Menopause Back Pain: Helping to Ease the Burden

By Christina Hanna, MPH, CHES • Published 7/18/2023

Medically Reviewed by MD, OB-GYN

woman with menopause experiencing back pain

As you know, menopause brings about many changes in the body. Alongside the commonly known symptoms like hot flashes and mood swings, menopause can also influence the arrival or worsening of joint pain, including chronic back pain. Many people 40+ complain of back pain, but this is an often-overlooked menopause symptom that we don’t often associate with the hormonal changes happening.

We know that estrogen plays a role in maintaining bone density and supporting the health of tissues surrounding the spine. As levels of estrogen decrease, it can increase the likelihood of experiencing chronic back pain. In studies around the world, the percentage of perimenopausal/menopausal people experiencing low back pain ranges anywhere from 34% to 83%. Regardless of the percentage, the majority of studies showed an increase in back pain during perimenopause. Some studies have also shown that those with an increased number of symptoms are more likely to have back pain associated with menopause.

Can menopause cause back pain? 

The link between menopause and chronic back pain is complex and has many factors. There are several changes in the body that occur because of hormonal changes that can contribute to chronic back pain.

Changes to musculoskeletal system

Hormonal changes can have a direct impact on the musculoskeletal system, which could lead to chronic back pain. Estrogen helps maintain the integrity and strength of bones in the spine. As estrogen levels decline, bone loss can occur, resulting in conditions such as osteoporosis. These conditions weaken the spine, making it more susceptible to chronic pain, stiffness, and discomfort.

Disc degeneration, which is the breakdown of your spinal disks, is also tied to the loss of estrogen. The spinal disks are rubbery cushions that sit between the vertebrae in the spine. They cushion the spine and prevent the bones from rubbing together, which can cause pain.

Changes to body fat distribution

The hormonal fluctuations during menopause can affect the distribution of body fat. Many people experience weight gain, particularly around their middle, during perimenopause/menopause. There is an association between higher body mass index (BMI) and increased back pain. Carrying weight in different parts of your body than you used to could lead to an altered posture and increased strain on the lower back. This change in body composition can make existing back pain worse or contribute to new pain symptoms.

Changes to muscles and joints

Menopause can also affect the muscles and joints, further contributing to chronic back pain. As estrogen declines, muscle mass may decrease, leading to weakened core muscles that support the spine. Weak muscles can affect spinal alignment, causing strain and tension on the back muscles.

Estrogen helps maintain the elasticity and lubrication of joints, reducing friction and helping with smooth movement of the joints. As estrogen decreases, joints may become stiffer, less flexible, and more prone to inflammation. All these could worsen chronic back pain.

woman in living room with her dog doing balance exercise during yoga to help improve menopause chronic low back pain

How can I manage menopause back pain?

There are several strategies to effectively manage menopause-related chronic back pain. As always, talk to your doctor if you have any questions or concerns.

Exercise and strength training

Regular physical activity can help increase bone density of the spine. Especially important are aerobic, strength, and balance exercises. Increased exercise can also be helpful in weight management, which can contribute to low back pain.

Some people may find it helpful to see a physical therapist or exercise specialist who can help personalize exercise programs targeting improving back pain. Exercises that help strengthen the pelvic floor and abdominal muscles can also help stabilize the lower spine. Exercise routines that include lots of stretching and muscle-strengthening activities can be helpful for chronic low back pain.

Those in pain often avoid extra movement, worried that it can worsen their pain. However, while it may be painful to get started, exercise is an important element of managing pain and may help improve how you feel.

Work towards and maintain a healthy weight

Excess weight gain can put additional strain on your back. A balanced diet and engaging in regular exercise can help you work towards a healthy weight. Talk to your doctor about what that might look like for you.


Entering postmenopause with a healthy level of vitamin D may help future back pain. In a study of 60–85-year-olds, they found that those with a vitamin D deficiency reported more back pain, more severe back pain, and more fractures. You can talk to your doctor about your vitamin D levels and whether changes to your diet or supplements may help. Food sources that contain high levels of vitamin D include fish (especially rainbow trout, salmon, and tuna), mushrooms, soy and almond beverages, milk, and yogurt.

Proper body mechanics

Practicing good body mechanics can help prevent back pain. Body mechanics refers to how we hold our bodies while we sit, stand, lift, carry, bend, and sleep. Examples of things to pay attention to are correctly lifting heavy objects, maintaining a neutral spine, and avoiding long sessions of sitting or standing.

Pain management techniques

There are many different ways to help manage the pain you may be feeling. You might consider heat or cold therapy. Or you may find some relief with over-the-counter pain relievers (like acetaminophen or nonsteroidal anti-inflammatory drugs (NSAIDs)). Some people also find temporary relief from complementary therapies like massage or acupuncture.

Menopausal hormone therapy (MHT)

In certain cases your doctor may consider prescribing MHT to help ease menopause symptoms, including back pain. MHT has been shown to help with menopause-associated osteoarthritis, but the evidence is mixed on whether it can help with back pain.

Menopause is a transformative phase of life that can bring about various changes, including chronic back pain. Understanding the hormonal and physical changes involved can help you prevent and manage that pain.

Last Updated 2/15/2024



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