Freezing in Advanced Parkinson’s: Causes, Triggers, and Treatments
Neurological DisordersParkinson's Disease

Freezing in Advanced Parkinson’s Disease: Why It Happens and How You Can Get Moving Again

Freezing in Advanced Parkinson’s Disease: Why It Happens and How You Can Get Moving Again
Everyday Health
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Published on March 5, 2026
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Freezing of gait (FOG), a frustrating and sometimes dangerous symptom of Parkinson’s disease, can feel like your feet are suddenly stuck to the floor, which stops you from walking forward. Up to 80 percent of people with advanced Parkinson’s experience FOG, which can also affect arm and hand movements, changing positions, and even how you talk and think.

FOG is “one of the most stubborn symptoms in Parkinson's,” says James Liao, MD, a neurologist at Cleveland Clinic Neurological Institute in Ohio. Freezing episodes happen without warning, which can increase your risk of falling and cause anxiety about walking.

You can freeze during “off times” — when your medications don’t work as well — but you can also experience it during “on times,” which is when your medications are optimized.

 Below, learn how you can manage freezing episodes and stay safe with advanced Parkinson’s disease.

How Freezing Looks and Feels

Freezing episodes come on suddenly and can feel frightening.

 FOG can leave you stuck standing or trembling in place, says Dr. Liao. “A freeze can be very brief — less than a second — but it can also last up to more than 30 seconds.”
If you watch a freezing episode, you may see the person moving their feet in place without going forward. Sometimes momentum pushes their upper body ahead, even though their feet can’t move, which can cause a fall.

Richie Rothenberg, a Michael J. Fox Foundation patient council member, was diagnosed with early-onset Parkinson's in 2004 at age 37, and he now experiences FOG often. “Suddenly my entire body rebels, and I can’t move forward or back or really in any direction,” says Rothenberg. “I can’t even take a step.”

Although Rothenberg has experienced freezing hundreds of times, each episode makes his mind and body panic. “They literally stop me in my tracks,” he says.

For many like Rothenberg, freezing episodes can feel annoying or embarrassing, but FOG can also cause injuries and affect how well you get around.

 Even loved ones can sometimes cause a fall by urging you forward when you stop.

Why Freezing Happens in Parkinson’s Disease

When you walk, your brain sends a complex group of signals that help organize your movements, but experts think that these signals may get blocked in Parkinson’s.

 Some triggers can prompt this brain messaging mix-up and spark a freezing episode.

FOG triggers vary but can include these situations:

  • Delaying or skipping Parkinson’s medication
  • Crossing over a change in flooring
  • Walking through doorways
  • Navigating narrow spaces
  • Feeling anxious or rushed
  • Stepping up or down
  • Taking a first step
  • Multitasking
  • Turning
One large study review found that turning was the most common trigger for freezing episodes, followed by walking through a doorway and trying to multitask.

 But triggers can look different from person to person.

For example, Rothenberg notices more freezes when he feels tired or stressed, and when he hasn’t eaten well or exercised that day. “Most often these sudden freezes happen when I’m walking through a doorway, or getting on or off an elevator,” says Rothenberg, who then falls to his knees or tries to grab something for balance.

Treatment for Freezing

To treat freezing episodes, your healthcare provider will want to know how often they happen and their timing related to your medication schedule. For example, they may ask, “How close to your next dose do you typically freeze?”

Once they have a clear picture of your FOG symptoms, they can recommend treatment options.

Medications and Dosing

“Medication adjustments are often the first step, since freezing can be linked to low dopamine levels or medications wearing off,” says Ejaz Shamim, MD, a neurologist at Kaiser Permanente in Maryland. Your provider may first suggest increasing your dosage of medications that boost dopamine production, like carbidopa-levodopa (Sinemet).

But sometimes, even when you get the right dose, freezing can continue.

 Beyond adjusting dopamine-stimulating medication, it’s worth trying other medications, like amantadine (Symmetrel), droxidopa (Northera), or stimulants like atomoxetine (Strattera), says Liao.
Apomorphine (Kynmobi), a fast-acting medication that helps your body use dopamine, can quickly relieve freezing and is available as a small injection or a dissolving film under the tongue, says Dr. Shamim. But it comes with side effects like mouth dryness and irritation, which may limit how much you can use it.

Deep Brain Stimulation

Researchers have studied using deep brain stimulation (DBS) for FOG with promising results, says Liao. An FDA-approved treatment for Parkinson’s, DBS manages electric brain messages through a device surgically placed in the brain.

