Menopause and Joint Pain: Understanding the Link and Finding Relief

Medically reviewed by Peter Weiss, MD

Joint pain is a common symptom of menopause and can affect any joint, including knees, shoulders, elbows, and hands. Hormonal declines, which are the cause of menopause, can affect various body areas, including the muscles and bones.

Menopause is part of the aging process. A person who menstruates is considered in menopause when they have gone 12 months without a period. The average age for menopause in the United States is 52.

The first stage of menopause is perimenopause, which typically starts in the early to mid-40s and can last an average of four years. Menopause that occurs before age 45 is considered early menopause.

This article will cover the causes of joint pain in menopause, what menopausal joint pain feels like, other possible cases, and more.

Can Menopause Cause Joint Pain?

Estrogen is a sex hormone responsible for many body functions, including keeping bones, joints, and cartilage healthy. It helps with natural bone replacement and preventing joint inflammation and pain. Estrogen also directly affects muscles, tendons, and ligaments and contributes to muscle mass and strength.

Bone and muscle function is improved with optimal estrogen levels. Research shows balanced estrogen levels can decrease stiffness in muscles, tendons, and ligaments, leading to better joint performance and reduced injury rates.

Up to 50% of people in menopause report joint pain. For 21%, joint pain is a significant symptom.

Joint pain and swelling related to estrogen decline often affects the small joints of the hands and feet. Other joint areas, including the knees, elbows, and neck, can also be affected.

Related: Coping With Menopause

What Does Menopause Joint Pain Feel Like?

Menopausal joint pain is often at its worst in the morning and improves with activity. You may also awaken to stiff joints.

Additional joint symptoms might include:

• Back pain

• Muscle pain

• Soreness in joints, neck, or shoulder

• Joint stiffness

• Decreased range of motion

• Pain with activity

• Crepitus (cracking and popping sounds) with joint movement

Menopausal joint pain can affect your ability to do daily activities, as well as your overall quality of life. Persistent pain and stiffness make performing routine tasks harder and affect the enjoyment of favorite activities. You may also experience stiffness that limits your range of motion and makes walking and other activities difficult.

Joint pain may affect your emotional health and lead to feelings of anxiety and depression. You might also experience sleep troubles because joint pain makes it challenging to find a comfortable sleep position, or joint pain may wake you up at night.

Other Possible Causes of Joint Pain During Menopause

Hormonal shifts during menopause can lead to joint pain and stiffness. But menopause is not the only possible cause of joint pain during this time.

Osteoarthritis

Osteoarthritis (OA), a type of wear-and-tear arthritis, strikes people assigned female at birth at higher numbers than those assigned male at birth, with an increased risk for hand and knee OA. The effects of knee and hand OA seem to increase with age and tend to be more rapid between ages 50 and 75.

The risk for hand OA peaks after menopause more than 3.5 times higher in women aged 50 to 60 compared to men of the same age range. Researchers believe that estrogen deficiency is to blame for the increased risk for females.

A Note on Gender and Sex Terminology

Verywell Health acknowledges that sex and gender are related concepts, but they are not the same. To reflect our sources accurately, this article uses terms like “female,” “male,” “woman,” and “man” as the sources use them.

Menopause and estrogen declines are not always the cause of OA, and joint pain in menopause may occur without OA. It is not unusual to experience joint pain or develop OA due to aging. OA is also related to other factors, including genetics. So, while menopause might be to blame for some people's joint pain, it is not always the primary cause.

Related: Joint Pain Causes and Treatment Options

Osteoporosis

Declining estrogen levels may also lead to the development of osteoporosis, a bone disease that weakens bones and makes them more vulnerable to fractures (breaks).

While osteoporosis does not directly contribute to joint pain, it may do so indirectly. For example, osteoporosis can lead to spinal, wrist, and hip fractures, which can cause you to have joint pain.

Rheumatoid Arthritis

Rheumatoid arthritis (RA) is an autoimmune inflammatory disorder affecting the synovial linings of the joints. Autoimmune diseases occur when the immune system malfunctions and starts attacking healthy tissues.

RA usually starts between ages 25 and 45 but can also develop in older adults. RA after age 45 is considered late onset.

