Menopause and musculoskeletal pain survey.

Why I wanted to conduct a survey into pain and menopause?

I’ve been an Osteopath for 30 years and in that time I have  treated people of all ages and huge variety of conditions, but my  recurring frustration continues to be the lack of understanding and research into the effect of the menopause on women's health and more specifically musculoskeletal symptoms, such as stiffness,  aches and pains. 

As part of my Continued Professional Development as an Osteopath,  I thought it would be interesting to perform a survey into the relationship between menopause and musculoskeletal pain. I reached out to women between 50 and 65 in my community and to my amazement 271 women responded.

I want to thank all the women that took part, your time and effort was important in the quest to understand menopause and its effects better.

I hope to share the results with fellow Osteopaths and other health professionals, but more importantly I want to share the preliminary result of the survey with the women who took part in the survey..

Survey results:

1. Age Range and Menopause Stages: The participants represented a wide age range within the 50-65 group, allowing for comparisons across different menopause stages, from perimenopause to post-menopause. This range offered a more comprehensive look at how MSK symptoms may progress over time

2. When asked about hormone replacement therapy (HRT), participants were divided nearly evenly between those currently taking HRT and those who had never taken it or had discontinued use. This 50/50 split offered a balanced perspective on the potential role of HRT in managing menopause-related MSK symptoms.

   
   

3. Self-Rated Health: Participants’ self-assessment of their overall health tended to decline with age, though the oldest participants were only 65. The study showed that perception of sense of health and wellbeing reduces with age. Sense of lack of wellbeing is significant and suggest that women need to be supported better as they transition through menopause and begin the ageing process

   In terms of overall health, the largest portion of participants experience ‘fair’ health, which indicates that there are issues that impede them feeling that their health is good or excellent. Some of that experience may be due to the normal ageing process, but some will be due to the menopause.

   
   

3. Impact of Menopause on MSK Pain: Most respondents attributed the onset or worsening of their MSK symptoms to menopause. Despite HRT’s known benefits for other menopause symptoms—like hot flashes and sleep disturbances—it did not appear to effectively address MSK pain, underscoring the need for alternative management strategies such as physical therapy, exercise, and lifestyle adjustments.

4. Pain experience and HRT status:

   Interestingly, It seems that being on HRT does not ‘protect’  from experiencing musculo-skeletal pain.

   HRT helps with many symptoms of the menopause such as hot flashes, brain fog, sleep disorders but perhaps MSK symptoms as might be expected. It may indicate that women need to look at other ways to manage MSK pain during peri-menopause and menopause such as exercise, physical therapy, diet and supplements.

5. Where do you feel most of the pain:

Heat map - Pain Location and age (the warmer the colour the higher the prevalence of pain)

Lower back, knees, hips, ankles and shoulders  are the most common pain locations.

Lower back pain is most common in pretty much all age groups, and tends to increase with age: (45-50 = 19, 51-55 = 23, 56-60 = 24) 

Low back pain increases with age and we see that in clinical practice too. Low back pain does not seem affected by being on HRT or not, so possibly strongly related to aging.

Shoulder pain seems most prevalent in the 51-55 year age group and we see a lot of ‘frozen shoulders’ and Rotator cuff tendinitis in females in that age group. The prevalence of shoulder pain in that group seems to indicate that aging isn’t the main cause of the pain. There is increasing feeling amongst physical therapists that ‘frozen shoulder’ and tendinitis of the shoulder are more common in menopause and there is some evidence that drop in estrogen increases inflammation and causes pain and reduction in movement.

Foot and ankle pain is also more common in the 51-55 year age group.

Hand and wrist pain increases with age, as does neck pain.

Hip pain is also most prevalent in the 51-55 year age group and there is some evidence that tendinopathies such as gluteal tendinopathy become more common in menopause and there is some evidence 

6. Does MSK pain impact your mental health:

   MSK pain during menopause also had a significant psychological impact, affecting participants’ mental well-being and quality of life. The findings suggest an urgent need for further research into the mental health effects of menopause-related MSK pain. Better support systems for women during this time are critical. More investigation into the effect of menopause on mental wellbeing is urgently needed so the needs of women during this time can be understood better. 

   
   

Conclusion:

The study highlights the high prevalence of MSK pain during menopause and underscores the inadequacy of existing treatments like HRT in addressing these symptoms. These findings will be shared in professional osteopathic and therapeutic publications to increase awareness and advocate for more comprehensive support and alternative treatment options for menopausal women experiencing MSK pain.