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Menopause and Musculoskeletal Pain: How Physical Therapy Can Help

Writer: Nashville PTNashville PT

Woman holding painful shoulder

Perimenopause and menopause are major transitions in a woman’s life, bringing hormonal changes that affect not just reproductive health but also the musculoskeletal system. Many women experience new or worsening joint pain, muscle stiffness, and even an increased risk of injury during this time. But while these changes are normal, they’re not something you just have to “live with.” Physical therapy (PT) can help women navigate menopause with less pain, more strength, and greater confidence in their bodies.

How Menopause Affects the Musculoskeletal System

The decline in estrogen levels during perimenopause and menopause can have a significant impact on muscles, joints, and bones. Here’s how:

1. Joint Pain and Stiffness

Many women in menopause experience joint pain, commonly in the knees, hips, shoulders, and hands. This is often due to increased inflammation, as estrogen plays a protective role in keeping inflammation in check. When estrogen levels drop, inflammatory markers rise, leading to discomfort and stiffness, particularly in the morning or after periods of inactivity (Hinge Health, 2022).

How PT Helps: A physical therapist can use manual therapy, mobility exercises, and strength training to keep joints moving properly, reducing stiffness and pain.

2. Bone Density Loss and Osteoporosis Risk

Estrogen is crucial for maintaining bone density. After menopause, bone breakdown outpaces bone formation, increasing the risk of fractures. Research shows that postmenopausal women can lose up to 20% of their bone mass in the first 5–7 years after menopause (Loyola Medicine, 2023).

How PT Helps: Weight-bearing exercises, resistance training, and balance exercises can help slow bone loss and reduce fall risk, which is critical for preventing fractures.

3. Loss of Muscle Mass and Strength

Sarcopenia (age-related muscle loss) accelerates during menopause, leading to decreased strength and endurance. Lower muscle mass can contribute to increased joint pain and a higher risk of injuries. Without intervention, women can lose about 3–8% of muscle mass per decade (Sydney Pelvic Clinic, 2023).

How PT Helps: Strength training is one of the most effective ways to preserve muscle mass and function. A physical therapist can create a personalized program that includes resistance exercises tailored to your needs and fitness level.

4. Increased Risk of Osteoarthritis

Many women notice that their osteoarthritis symptoms worsen during menopause. While osteoarthritis (OA) is a normal part of aging, the decline in estrogen may contribute to cartilage thinning and joint degeneration. Knee and hip OA are particularly common in postmenopausal women (PubMed, 2019).

How PT Helps: Physical therapy can improve joint mobility, strengthen surrounding muscles to offload pressure from the joints, and provide pain management strategies such as manual therapy or dry needling.

5. Postural Changes and Spinal Pain

Menopause-related changes, including muscle imbalances and bone loss, can contribute to postural shifts that lead to back and neck pain. Many women also develop forward head posture and rounded shoulders due to prolonged sitting and weakened postural muscles.

How PT Helps: A physical therapist can help correct posture through targeted strengthening and mobility exercises, reducing strain on the spine and improving overall alignment.

Why Physical Therapy Should Be Part of Your Menopause Plan

Many women don’t realize that physical therapy can be a game-changer during menopause. Here’s why it should be part of your approach to managing musculoskeletal symptoms:

✔️ Pain Relief Without Medications

While some women turn to painkillers or hormone replacement therapy (HRT) for symptom relief, physical therapy provides a drug-free approach to managing pain through movement, strength, and targeted manual techniques.

✔️ Customized Exercise Plans for Your Unique Needs

Unlike generic exercise programs, a PT will design a plan based on your specific symptoms, whether it’s joint pain, muscle weakness, or balance concerns.

✔️ Preventing Falls and Fractures

Strength, balance, and coordination exercises reduce the risk of falls, which become more dangerous as bone density decreases.

✔️ Keeping You Active and Independent

Menopause doesn’t have to mean slowing down. Physical therapy ensures you stay strong, mobile, and pain-free so you can keep doing the activities you love.

Take Control of Your Health and Your Pain—Start PT Today

Menopause-related musculoskeletal pain is common, but it doesn’t have to define this stage of life. If you’re struggling with joint pain, stiffness, or mobility issues, physical therapy can help you move better, feel stronger, and stay active. At Nashville Physical Therapy & Performance, we specialize in one-on-one, cash-based physical therapy that gives you the time and attention you deserve.

✅ No waiting for insurance approvals.

✅ No rushed appointments.

✅ Just expert care designed for you.

Ready to take control of your musculoskeletal health? Call us today to schedule your evaluation and start feeling your best.

References

  1. Hinge Health (2022). The Musculoskeletal Syndrome of Menopause. Retrieved from Hinge Health

  2. Loyola Medicine (2023). Menopause-Related Musculoskeletal Pain. Retrieved from Loyola Medicine

  3. Sydney Pelvic Clinic (2023). Menopause and the Musculoskeletal System. Retrieved from Sydney Pelvic Clinic

  4. PubMed (2019). Estrogen Deficiency and Osteoarthritis: A Review. Retrieved from PubMed


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