“Menopause Joint & Muscle Pain: What Helps Beyond Exercise?”

If your body has started feeling stiffer, sorer or slower to recover through perimenopause or menopause, you're not imagining it.

In our first article in this series, Musculoskeletal Syndrome of Menopause: Why Does My Body Hurt?, we explored the emerging concept of Musculoskeletal Syndrome of Menopause (MSM) and why changes in oestrogen can affect our muscles, joints, tendons, connective tissues and bones.

We also looked at some of the foundations for supporting musculoskeletal health; strength training, regular movement, Qigong, adequate protein, anti-inflammatory foods, key nutrients and metabolic health.

But what if you're already in pain?

What if stiffness makes exercise difficult, your muscles constantly feel tight, or discomfort is affecting your sleep and ability to move?

This is where complementary therapies may have a role.

From something as simple as a hot water bottle through to acupuncture, massage and emerging technologies such as PEMF and photobiomodulation, there are many different ways we may be able to support comfort and function.

The aim isn't to replace movement.

It's to help make movement easier.

1. Heat Therapy: Simple Ways to Support Muscles and Joints

Have you ever noticed how much better your body feels after a warm shower, bath or sauna?

Heat is one of the simplest ways to help relieve muscular tension and stiffness. It can encourage blood flow, promote relaxation and make movement feel more comfortable.

And there are many ways to add heat, from a humble hot water bottle to more specialised therapies.

Hot Water Bottles and Heat Packs

Sometimes the simplest approaches are the most useful.

Applying gentle warmth to an aching lower back, stiff shoulders or tight muscles can provide short-term relief. Research into superficial heat therapy has found improvements in pain and disability, particularly for acute and subacute lower back pain.

I particularly like combining heat with movement.

Use warmth to make movement more comfortable, rather than using it as a replacement for movement.

Try a heat pack followed by a few minutes of gentle stretching or mobility exercises.

Warm Baths, Epsom Salts and Balneotherapy

A warm bath can be wonderfully therapeutic for tired, stiff or aching muscles. The combination of heat and water immersion can encourage relaxation, ease muscular tension and make movement feel more comfortable.

Research has also investigated balneotherapy — therapeutic bathing in warm, naturally mineral-rich water, often from thermal or hot springs. A systematic review of 12 randomised controlled trials found that balneotherapy may help reduce chronic lower back pain and improve function.

Of course, most of us don't have a therapeutic mineral spring nearby.

A simple at-home alternative is a warm Epsom salt bath. Epsom salts contain magnesium sulphate, and magnesium plays an important role in normal muscle and nerve function. Combined with the therapeutic effects of warmth and water immersion, it can be a lovely way to soothe tired muscles, relax at the end of the day and prepare the body for sleep.

Try following your bath with a few minutes of gentle stretching while your body is still warm.

Steam, Sauna and HOCATT

Steam rooms and saunas offer another way to introduce whole-body heat. Heat can encourage circulation, relaxation and temporary relief from muscular tension and stiffness, which may make movement feel easier.

HOCATT takes this a step further by combining steam heat with several other modalities, including ozone, carbonic acid and FSM.

Whether it's a steam room, sauna or a more specialised therapy such as HOCATT, heat may be a useful addition to a broader plan for supporting comfort, recovery and movement.

A Few Heat Therapy Precautions

More heat isn't necessarily better. Choose comfortable warmth rather than extreme temperatures, stay well hydrated and protect your skin when using heat packs or hot water bottles.

Extra care may be needed if you experience dizziness, low blood pressure, impaired temperature regulation or significant cardiovascular concerns.

And remember, heat is primarily a supportive therapy.

The goal isn't simply to feel better while you're warm, it's to reduce stiffness and discomfort enough to help you keep moving.

2. Hands-On and Practitioner Therapies

Sometimes pain and stiffness make it difficult to move well in the first place. This is where hands-on therapies may have a role, helping reduce discomfort, muscular tension and restriction so that movement becomes easier.

Traditional Chinese Medicine (TCM)

Traditional Chinese Medicine offers several approaches to musculoskeletal pain, including acupuncture and cupping.

