What causes menopause joint pain?
It may be a natural part of the female ageing process, but menopause can bring discomfort and pain in a number of ways. Learning how to manage your symptoms can make a big difference in your quality of life during this period.
From hot flushes and vaginal dryness to disturbed sleep and anxiety, there are lots of possible symptoms that may make daily activities more challenging. These noticeable changes reflect the significant change that's taking place in your body, as your sex hormone levels fluctuate and cause your ovaries to lose their reproductive function.
Ann Clare, a physiotherapist for MBST UK, explains how these changes can lead to menopause joint pain: "Oestrogen, the hormone that plays a key role in regulating your menstrual cycle, helps to decrease inflammation and keep the joints lubricated. During the menopause and perimenopause, oestrogen levels decrease and as a result, some women experience joint pain."
"Recent studies have suggested that a decrease in oestrogen not only reduces natural bone density but also affects muscle strength and tendon health. In turn, this may result in longer injury recovery times," says Kirsty Lee, senior physiotherapist and pelvic health lead at Ascenti.
Menopause joint pain, osteoarthritis, or osteoporosis?
Menopause joint pain can affect joints all over your body and can also result in longstanding injuries becoming more painful.
According to Lee, menopause joint pain most commonly affects the following areas:
- Neck.
- Shoulders.
- Spine.
- Elbows.
- Hands.
- Knees.
"As oestrogen continues to decrease, joints can become more inflamed and painful, resulting in an increased risk of osteoporosis (thinning of the bone) and osteoarthritis (inflammation of the joints) developing," she adds.
When it could be osteoarthritis
Osteoarthritis is more likely to occur in people over 50 years, around the same time that many women start menopause. While joint pain and stiffness around the time of menopause doesn't always indicate osteoarthritis, it can be a symptom. Osteoarthritis joint pain is more likely to occur in the knees, hips, lower spine, fingers, and thumbs.
When it could be osteoporosis
Being over 40 and going through menopause increases your chances of rapid bone loss, which may lead to osteoporosis. Unlike menopause joint pain and osteoarthritis, you usually won't feel pain unless you break a bone. Your doctor may wish to test you for osteoporosis if you are menopausal and have had a bone breakage from a minor injury.
Is back pain a symptom of menopause?
Back pain, and particularly lower back pain, can become a problem for many women as they go through menopause. In fact, one survey of 5,325 women found that postmenopausal women were twice as likely to report lower back pain as premenopausal women.
Your spine is made up of multiple joints, including facet joints that allow movement in your back. Decreased oestrogen results in greater inflammation of these joints and also causes your spinal (intervertebral) discs to wear down.
Does menopause cause knee pain?
Menopause joint pain of the knees is also very common. This may not be surprising, given that your knee is one of your largest joints, connecting and supporting your thighbone (femur), kneecap (patella), shinbone (tibia), and calf bone (fibula). Your knees are subject to a great deal of pressure and wear throughout your life as they support a large portion of your weight.
Easing menopause joint pain
The good news is, there are both medical and non-medical forms of pain management that are proven to significantly reduce menopause joint pain. This can start with simple routines in the home.
Home treatments include:
- Gentle stretching exercises.
- Using ice packs on sore areas.
- Using hot water bottles on sore areas.
- Having hot baths.
- Practising relaxation techniques and mindfulness.
Diet for menopause joint pain
Your diet is hugely important in both preventing and managing health issues, and menopause joint pain is no different. "Try to eat a healthy, balanced diet that is high in fibre with lots of fruit, vegetables and wholegrain foods," advises Clare.
Eating the right foods can improve a range of menopause symptoms. The key is to consume lots of nutrients from various food groups.
The foods that most directly impact joint and bone health include:
- Dairy products (milk, cheese, yoghurt) - contain calcium, potassium, phosphorus, magnesium and vitamins D and K.
- Oily and tinned fish (salmon, sardines, mackerel) contain vitamin D and omega-3 fatty acids, and tinned fish with bones are high in calcium.
- Richly coloured fruits and green leafy vegetables (cherries, blueberries, kale) - contain vitamin C.
