Joint and Musculoskeletal Pain in Menopause

Does it feel like every part of your body is aching?

Menopause might be the culprit. 

As I am navigating through menopause, I have been taken aback by how much my body has changed and continues to change. One of the most surprising and challenging symptoms I encountered was, and unfortunately still is musculoskeletal pain. It seemed like almost overnight; my joints and muscles were stiff and aching, and simple movements became painful. I started developing plantar fasciitis, and making a simple fist became painful. I got checked out: X-rays, MRIs, blood tests, you name it, I got it, but nothing could tell me a reason why all this was happening. After eliminating the obvious things, only one culprit remained: menopause. This prompted me to dive deep into why this happens and explore ways to manage it. If you're experiencing similar issues, know that you're not alone, and there are several ways to find relief. It is estimated that more than half of menopausal women experience joint pain and that “musculoskeletal pain (MSP) is one of the most severe complaints in women undergoing menopause.” Yet, many of us don’t associate this type of pain and discomfort with menopause and we end up not getting the help we deserve and need.

Why Does Joint and Musculoskeletal Pain Occur During Menopause?

First, let's talk about why this happens. Joint pain, or arthralgia, is common during menopause due to hormonal changes. Estrogen plays a crucial role in maintaining joint health by reducing inflammation and, supporting the function of muscles, tendons, ligaments, and maintaining joint and bone health. It helps reduce inflammation and keeps the cartilage—the tissue that cushions our joints—healthy. Joint pain during menopause can manifest as aching, stiffness, and swelling in various joints, including the hands, knees, hips, and spine. This discomfort is primarily attributed to hormonal fluctuations, particularly the decline in estrogen levels. This hormonal change also affects the synovium, the soft tissue that lines the joints, making them more susceptible to pain and stiffness.  Another factor is a change in pain sensitivity. Estrogen fluctuations can alter pain perception. Lower estrogen levels are associated with increased sensitivity to pain. This is because estrogen modulates pain processing pathways, including those involving endogenous opioids, which are the body's natural painkillers. Studies have shown that women with low estrogen levels experience higher pain sensitivity and lower pain thresholds.

Non-Hormonal Options for Managing Joint Pain

While menopausal hormone therapy (MHT) is one option, I, like many others, prefer to explore non-hormonal methods first. There are many first steps you can take to evaluate if you experience relief with those, and if you don’t, I encourage you to talk with your healthcare team to evaluate other options. Here are several scientifically-backed strategies that have helped me initially and can help you manage joint pain.

Regular Physical Activity

I’m sure you saw this one coming, but I have to say it anyway. Regular physical activity is one of the most effective ways to reduce joint pain and improve overall joint health. Low-impact aerobic exercises such as swimming, cycling, and walking can provide cardiovascular benefits without putting excessive stress on joints. Strength training helps build muscle strength, which supports and protects joints, while flexibility exercises like yoga and Pilates can improve range of motion and reduce stiffness. Menopause leads to a decline in muscle mass, which can further strain joints and increase the likelihood of pain and injury. Maintaining and gaining muscle mass is critically important, which is why strength training has to be part of your exercise routine. Aim for at least 2-3 strength training workouts per week.

Dietary Adjustments

Nutrition is another critical factor. A well-balanced diet rich in anti-inflammatory foods can help manage joint pain. Foods high in omega-3 fatty acids, such as salmon, mackerel, flaxseeds, and walnuts, have been shown to reduce inflammation. Incorporating plenty of fruits and vegetables, particularly those rich in antioxidants, can also help alleviate joint pain. Avoiding processed foods and sugars, which can increase inflammation, is equally important

Physical Therapy

Physical therapy can be highly beneficial for managing joint pain. A physical therapist can design a personalized exercise program to strengthen muscles, improve flexibility, and reduce pain. Techniques such as manual therapy, ultrasound, and electrical stimulation can also be beneficial in alleviating pain and improving joint function. I am currently in physical therapy and have seen improvement. 

Mind-Body Techniques

Practices like yoga, tai chi, and meditation can help manage stress and promote relaxation. These mind-body techniques also enhance body awareness, posture, and balance. A systematic review found that yoga and tai chi are effective in reducing pain and improving physical function in individuals with joint pain.

Acupuncture

I also gave acupuncture a try, and it provided relief by reducing pain and inflammation temporarily but, for me, not in the long term. It might work for you, though. There is evidence to suggest that acupuncture may be a viable treatment for chronic pain, including joint pain, and can be an effective adjunct to conventional therapy. 

The decline in estrogen levels during menopause significantly impacts joint pain perception by increasing inflammation, altering pain sensitivity, and affecting joint and bone health. While MHT might be an option to explore, it is essential to consider the potential risks and benefits. Non-hormonal strategies, such as regular exercise, dietary adjustments, and stress reduction, can also help manage menopausal joint pain effectively. For me, giving lifestyle adjustments a try is always my first strategy. 

Have you found anything that has helped you with joint and muscle pain? I’d love to hear. Email me at [email protected]