RA can develop during menopause, but hormonal imbalances may not be the cause of joint symptoms. No evidence suggests that menopause can lead to the development of RA.

The earliest symptoms of RA are joint pain and tenderness. Additional symptoms include:

• Joint swelling and stiffness

• Morning stiffness that lasts 30 or more minutes

• Symmetrical involvement—joint symptoms on the same joints on both sides of the body, such as both knees or both wrists

• Small joint involvement (hands and feet), especially early on

• Chronic fatigue

• Low-grade fever: A body temperature between 99 and 100.4 degrees F

Psoriatic Arthritis

Like RA, psoriatic arthritis (PsA), is an autoimmune disease in which the immune system malfunctions and attacks healthy tissues. PsA affects both the skin and joints. Its shared connection to menopause is dropping estrogen levels, which may increase your risk for the condition.

PsA and menopause might also share some overlapping symptoms, which makes it harder to distinguish between the two conditions.

Such symptoms include:

• Fatigue

• Sleep problems

• Mood swings

• Itchy, dry skin

Related: What to Know About Psoriatic Arthritis (PsA) and Menopause

Fibromyalgia

Fibromyalgia is a disorder characterized by widespread musculoskeletal (muscle, joint, and other body tissues) pain. It also causes severe fatigue and problems with sleep, memory, and mood.

Researchers believe fibromyalgia amplifies painful sensations by affecting how the brain and spinal cord respond to painful and unpainful stimuli. Symptoms are often triggered after an event, such as physical trauma, psychological stress, or an illness or infection. The condition is more common in people assigned female at birth.

Some people report that fibromyalgia symptoms begin after menopause, suggesting a connection between a hormonal imbalance and widespread musculoskeletal pain. Fibromyalgia symptoms also seem to worsen with the onset of menopause.

Related: Joint Pain Causes and Treatment Options

How to Relieve Menopausal Joint Pain

Lifestyle modifications, including exercise and diet, can reduce menopausal joint pain and even reduce your risk for OA and osteoporosis. Additional lifestyle changes include stress management and quitting smoking. Treatment options include over-the-counter (OTC) pain relievers, acupuncture, hormone therapy, and nutritional supplements.

Exercise Regularly

If you experience joint pain, you might want to limit your movement, but healthcare providers recommend physical activity to manage pain and stiffness.

Regular physical activity can keep muscles around affected joints strong, decrease muscle loss, and control joint swelling and pain.

Regular exercise can also help increase joint cartilage lubrication, further reducing pain and stiffness. It can improve sleep and decrease fatigue.

Eat More Anti-Inflammatory Foods

Your diet plays a vital role in managing menopausal joint pain. You will want to eat a well-balanced diet with many fruits and vegetables, whole grains, fish, lean meats, and healthy fats.

Adding foods considered anti-inflammatory, such as nuts, leafy green vegetables, olive oil, and oily fish, might help to prevent joint pain. You will also want to avoid foods that increase inflammation, such as refined carbs (i.e., white bread), fried foods, soda and other sweetened beverages, red meats, margarine, and other shortenings.

Related: 15 Anti-Inflammatory Foods

Find Ways to De-Stress

Joint pain can be exacerbated by stress. You might be able to reduce joint and better manage it if you find ways to cope.

Consider talking to a therapist. This person can help you to better manage the effects of menopause and joint pain on your life. You may benefit from interventions like cognitive behavioral therapy (CBT), which can help you better understand and manage stressful issues.

You may also consider finding ways to relax, such as deep breathing, taking walks, meditation, or yoga.

Maintain Your Body Weight

Keeping a healthy weight is vital to managing joint pain, and research shows that losing as little as 10 pounds can decrease the progression of knee arthritis by up to 50%.

Losing weight can take the stress off joints, easing joint symptoms. Any joint damage, however, cannot be reversed.

Quit Smoking

Every tissue in the body is affected by smoking, including the joints. Smoking can increase your risk for osteoporosis, reduce blood supply to bones, slow down the production of bone-forming cells, cause estrogen to break down too quickly, and decrease calcium absorption. Calcium is necessary for bone mineralization.