- Animal and non-animal protein (chicken, egg, beans),
"You should also try to avoid large quantities of saturated fats. If you are suffering from hot flushes, try to make a note of what seems to bring them on - for some people it is alcohol and for others caffeine," adds Clare.
Exercise for menopause joint pain
If you experience menopause joint pain, you may be tempted to limit your movements. It may feel counter-intuitive at first, but the experts recommend staying as physically active as possible.
Lee says: "Move! Motion is lotion, and if this is managed and progressed slowly it can be an effective tool for pain management."
Why: "Unfortunately, weight gain is also a common side effect of menopause, and increased weight can have a detrimental effect on joint and muscle pain due to increased load. Therefore, weight management is a key part of managing joint pain."
What: "There are lots of forms of exercise that can help with pain as well as other menopause symptoms. An effective 'menopause friendly' programme should consist of endurance, strength/resistance, and balance exercises."
- Yoga and Pilates - for muscles strength, flexibility, and strengthening of your pelvic floor muscles (which can weaken during menopause).
- Weight training and higher impact activities - improve bone density but need to be closely monitored by a trained personal trainer or a physiotherapist.
Clare says: "It is best to be as active as possible and most of all enjoy your sports."
Why: "Weight-bearing exercises will strengthen your musculoskeletal system which will help to alleviate joint aches and pains, protect brittle bones, and may prevent osteoporosis."
What:
Ivana Daniell, movement and posture expert, says: "The right choice of exercise programme can be of great support during the time of menopause, both physically and mentally. Be aware of not pushing your body too hard, especially during this delicate hormonal transition."
Why: "When the female body is pushed too hard, it goes into adrenal stress and this creates havoc in the incredibly engineered yet delicate hormonal balance."
What: "Quality of movement versus quantity is paramount. Regular and consistent exercise is better than sporadic visits to the gym that make you exhausted. Choose activities that uplift your mood and practise 2-3 times per week in addition to your daily 30-40 minute walk."
- Dancing.
- Walking in nature.
- Your favourite sport.
- Yoga.
- Pilates.
- Pelvic floor exercises - every day for a couple of minutes.
- Core strengthening exercises.
Medical interventions for menopause joint pain
You may also use over-the-counter medicines to help reduce inflammation and painful joints. These include common painkillers and anti-inflammatory gels and medication. Your pharmacist will be able to advise.
It should also be noted that hormone replacement therapy (HRT) is widely accepted as the most effective method for managing the symptoms of menopause. By restoring the oestrogen levels you lose during menopause, there is strong evidence that HRT can ease menopause joint pain alongside a whole host of other symptoms.
Supplements for menopause joint pain
There are also several menopause herbal remedies and supplements on the market. Biomedical gerontologist Dr Marios Kyriazis says that supplementation should be used alongside - and not as a substitute for - healthy lifestyle changes:
"The most effective lifestyle changes include switching to an anti-inflammatory diet, incorporating light to moderate physical activity, practising breathing and relaxation exercises on a daily basis, and improving sleep patterns. Under these conditions, herbal blends and anti-inflammatory supplements work best."
Kyriazis recommends supplementing curcumin, the active ingredient in turmeric.
Curcumin may:
- Relieve joint pain and reduce the risk of osteoarthritis via an anti-inflammatory action.
- Reduce hot flushes and prevent the development of breast cancer cells, as it's a natural source of antioxidants and phytoestrogens (plant-based compounds that mimic oestrogen in the body).
- Act as an anticoagulant (preventing blood clots) and improve cardiovascular (heart and blood vessels) health.
- Boost immunity by triggering antibody production, preventing autoimmune disease.
- Prevent vaginal infection as it has natural anti-fungal and anti-microbial action.
- Reduce the symptoms of depression, improve brain health, support sleep, and relieve stress.
- Improve the microbiome and digestion, good for overall health.
"By fermenting turmeric, its curcumin content becomes more bio-available at a smaller dose and is gentler on the stomach than the usual raw turmeric with black pepper that is generally recommended," he adds.