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Joint and muscle pain

Joint and muscle pain can afflict us at every age, but it is also a commonly reported symptom during a woman’s peri- and post-menopausal years.  A woman may experience generalized pain (such as pain in the lower back or shoulder pain), or discomfort in a specific area (particularly occurring in fingers, toes, knees, elbows, or neck areas). You may experience more than one of the following typical symptoms: joints that are red or hot, joint or bone-related pain that feels like something is broken, swelling in your joints, early morning stiffness, pain at night, severe headaches (without a previous history of headaches), changes to your daily activities due to inflexibility, immobility, or pain avoidance. 

A recent study in Japan concluded that 56% of women between the ages of 40 - 59 reported almost daily joint and/or muscle pain.

Pain resulting from muscle strain or hampered joint operation can cause additional symptoms such as insomnia, fatigue, irritability, and weight gain. In the confusion of the menopausal body changes and the wide variety of symptoms possible, muscle and joint pain are often under-diagnosed and under-discussed. However, a medical professional can evaluate whether these common menopausal symptoms are coincidentally concurrent or interdependent with musculoskeletal pain. Either way, there are treatment options available to restore your quality of life. 

The Lowdown on Joint and Muscle Pain

Why does this happen, how does it impact you, how is it diagnoses and common triggers/ risk profiles.

Joint pain is referred to as “arthralgia” and muscle aches are “myalgia.” Both conditions tend to worsen as women age, however they can also be related to conditions resulting from menopause. Some women suffer from both arthralgia and myalgia symptoms, while others suffer only one in isolation.

As a woman’s estrogen levels drop during peri-menopause, estrogen’s normal function for healthy joint operation and lubrication changes. Estrogen’s normal involvement with muscle mass, muscle strength, and musculoskeletal function during pre-menopause is altered during peri-menopause and remains changed, with degenerative compounding effects, during post-menopause.

While the relationship between pain and menopause continues to be studied, it is already well known that these conditions are exacerbated by aging, the presence of sarcopenia (muscle degeneration), osteoarthritis (degenerative joint disease from mechanical wear), and clinical inflammation (acute, chronic, autoimmune, or sudden onset). How these preexisting conditions might be exacerbated by menopause’s hormonal fluctuations continues to be an area of important medical research.

If you have a precondition that affects your muscle or joint health, you will need to pay special attention to keeping your healthcare provider informed as you enter peri-menopause.

Reports of joint and muscle pain may have a correlation with the following health concerns:

  • Depression 
  • Higher-than-recommended body mass index (BMI)
  • Insomnia and excessive daytime fatigue
  • Rheumatoid arthritis
  • Reduced daily mobility or exercise routines due to other causes
  • Inflammatory bowel disease (IBD)

For joint and muscle pain with menopausal onset, your self-reported symptoms will be evaluated by your physician according to a pain-level assessment scale. Your doctor will also be looking for the presence of concurrent disease or medical conditions.

Joint and muscle pain is positively correlated with low-grip strength and insomnia. The relationship between these afflictions is not fully understood and it is unclear which side of the multiple symptom scenario is the root cause.

Physical health

What time of day is joint pain the worst?

No one likes to start their day in pain, but menopausal joint pain isn’t very considerate. In most cases, joint pain will be the worst first thing in the morning, as that’s when your joints are generally at their least flexible. Once you’ve had time to stretch and move around a bit, your joints adjust and become less stiff.

Prevention and Treatment

Learn more about your options for prevention, management and treatment of Muscle and Joint Pain. This is not an exhaustive list of the treatment options available, but a good start.

Muscle and joint pain can be treated in several ways and “menopausal pain” may benefit from  hormone-related therapies. Lifestyle adaptation is also important to consider, as general health conditions could affect the presence, severity, and recurrence of pain. A key lifestyle recommendation related to control or elimination of musculoskeletal pain is maintaining a pattern of high-quality nighttime sleep. Poor rest is directly correlated with increased levels of pain.

‍In order to obtain an optimal level of rest during menopause, it is important to consider your sleep hygiene and to promote excellent sleep habits, such as having a nighttime routine, participating in soothing psychological activities prior to bedtime, regulating caffeine and alcohol consumption, reducing pre-bedtime phone use, and establishing habitual sleep-wake time patterns.

Adherence to the guidelines of a Mediterranean diet has a positive effect on bone mineral density in menopausal women. A Mediterranean diet focuses on whole grains, fish, fruits, vegetables, beans, and nuts and is also highly recommended for cardiovascular and ideal body weight maintenance.

Increased muscle strength and improved posture help to reduce muscle and joint pain. An exercise regime that focuses on flexibility, such as pilates or yoga, as well as frequent aerobic exercise is ideal for pain elimination or mitigation. For some pain-related conditions which mirror or coexist with menopausal pain (for example, sarcopenia) resistance training exercises, such as squats, lifting weights, and stair-machine use can offer protection and relief.

A key lifestyle recommendation related to control or elimination of musculoskeletal pain is maintaining a pattern of high-quality nighttime sleep. Poor rest is directly correlated with increased levels of pain.

In order to obtain an optimal level of rest during menopause, it is important to consider your sleep hygiene and to promote excellent sleep habits, such as having a nighttime routine, participating in soothing psychological activities prior to bedtime, regulating caffeine and alcoho consumptionl, reducing pre-bedtime phone use, and establishing habitual sleep-wake time patterns.

  • Magnesium supplements have been shown to help promote muscle relaxation and may provide menopausal pain relief.
  • Vitamin D is important to your nervous system’s operation, as well as bone health, inflammation control, and muscle movement. Although there is scientific evidence that vitamin D supplementation does not provide pain relief if your body’s pre-existing level is normal, depleted levels of vitamin D should be corrected with supplementation.

If your pain is intermittent, over-the-counter pain medication may provide relief for the times when your pain level increases. Anti-inflammatory pharmaceuticals such as ibuprofen may also help when pain flares. Anti-inflammatory medication is available in tablet (oral) or gel (skin absorption, rubbing application) form.

Other than medication to help manage the pain in very severe cases, there is no known effective prescription medication to treat or prevent joint & muscle pain.

Research studies have indicated that Hormone Replacement Therapy (HRT) can provide a degree of joint or muscle pain relief and may prevent new areas of pain from emerging. However, HRT is not normally the first line of treatment if musculoskeletal pain is the only menopausal symptom reported. 

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Sources used

Medical journals

Silva, T. R., Martins, C. C., Ferreira, L. L., & Spritzer, P. M. (2019b). Mediterranean diet is associated with bone mineral density and muscle mass in postmenopausal women. Climacteric, 22(2), 162–168

Terauchi, M., Odai, T., Hirose, A., Kato, K., Akiyoshi, M., & Miyasaka, N. (2018b). Muscle and joint pains in middle-aged women are associated with insomnia and low grip strength: a cross-sectional study. Journal of Psychosomatic Obstetrics & Gynecology, 41(1), 15–21.

Yasuda T. Selected Methods of Resistance Training for Prevention and Treatment of Sarcopenia. Cells. 2022 Apr 20;11(9):1389. doi: 10.3390/cells11091389. PMID: 35563694; PMCID: PMC9102413.

Other online sources

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