Parkinson's treatment combines medication, exercise, and specific therapies, with device-based options for advanced disease. Exercise has better evidence for maintaining function than almost anything else and belongs at the centre rather than the margin. Physical, occupational and speech therapy each address different problems, and speech therapy in particular is often not offered until specifically requested.
Parkinson's treatment combines medication, exercise, and specific therapies, with device-based options for advanced disease. Exercise has better evidence for maintaining function than almost anything else and belongs at the centre rather than the margin. Physical, occupational and speech therapy each address different problems, and speech therapy in particular is often not offered until specifically requested.
This belongs first because it is consistently underemphasised. Regular vigorous exercise has stronger evidence for maintaining function in Parkinson's disease than most other available interventions, and intensity appears to matter rather than movement alone. Programmes emphasising large amplitude movement, treadmill training, boxing-style programmes, dance and tai chi all have support. Starting early is better than waiting for problems, so asking for a physical therapy referral at diagnosis is reasonable.
Levodopa with carbidopa is the most effective symptomatic treatment, with dopamine agonists, MAO-B inhibitors and COMT inhibitors used alone or alongside it depending on age, symptoms and side effect tolerance. Physical therapy addresses gait, balance and freezing. Occupational therapy addresses daily tasks and home safety. Speech therapy addresses voice volume, clarity and swallowing, and is frequently not offered until asked for, despite the difference it makes.
For advanced disease with troublesome fluctuation or dyskinesia, deep brain stimulation, focused ultrasound and infusion-based therapies are options, evaluated at specialised centres. This practice performs no surgery and operates no infusion suite, so those are arranged elsewhere while neurological care continues here. Separately, treating constipation, sleep disturbance, low mood and blood pressure drops often improves quality of life more than adjusting the movement medication does.
Clinical Neurology Specialists has been physician-owned since 1998, when Leo Germin, M.D., FAANEM founded it. Five board-certified neurologists and four advanced practice providers see patients at the Las Vegas and Henderson offices, each with its own AANEM-accredited electrodiagnostic laboratory.
Clinical Neurology Specialists is an adult outpatient neurology practice for patients 18 and older. The practice performs no surgery and operates no imaging suite, infusion suite or interventional pain programme, and provides no emergency or inpatient care.
Physician-reviewed. Reviewed by the physicians of Clinical Neurology Specialists — board-certified neurologists, AANEM-accredited electrodiagnostic laboratories, physician-owned since 1998. Reviewed 1 August 2026. This article is general education for adults 18 and older and is not a substitute for a consultation.
Sources and further reading: MedlinePlus: Parkinson's disease; National Institute of Neurological Disorders and Stroke; National Institute on Aging.
Adults 18 and older, at the Las Vegas and Henderson offices. Call 702-804-1212 or request an appointment online.