’s at rest.

Rigidity of any kind can be an early symptom of Parkinson’s disease. Thus, it can help doctors diagnose Parkinson’s disease.

To test you for cogwheel rigidity, your doctor will have you relax the muscles in your limb. They’ll then flex and extend your limb. They’re looking to see if:

  • your muscle is stiff and inflexible when they try to move it
  • your limb moves with small, “jerky” motions (ratcheting motions)

Ratcheting motions are the hallmark of cogwheel rigidity. For you, this might feel like a click or catch in your muscle as you move your arm.

Another hallmark of cogwheel rigidity is that the jerky movements happen even when the doctor moves your limb slowly.

This distinguishes it from spasticity, which is most often seen in conditions of brain injury, such as stroke or MS, or injuries affecting the spinal cord.

The basal ganglia are parts of the brain that help control your body movements and keep them smooth. To do this, the neurons in the basal ganglia use dopamine to connect and communicate with one another.

People with Parkinson’s disease have less dopamine, a type of neurotransmitter (a chemical in the brain). When there’s less dopamine, the cells in the basal ganglia can’t connect or communicate as well. This means they can’t keep your motions as smooth as they would otherwise be, which causes rigidity and the other body movement issues common to Parkinson’s disease, like tremors.

Other causes of cogwheeling

Cogwheeling can be present in other conditions besides Parkinson’s disease. These include:

These conditions have similar symptoms but different causes. However, cogwheel rigidity is most common in Parkinson’s disease.

You can help treat cogwheel rigidity by treating the underlying condition causing it. The most common and effective treatment for Parkinson’s disease is levodopa (L-DOPA). It can help all symptoms, not just cogwheel rigidity.

It’s often combined with carbidopa, which can help lessen side effects, allow a greater amount of levodopa to reach the brain, and thereby reduce the amount of L-DOPA needed.

Other medications that treat Parkinson’s disease include:

  • dopamine agonists
  • enzyme inhibitors (e.g., MAO-B inhibitors, COMT inhibitors)
  • amantadine
  • anticholinergic drugs

If no other medication has worked, some people with advanced Parkinson’s disease are candidates for deep brain stimulation. In this procedure, electrodes are positioned in the basal ganglia, where they send small electrical signals into the brain. This can help lessen cogwheel rigidity.

There are also things you can do at home to help manage your cogwheel rigidity. These include:

  • Bouncing a ball — like dribbling a basketball — to keep your arms moving
  • Exercising can help improve functionality and motor skills. Aerobic exercise that involves large movements (like certain types of dancing) is best for reducing rigidity. Just be sure not to push yourself beyond your physical limitations.
  • Stretching, to keep your muscles flexible
  • Practicing tai chi or yoga
  • Eating a healthy diet
  • Reducing stress. While stress doesn’t cause Parkinson’s disease, it may make your symptoms worse.

When you do any type of exercise, make sure you cool down properly. This helps keep your muscles from getting stiff again.

If you have Parkinson’s disease, you should speak with your primary care provider before starting a new exercise routine. They may refer you to a physical therapist who can help you find the best exercise and stretching routine for you.

Parkinson’s disease isn’t curable at the current time, but the symptoms can be treated with medication and lifestyle changes like exercise and stress reduction.

Early diagnosis is particularly important for effective treatment. Cogwheel rigidity is often an early sign of Parkinson’s disease, so talk to a doctor if you have this symptom. This will help ensure you get a proper diagnosis and treatment.