From Frozen Shoulder to Restless Legs, Your Menopause Joint Pain Is Real
By Sandra Rose Salathe (Published in Flow Space)
As women enter midlife, their ovaries gradually slow down and eventually stop producing estrogen, leading more than 47 million women worldwide into menopause each year. But this transition isn’t just about hot flashes and mood swings-it often brings a host of orthopedic challenges like frozen shoulder, joint pain, muscle loss and widespread body pain.
In fact, over 70% of these women will face musculoskeletal issues, and an astonishing 25% will become disabled by them as they progress from perimenopause to postmenopause. To address this, a recent study has introduced the term “Musculoskeletal Syndrome of Menopause (MSM),” a concept developed by Dr. Vonda Wright, an orthopedic sports surgeon, researcher, longevity expert and associate professor of orthopedic surgery at the University of Central Florida School of Medicine (UCF SOM).
Coining a new term
When women in their mid-30s to early 60s visit Wright’s clinic with complaints like unexplained shoulder pain, they often assume it’s just a sign of aging. However, Wright, who has delved deeply into the complexities of menopause, recognized the pattern which led her to author the study and coin an official term for it. So far, 70,000 people have downloaded the study, making it the number one downloaded article from the International Menopause Society’s website.
“Typically, when women in this demographic come in with shoulder pain, it appears to happen out of nowhere,” Wright tells Flow Space. “What they’re often experiencing is frozen shoulder, a condition that is exacerbated by inflammation caused by the loss of estrogen.”
This discovery is not new, as Wright points out; the connection between menopause and musculoskeletal issues like arthritis has been known for more than 30 years. Yet, it has largely flown under the radar in mainstream medical discussions. Women often report a host of symptoms-such as losing muscle mass, joint pain and overall body aches-that are all too often dismissed or misdiagnosed due to the sheer complexity of menopause-related changes.
Another recent study conducted in England found that women were forced to attend up to 10 doctor’s appointments just to get an official menopause diagnosis. Published exclusively by The Independent, the research revealed that nearly 5 million hours of general practitioner (GP) time are wasted annually on unnecessary menopause appointments, largely attributed to a lack of knowledge among healthcare professionals.
The problem could potentially lie with the array of conditions associated with menopause or hormonal changes, says Dr. Jennifer Lang, a board certified OB-GYN specializing in holistic gynecology and preventive oncology.
“You’re not sure if you should see a sleep specialist because all of a sudden you’re not sleeping well and exhausted in the morning,” Lang told Flow Space. “The list of conditions goes on: Should you see an orthopedic doctor because you have joint pain? Should you see a dermatologist because your skin is changing? Should you see a gastroenterologist because you feel like you’re digesting food differently? So, you have these symptoms that are not clearly being linked to each other, presenting in a way that sends women to different specialists.”
Estrogen’s critical role in musculoskeletal health
Wright emphasizes that estrogen is not just a hormone associated with reproduction-it plays a critical role in musculoskeletal health.
“Estrogen is vital for building Type 2 skeletal muscle [fibers], stimulating muscle protein synthesis and maintaining bone density,” she says. “When estrogen levels drop, as they do during perimenopause and menopause, the effects are profound. Cartilage, the smooth end cap of bones, begins to break down, leading to increased arthritis pain. The inflammation triggered by the loss of estrogen also contributes to conditions like frozen shoulder and total body pain, known as arthralgia.”
Moreover, estrogen is crucial for the replication of muscle stem cells, which keep our muscles youthful and strong. As estrogen declines, women may start to experience what Wright calls “musculoskeletal ageing,” which can lead to significant pain and mobility issues much earlier than commonly expected.
Early prevention and treatment
One of the key messages Wright wants to convey is that these changes begin much earlier than most women realize.
“We often think these problems are for older women in their late 50s and 60s, but in reality, the decline in estrogen and testosterone starts in our 40s, or even earlier,” she explains. “By the time women reach their 50s, when estrogen has essentially left the building, it’s critical to take action. Waiting until the 60s, when many insurance plans finally cover bone density scans, often results in irreversible damage.”
Wright’s mission is to empower women to take control of their musculoskeletal health earlier in life. This includes prioritizing weight-bearing exercises, lifting heavy weights and ensuring adequate protein intake during their 40s and beyond. Research shows that doing 30 to 60 minutes of strength training a week can lower your risk of premature aging, heart disease and cancer by 10 to 20 percent.
What’s more, dedicating an hour per week to lifting weights has been shown to prevent loss of muscle mass (sarcopenia), reduce the risk of falls and injuries, improve the function of joints, help ease pain and reduce the risk of heart attack or stroke.
From enhancing muscle mass and bone density to improving balance and mental well-being, strength training is a powerful tool that can significantly improve your quality of life. Wright also stresses the importance of making informed decisions about hormone replacement therapy, which can play a crucial role in mitigating the musculoskeletal decline associated with menopause.
A call for change
The nomenclatureof MSM is just the beginning. Wright hopes that by giving a name to this collection of symptoms, more women will be able to recognize and address them before they become debilitating.
She also calls for a shift in how the medical community approaches menopause-related issues, particularly in specialties like orthopedics, which is still predominantly male and often unaware of the nuances of female musculoskeletal health.
“I didn’t know what was happening when I was 40,” Wright reflects. “I was in the best shape of my life, but by 47, I thought I was going to die from the pain. Now, having gone through this journey, I feel younger and more capable than ever. My hope is that we can use this new understanding to help the next generation of women avoid the struggles that many of us have faced.”
With MSM now in the medical lexicon, Wright is optimistic that future generations, including her own daughters, will navigate midlife with greater knowledge, support and health.
“I’m excited that the word will become commonplaceand I’m very excited that we will be able to use it to help women like my daughter, who is turning 30,” Wright says. “I do not want the next generation to have to go through what we had to go through. So that’s the real hope of this.”
At Pain Spa, Dr Krishna is very experienced in managing persistent pain. Please email us for further details at clinic@painspa.co.uk if you are interested in having a consultation with Dr Krishna.