Menopause and Joint Pain: Why, and What Helps

Introduction

Many women approaching their late 40s or early 50s notice new aches and stiffness in joints that previously felt perfectly healthy. Hips that are sore after a walk, knees that complain after climbing stairs, or hands that feel less agile — these changes can be surprising, even frustrating. If you’re experiencing this, perimenopause or menopause may be a factor, and understanding what’s happening can make a real difference in how you manage it.

Why Menopause Impacts Joints

Oestrogen is a key hormone that helps maintain healthy bones, ligaments, tendons, cartilage, and muscle. It’s not just about hot flashes — declining oestrogen levels during perimenopause and menopause affect musculoskeletal health in several ways:

1. Reduced joint lubrication and cartilage resilience
   Oestrogen helps regulate the production of synovial fluid, which keeps joints well-lubricated. Lower levels can make joints feel stiff and increase friction, which can accelerate wear on cartilage over time.

2. Changes in connective tissue and ligaments
   Ligaments and tendons contain collagen, a structural protein that provides strength and elasticity. Oestrogen influences collagen synthesis. As levels fall, connective tissues may become less flexible, making joints feel less stable and more prone to strain.

3. Altered pain perception and inflammation
   Oestrogen modulates the inflammatory response and pain signalling pathways. Declining levels may increase sensitivity to pain and inflammation, meaning minor stresses on joints may feel more uncomfortable.

4. Muscle mass and support
   Ageing, combined with hormonal changes, can reduce muscle mass (sarcopenia), which diminishes the support muscles provide to joints. Weak stabilising muscles around the knees, hips, and spine can exacerbate joint pain.

Common Joint Symptoms During Perimenopause

Women in perimenopause and menopause often report:

• Morning stiffness or joints that feel “tight” after inactivity

• Achy hips, knees, lower back, or fingers

• Flare-ups of previous injuries or niggles

• Fatigue after normal daily activities

• Occasional swelling or discomfort in weight-bearing joints

It’s important to note that while these symptoms are common, persistent, severe, or worsening pain should always be assessed by a healthcare professional. Osteopaths can help distinguish between age-related changes and conditions such as osteoarthritis or inflammatory joint disease.

What Can Help

There are effective ways to manage perimenopausal and menopausal joint discomfort, and maintain long-term joint health.

1. Gentle but consistent movement
   Exercise keeps joints lubricated, muscles strong, and connective tissue flexible. Low-impact activities such as swimming, Pilates, yoga, or brisk walking are excellent for maintaining mobility without overloading joints.

2. Strength and resistance training
   Building or maintaining muscle mass around key joints — for example, quadriceps for knee support or gluteals for hip stability — can reduce stress on joints. Resistance bands, bodyweight exercises, or using weights can be highly effective.

3. Postural awareness and ergonomics
   Changes in posture or movement patterns can increase strain on certain joints. Osteopathic assessment can identify compensatory patterns and teach corrective strategies to offload stress.

4. Manual therapy
   Osteopathic treatment can help restore joint mobility, reduce stiffness, and relieve discomfort. Techniques may include soft tissue massage, myofascial release, gentle joint mobilisation, and functional movement retraining. The aim is to improve mechanics and support optimal function across the musculoskeletal system.

5. Lifestyle considerations
   Adequate hydration, balanced nutrition (especially calcium, vitamin D, and protein), and weight management are crucial for joint health. Avoiding long periods of inactivity or repetitive strain can also reduce discomfort.

When to Seek Professional Help

Persistent joint pain, swelling, or reduced mobility is not something to ignore. Early intervention can prevent minor stiffness from developing into more significant issues. Osteopathic assessment is particularly valuable because it considers the whole-body context: alignment, muscle balance, posture, and how hormonal changes may influence joint mechanics.

At Outline Health, we take a holistic, evidence-informed approach. For women experiencing perimenopausal joint discomfort, we combine:

• Thorough osteopathic assessment to identify movement and postural imbalances

• Individualised exercise and rehabilitation programmes

• Hands-on therapy to reduce stiffness and improve mobility

• Lifestyle and movement advice tailored to each stage of life

Our goal is to help you maintain joint comfort, mobility, and strength, so you can continue your favourite activities with confidence.

Joint discomfort during perimenopause is common, but it doesn’t have to limit your life. With early intervention, the right exercises, and targeted osteopathic support, you can maintain healthy joints well into your 50s, 60s, and beyond.

👉 Book your women’s health osteopathy appointment today and start moving with ease again.