Treatments Under Research

Ongoing studies are testing new ways of preventing freezing in Parkinson’s, like brain training and wearable technology.

 “Many of these techniques are still in the research phase but will roll out to the general Parkinson's patient population soon,” says Liao.

How Physical and Occupational Therapists Can Help

Physical and occupational therapists can help you prevent freezing episodes and lower your risk of falling when you have them.

Physical Therapy

Specialized targeted physical therapy (PT) can strengthen pathways for your brain to send messages that help you walk, says Liao.

Physical therapists can also help you identify your freezing triggers so you can avoid them, says Leslie Cloud, MD, a neurologist at the Parkinson’s and Movement Disorders Clinic at VCU Health in Richmond, Virginia.

PT for FOG may include cueing techniques to train your brain to respond to rhythmic sounds or visual lines, which can break the freeze and get you moving again. Cueing may include these elements:

  • Metronomes Listen to the beat and try to take a step.
  • Laser Pointers Focus on the red dot and step toward it.
  • Arm Movement Raise an arm over your head or point.
  • Change Your Trajectory Step to the side or back first.
  • Count After three counts, take a step.
  • Shift Your Weight Lean from side to side, then step.
  • March Lift your feet in place before stepping forward.
  • Stick on the Floor Place a cane or walking stick on the ground and step over it.
If you need extra support while walking, your physical therapist can help you learn to use a walker with automatic brakes that can stop falls.

Occupational Therapy

“Occupational therapists help people stay independent by recommending adaptive tools and making home safety changes to reduce fall risk,” says Shamim. Your occupational therapist may recommend these changes:

  • Adding more light in room transitions at home
  • Removing throw rugs, which can cause tripping and trigger a freeze
  • Applying bright tape to give you a target in danger zones like the bathroom
  • Placing a swivel seat cushion in your car for easier transitions
They can also help you adjust your daily routines to prevent the need for multitasking and avoid stress.

Self-Management for Freezing

Besides the tips you learn from physical and occupational therapists, you can try other strategies to move past a freezing episode. “If I can remember to pause, stand up straight, look ahead and take a big step, I can usually ride it out,” says Rothenberg. “If not, I find a place to sit down and let it pass.”

To manage freezing at home or out and about, you will start to learn what works for you and what doesn’t. If you have any questions or need help adjusting your freezing strategies, reach out to your provider, who can help.

The Takeaway

  • Parkinson’s disease freezing makes you feel suddenly stuck to the floor and can last from 1 to 30 seconds.
  • FOG in advanced Parkinson’s disease can feel frustrating, make you less mobile, and increase your risk for falls.
  • Your healthcare providers can help you lessen and move past freezing episodes with medication adjustments, deep brain stimulation, and physical and occupational therapy.

Resources We Trust

EDITORIAL SOURCES
Everyday Health follows strict sourcing guidelines to ensure the accuracy of its content, outlined in our editorial policy. We use only trustworthy sources, including peer-reviewed studies, board-certified medical experts, patients with lived experience, and information from top institutions.
Resources
  1. Conde CI et al. Triggers for Freezing of Gait in Individuals With Parkinson’s Disease: A Systematic Review. Frontiers in Neurology. December 20, 2023.
  2. Freezing. Parkinson's Foundation.
  3. Freezing of Gait in Parkinson’s Disease. American Parkinson Disease Association.
  4. Levodopa and Carbidopa. MedlinePlus. June 20, 2024.
  5. Apomorphine (Sublingual Route). Mayo Clinic. February 1, 2026.
  6. Deep Brain Stimulation (DBS). National Institute of Neurological Disorders and Stroke. August 1, 2025.
  7. Occupational Therapy and PD. Parkinson's Foundation.
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Jessica Baity, MD

Medical Reviewer
Castle Connolly Top Doctor

Jessica Baity, MD, is a board-certified neurologist practicing in southern Louisiana. She cares for a variety of patients in all fields of neurology, including epilepsy, headache, dementia, movement disorders, multiple sclerosis, and stroke.

She received a bachelor's degree in international studies and history from the University of Miami and a master's in international relations from American University. She graduated from the Louisiana State University School of Medicine, where she also did her internship in internal medicine and her residency in neurology.

Prior to practicing medicine, she worked in international relations and owned a foreign language instruction and translation company. 

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Abby McCoy is an experienced registered nurse who has worked with adults and pediatric patients encompassing trauma, orthopedics, home care, transplant, and case management. She is a married mother of four and loves the circus — that is her home! She has family all over the world, and loves to travel as much as possible.

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