Many of the effects of smoking can be reversed by quitting. If you find quitting challenging, a healthcare provider can provide you with information and resources to help.

Related: How to Realistically Quit Smoking: 24+ Steps to Take Right Now

Consider Acupuncture

Acupuncture is an alternative medicine practice that uses small, thin needles that go into the skin at specific points on the body. Western medicine experts believe the procedure stimulates muscles, nerves, and other tissues.

While limited, some of the research on acupuncture suggests it may help the body to release natural painkillers. The risk of harm with acupuncture is low, provided the practitioner uses new, sterile needles for each client.

If you want to try acupuncture, check with your healthcare provider. They can review your medical history and help you decide whether acupuncture is a safe option for you.

Try OTC Painkillers

Many options for OTC medications can help you manage your joint pain. Your OTC pain relief options might include:

• Tylenol (acetaminophen)

• Advil or Motrin (ibuprofen)

• Aleve (naproxen sodium)

• Topical pain relief creams, lotions, gels, or patches containing capsaicin, menthol, salicylate, or lidocaine

Consult with your healthcare provider if OTC medicines don't help relieve your joint pain. They can prescribe more potent pain relief medicines and treat other causes of joint pain, such as OA, RA, and fibromyalgia.

Apply Ice and Heat

Applying heat to achy joints can provide temporary pain relief. You can use a heating pad, hot water bottle, warm compresses, or soak in the tub. For inflamed (swollen) joints, use an ice pack to bring down swelling to reduce pain.

Try Menopausal Hormone Therapy

Hormone replacement therapy (HRT) is a form of estrogen treatment. It has been shown to reduce joint pain during perimenopause and following menopause.

There are many different HRT options. Your healthcare provider can advise you on the best options for your unique health situation.

Supplements

Some dietary supplements can help improve your joint health and manage joint pain.

The following supplements are believed to relieve joint pain and inflammation:

• Fish oil: These supplements contain polyunsaturated omega-3 fatty acids, similar to those in fatty fish like salmon and mackerel. These fatty acids have potent anti-inflammatory benefits, and research has shown fish oil supplements can improve joint pain, stiffness, and swelling.

• S-adenosyl-methionin (SAMe): SAMe is a naturally occurring compound in the body with anti-inflammatory and cartilage-protecting properties. It is available as a supplement, and research has shown it has a similar effect as nonsteroidal anti-inflammatory drugs (NSAIDs) like Advil, Motrin, or Aleve.

• Curcumin: This is the active ingredient in turmeric, a spice commonly used in Indian curries. It has been found to have pain- and inflammation-relieving properties. If you do not like adding turmeric to your meals, consider taking a supplement.

• Glucosamine and chondroitin sulfate: Glucosamine and chondroitin sulfate are the most widely used and promoted supplements for joint pain. They are components of natural cartilage and are believed to provide pain relief.

• Vitamin D supplements: Vitamin D is vital for promoting various health functions, including calcium absorption, which is vital for building strong bones. It can also help to slow down and minimize the effects of decreased estrogen, including those that lead to bone and joint problems.

Talk to your healthcare provider before starting any new supplement. They can review your medical history and help you decide whether a supplement might help with your joint pain and if it is safe to take based on your unique health situation. 

When to Contact a Healthcare Provider

You should let your healthcare provider know if you are experiencing persistent joint pain. They can identify the cause, rule out other conditions, and find a treatment plan that works for you.

You should also contact your healthcare provider for joint pain accompanied by fever or severe fatigue, or you have significant pain that affects your ability to perform daily tasks.

Summary

Menopause is the time of life that occurs when you stop having menstrual periods for 12 months in a row. Declining hormone levels can affect your body in many ways. Joint pain is common during menopause and the time before periods end, called perimenopause. The risk for arthritis and osteoporosis also increases during this time.

Joint pain in menopause can be managed and treated in many ways. This includes lifestyle changes like eating a healthy diet, exercising, managing stress, and quitting smoking. Treatment options for managing menopausal joint pain include OTC pain relievers, acupuncture, hormone replacement therapy, and natural supplements.

Contact your healthcare provider for persistent joint pain, severe pain, or pain accompanied by severe fatigue and low-grade fever.

Read the original article on Verywell Health.