*Content reviewed by HotPause Health  Pelvic Health Therapist, Tanya Goodrich, PT, DPT

Menopause and Joint Pain

Why does joint pain happen during menopause? During menopause, many women experience new or increased joint pain. Research indicates that more than half of women going through perimenopause and menopause report some kind of joint pain. [1] This discomfort can manifest in various ways:

• Persistent Dull Ache: A continuous, mild pain in the joints.
• Sharp Twinges: Sudden, intense pains that may occur with movement.
• Stiffness: Especially noticeable after periods of inactivity or upon waking.
• Sensation of Pain in Surrounding Areas: Pain may also seem to come from muscles, tendons, or bones around the joints.

Hormonal Changes and Inflammation

The primary reason for increased joint pain during menopause is the decline in estrogen levels. Estrogen plays a crucial role in:

• Reducing Inflammation: Estrogen has anti-inflammatory properties. Its decrease can lead to heightened inflammation, causing pain and stiffness that can impact daily life and overall happiness.
• Maintaining Joint and Cartilage Health: Estrogen helps preserve cartilage and the tissues that cushion your joints. With lower estrogen levels, these tissues may deteriorate, leading to joints rubbing together more and increasing discomfort. [2]

Arthritis In Menopause

Conditions like osteoarthritis (OA) and rheumatoid arthritis (RA) are more common during menopause, contributing to joint pain.

Rheumatoid Arthritis (RA): RA is an autoimmune disorder in which the immune system thinks the healthy synovial membrane within the joints is a threat — like a virus or bacteria — and attacks it, targeting several joints at once. This produces inflammation and pain. RA affects 1.5 million people in the United States.[3] Nearly three times more women than men are diagnosed with RA, according to the Arthritis Foundation.

Osteoarthritis (OA): Osteoarthritis is a degenerative condition resulting in wear and tear on the joints that destroys cartilage over a lifetime. More than 31 million Americans — almost 10 percent of the population — have the condition, making it the most common form of arthritis. [4] About 73% of people living with osteoarthritis are older than 55 years, and 60% are female [5]. The knee is the most frequently affected joint, followed by the hip and the hand [6].

Joint Pain & Arthritis Risk Factors

• Age: The risk of OA increases with age.
• Sex: Women are more likely to develop OA than men, especially after age 50.
• Weight: Being overweight or obese can increase the risk of OA, especially in weight-bearing joints like the hips or knees.
• Family history: People with a family member who has OA may be at higher risk.
• Joint injury: Injuring or overusing a joint can increase the risk of OA.
• Repetitive movements: Repetitive movements of the joint can increase the risk of OA.
• Pre-existing joint disease: Pre-existing joint diseases, such as rheumatoid arthritis or gout, can increase the risk of OA.
• Metabolic disease: Metabolic diseases, such as diabetes, can increase the risk of OA.
• Smoking: Smoking can increase the risk of getting arthritis and make it worse.
• Weight Gain: Menopause often leads to weight gain, adding stress to joints and muscles and exacerbating pain.
• Decreased Physical Activity: Reduced activity can lead to muscle weakness and joint stiffness.

What Can You Do About Joint Pain During Menopause?

Managing menopause and joint pain involves a holistic approach to alleviate discomfort and improve quality of life. Here are several strategies:

Stay Active with Regular Exercise

• Low-Impact Activities: Engage in exercises like walking, swimming, or yoga to strengthen muscles and improve flexibility without putting excessive strain on the joints
• Range of Motion Exercises: These exercises help improve joint function, keep your joints flexible, reduce pain, and improve balance and strength. Range of motion is how far you can move your joints in different directions.
• Strength Training: Build muscle mass to support joints through:
  • Weight-Bearing Exercises: Such as Pilates or light weightlifting.
  • Resistance Bands: Utilize bands to add resistance without heavy weights.
  • Bodyweight Exercises: Include squats, lunges, and push-ups.

