Aching Joints in Midlife - A Guide to Joint Pain
- Kate Costello, MS, CNS, LDN
- 2 hours ago
- 4 min read
I turn 38 this year, and as many of you know, I am deep in what I call “perimenopause prep.”
Right now, my prep looks like:
Tracking my cycle using Oura Ring and Natural Cycles
Running functional testing, including DUTCH
Taking daily supplements
Meditating and journaling every morning
Recently added daily spinal waves and joint circles for mobility and joint health
Perimenopause Joint Pain (and Menopause Joint Pain)
Joint pain in the midlife transition is incredibly common—and often under-discussed and under-studied. It’s estimated that over 50% of women experience arthralgia (joint pain), stiffness, or inflammatory joint symptoms during this transition.
Interestingly, the connection between menopause and joint pain has been recognized for nearly a century. Authors “Cecli and Archer wrote in their landmark 1926 article, ‘Arthritis of the menopause’, a subset of degenerative arthritis affecting women around age 52. Interestingly, some of its clinical features, such as early knee involvement, lumbar pain, Heberden’s nodes, and association with obesity, resemble those of OA” (Blumer, 2023).
It’s not lost on me that this was cited 100 years ago—yet treatment has largely remained symptom-focused rather than root-cause oriented!
Many of my clients describe stiffness or pain that seems to move between joints, or a general sense of feeling less mobile in their bodies.“Menopause-associated arthralgia is typically transient and self-limiting and may not present to a physician, but may be a source of persistent pain for a minority of women, or evolve into arthritis or chronic widespread pain in susceptible individuals” (Watt, 2018).
This often shows up as:
Morning stiffness
Achy knees, hips, or shoulders
Reduced mobility or flexibility
Slower recovery from workouts
New discomfort without a clear injury
Why This Is Happening
Estrogen receptors are not only present in bone (where they influence osteoblast and osteoclast activity), but also in:
Articular cartilage
Synovial membranes
Muscles
Ligaments
Tendons
Which means the entire musculoskeletal system is influenced by estrogen.
As estrogen declines, several key changes occur:
1. Increased Inflammation
Estrogen has anti-inflammatory effects. As levels drop, inflammatory signaling increases—leading to more joint sensitivity, stiffness, and pain.
2. Reduced Collagen & Tissue Integrity
Estrogen also supports collagen production and tissue repair. With less estrogen:
Collagen synthesis declines
Cartilage becomes less resilient
Tendons and ligaments lose strength and elasticity
Experimental studies show that estrogen plays a key role in regulating cartilage metabolism—this isn’t just about “feeling older,” it’s a true physiological shift in joint structure and function.
3. Sarcopenia as a Confounding Factor
Loss of muscle mass and strength accelerates during this life stage, further impacting joint stability and resilience.
“The mechanism of action is primarily due to an imbalance in muscle protein synthesis and breakdown, as well as the increase in catabolic factors such as inflammation and oxidative stress” (Blumer, 2018).
Less muscle support around joints means more load on the joints themselves—contributing to pain, instability, and injury risk.
My Daily Nutrition To Prevent Aching Joints
For joint health, I focus on a few foundational elements:
Protein → supports tissue repair and muscle maintenance
Anti-inflammatory foods → help reduce joint pain
Blood sugar stability → lowers cortisol-driven inflammation
Two of my go-to meals that combine all three:
Meal 1: 2 eggs + 2 oz smoked salmon + 2 cups arugula + ½ cup sweet potato + 1 cup berries
Meal 2: 1 cup plain Greek yogurt + 2 cups berries + 1 tbsp chia seeds + 1 tbsp hemp hearts + cinnamon
My Movement Practice
In January, I started a virtual self-study program with an incredible movement teacher named Shai. I practice on my own four times per week for about two hours each session.
Through this work, I’m learning self-discipline, slowing down, mindfulness, process over outcome, and coordination—but more importantly, I’m developing a profound awareness of where every joint, pain point, and old injury (both physical and emotional) lives in my body.
This practice is deeply joint-focused—wrists, elbows, shoulders, hips, knees, and spine—and emphasizes:
Slow, controlled movement
Full range of motion
Joint articulation
Nervous system regulation
The practice includes:
Spinal waves (from top and bottom)
Side spinal waves
Head, chest, and hip circles in all planes
Wrist, elbow, and shoulder circles
It’s a lot—and sometimes I feel a little dizzy after—but the changes have been incredible!
I no longer have low back pain. My shoulders and neck feel more at ease. My wrists don’t snap, crackle, and pop like they used to. My spine feels more fluid and responsive.
What I’m Learning (and What I Want You to Know!)
Spinal waves won’t bring estrogen back—but they do support how your body adapts to its decline.
To me, this falls under a simple principle: If you don’t use it, you lose it.
Movement is not just about exercise in this phase—it’s about maintaining joint health, circulation, coordination, and resilience.
I now consider this work a core part of my perimenopause prep. I want my joints to stay healthy, flexible, supported, and well-nourished with blood flow for years to come.
Because at the end of the day: I want this body—my body—to live well for as long as it’s meant to.
Check out this infographic on estrogen actions on target articular tissues.
References:
Blumer J. Arthralgia of menopause - A retrospective review. Post Reprod Health. 2023 Jun;29(2):95-97. doi: 10.1177/20533691231172565. Epub 2023 May 1. PMID: 37127408.
Roman-Blas JA, Castañeda S, Largo R, Herrero-Beaumont G. Osteoarthritis associated with estrogen deficiency. Arthritis Res Ther. 2009;11(5):241. doi: 10.1186/ar2791. Epub 2009 Sep 21. PMID: 19804619; PMCID: PMC2787275.
Watt FE. Musculoskeletal pain and menopause. Post Reprod Health. 2018 Mar;24(1):34-43. doi: 10.1177/2053369118757537. Epub 2018 Feb 7. PMID: 29412042.
Wluka, A. E., Cicuttini, F. M., & Spector, T. D. (2000). Menopause, oestrogens and arthritis. Maturitas, 35(3), 183–199. https://doi.org/10.1016/S0378-5122(00)00118-2
Kate Costello – MS, CNS, LDN: Kate’s experience with a severe nut allergy inspired her path as a nutritionist and wellness coach. She helps clients rebuild their relationship with food while navigating chronic health challenges, hormonal changes, and digestive issues. Her approach combines science and empathy, focusing on meaningful, lasting transformation through personalized nutrition and lifestyle guidance.
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