18/10/2025
💡 Understanding Musculoskeletal Syndrome in Menopause
As oestrogen levels decline during perimenopause and menopause, many women experience what’s now recognised as menopausal musculoskeletal syndrome — a combination of joint pain, muscle stiffness, reduced flexibility, and loss of strength that affects daily movement and quality of life.
🔍 Why it happens
Oestrogen plays a crucial role in maintaining the health of muscles, joints, and connective tissues. When levels fall:
• Joint cartilage becomes thinner and less hydrated → increasing stiffness and wear.
• Muscle mass and strength decline faster → known as sarcopenia.
• Tendon elasticity and ligament support reduce → leading to higher injury risk.
• Bone density decreases → raising the risk of osteopenia and osteoporosis.
• Inflammatory responses in joints and soft tissue can increase → contributing to pain and swelling.
These changes can manifest as:
• Generalised aches and stiffness (especially in the morning)
• Shoulder, neck, knee, hip, and hand pain
• Low back pain or sciatica-type symptoms
• Fatigue, poor posture, or reduced balance
• Reduced confidence in movement or exercise
How physiotherapy helps
Physiotherapy plays a key role in preventing and managing these symptoms.
A tailored plan may include:
• Targeted strengthening to maintain muscle mass and joint support
• Postural correction and mobility work to ease stiffness
• Manual therapy to reduce pain and restore joint movement
• Bone health advice – including safe resistance and weight-bearing exercise
• Education and movement confidence – supporting an active, pain-free lifestyle
💬 Key message
Menopause is a natural transition, but musculoskeletal discomfort doesn’t have to be accepted as “normal.” With the right physiotherapy, women can maintain strength, mobility, and comfort well into midlife and beyond.