Maintain a Healthy Diet

• Anti-Inflammatory Foods: Incorporate fruits, vegetables, fatty fish (like salmon), nuts, and seeds to help reduce inflammation.
• Hydration: Drink plenty of water to keep tissues lubricated and reduce joint friction.
• Limit Processed Foods: Reduce intake of sugars, refined carbs, caffeine, and alcohol, which can increase inflammation.

Manage Weight Effectively

• Healthy Weight Management: Achieve and maintain a healthy weight to reduce stress on joints, easing pain and preventing further damage.
• Increased Weight Impacts Pressure on Joints: A key study published in Arthritis & Rheumatism of overweight and obese adults with knee osteoarthritis (OA) found that losing one pound of weight resulted in four pounds of pressure being removed from the knees. As an example, if you lost just 10 pounds, it would reduce 40 pounds of pressure from your knees. [7]

Utilize Pain Relief Methods

• Over-the-Counter Medications: Use NSAIDs like ibuprofen or acetaminophen for temporary relief (consult your healthcare provider first).
• Heat and Cold Therapy:
  • Heat: Apply warm towels or heating pads to relax muscles and increase blood flow.
  • Cold: Use ice packs to reduce inflammation and numb sore areas.

Consider Supplements

• Omega-3 Fatty Acids: Found in fish oil, may help reduce joint inflammation.
• Glucosamine and Chondroitin: Supplements that support joint health.
• Vitamin D and Calcium: Essential for bone strength and joint function.

Explore Alternative Therapies

• Physical Therapy: A therapist can create a personalized exercise program to strengthen muscles around joints
• Acupuncture: May alleviate pain by stimulating nerves and improving blood flow.
• Massage Therapy: Helps reduce muscle tension and enhance circulation.
• Menopause Hormone Therapy (MHT): Discuss MHT with Your Doctor. For some women, MHT can help alleviate menopausal symptoms, including joint pain, by balancing hormone levels.

Lifestyle Modifications

• Stress Reduction: Practice meditation, deep-breathing exercises, or yoga to reduce stress-induced inflammation.
• Adequate Sleep: Ensure sufficient restful sleep to help the body repair and reduce pain sensitivity.

Conclusion

Experiencing joint pain during menopause is common due to hormonal changes, but it doesn’t have to diminish your quality of life. By understanding the connection between menopause and joint pain and implementing a combination of lifestyle changes, medical treatments, and alternative therapies, you can effectively manage symptoms and maintain an active, comfortable lifestyle.

References:

1. Magliano M. Menopausal arthralgia: Fact or fiction. Maturitas. 2010 Sep;67(1):29-33. doi: 10.1016/j.maturitas.2010.04.009. PMID: 20537472.
2. Sniekers YH, Weinans H, van Osch GJ, van Leeuwen JP, van der Kraan PM. Oestrogen is important for maintenance of cartilage and subchondral bone in a murine model of knee osteoarthritis. Arthritis Res Ther. 2010;12(5)
   . doi: 10.1186/ar3148.
3. Rheumatoid arthritis: causes, symptoms, treatments and more. Arthritis Foundation. https://www.arthritis.org/diseases/rheumatoid-arthritis. Updated Oct, 15, 2021.
   Center of Disease Control, Osteoarthritis,Data from National Health and Nutrition Examination Survey 2017–March 2020.
4. GBD 2019: Global burden of 369 diseases and injuries in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019. https://vizhub.healthdata.org/gbd-results/.
5. Long H, Liu Q, Yin H, Diao N, Zhang Y, Lin J et al. Prevalence trends of site-specific osteoarthritis from 1990 to 2019: Findings from the global burden of disease study 2019. Arthritis Rheumatol 2022; 74(7): 1172-1183.
6. Messier SP, Gutekunst DJ, Davis C, DeVita P. Weight loss reduces knee-joint loads in overweight and obese older adults with knee osteoarthritis. Arthritis Rheum. 2005 Jul;52(7):2026-32. doi: 10.1002/art.21139. PMID: 15986358.