Acupuncture has one of the larger evidence bases for chronic musculoskeletal pain. Research suggests it may help with conditions such as osteoarthritis, lower back pain and neck pain, potentially through effects on pain signalling and the body's own pain-modulating systems.

A large individual-patient meta-analysis involving almost 18,000 people found acupuncture was more effective than both sham acupuncture and no-acupuncture controls for chronic pain.

Cupping is another traditional therapy commonly used for muscular tension and pain. It uses suction to gently lift the skin and superficial tissues rather than applying downward pressure. A 2025 systematic review and meta-analysis found that cupping may reduce chronic musculoskeletal pain, particularly in the short term.

These therapies may be particularly useful when pain or muscular tension is making it difficult to sleep, exercise or move comfortably.

Massage and Other Soft-Tissue Therapies

Massage may help relieve muscular tension, improve short-term comfort and encourage relaxation.

There are also many different styles of hands-on treatment, including remedial massage, myofascial techniques and Bowen therapy.

Bowen therapy uses gentle, targeted movements over muscles and connective tissues, usually separated by short pauses. Some people find this particularly appealing when stronger massage feels uncomfortable.

Chiropractic and Osteopathy

Chiropractors and osteopaths may use a combination of joint mobilisation, spinal adjustments, soft-tissue techniques, movement assessment and exercise advice to address musculoskeletal discomfort.

The Goal: Make Movement Easier

Whether you choose TCM, massage, Bowen therapy, chiropractic or osteopathy, these treatments can be thought of as supporting movement rather than replacing it.

If a treatment reduces pain or stiffness enough that you can walk more comfortably, sleep better or return to strength training, that's where it may become particularly valuable.

The goal is to help your body move and function better.

3. Emerging Technologies: PEMF, Photobiomodulation and Whole-Body Vibration

Technology is also finding its way into musculoskeletal care, with researchers investigating ways to influence pain, inflammation, circulation, muscle activation and tissue recovery.

Three therapies I find particularly interesting are PEMF, photobiomodulation and whole-body vibration.

Pulsed Electromagnetic Field Therapy (PEMF)

PEMF uses pulsed electromagnetic fields to interact with tissues, with research exploring potential effects on pain, inflammation and cellular activity.

Much of the clinical research has focused on osteoarthritis, particularly knee osteoarthritis. Meta-analyses of randomised controlled trials suggest PEMF may help reduce pain and improve physical function, although results vary depending on the device, frequency, intensity and treatment protocol.

This is important because not all PEMF devices are the same.

PEMF may therefore be a useful adjunct for some women experiencing joint pain and stiffness.

Photobiomodulation (PBM)

Photobiomodulation uses specific wavelengths of red and near-infrared light to interact with cells and tissues.

One proposed mechanism involves effects on mitochondrial function and cellular energy production, which makes PBM particularly interesting from a cellular-health perspective.

Research has investigated PBM for a range of musculoskeletal conditions. A 2024 systematic review and meta-analysis of 10 studies involving 542 people with knee osteoarthritis found that PBM reduced pain at rest compared with placebo.

As with PEMF, wavelength, intensity, dose and treatment duration matter, so results from one type of device cannot automatically be applied to another.

Whole-Body Vibration

Whole-body vibration uses a vibrating platform to create rapid mechanical stimulation through the body, encouraging muscles to repeatedly contract and relax.

This one is particularly interesting for menopause because it has been studied specifically in postmenopausal women.

A 2024 systematic review and meta-analysis involving 13 randomised controlled trials and 783 postmenopausal women with osteoporosis found improvements in lumbar spine and femoral neck bone mineral density, along with reductions in pain.

Whole-body vibration may also support muscle activation, balance and postural control, making it an interesting adjunct for women wanting to maintain musculoskeletal function as they age.

It doesn't replace resistance training, but it may provide another way to challenge the muscles and bones.

Where Do These Technologies Fit?

PEMF, photobiomodulation and whole-body vibration are promising tools.

Research is continuing to determine which protocols work best, who is most likely to benefit and how these technologies compare with established treatments.

I see them as adjuncts to the foundations we discussed in Article 1 — strength training, regular movement, adequate protein, good nutrition and metabolic health.

Used appropriately, they may help reduce discomfort or support function enough to make movement and rehabilitation easier.

And ultimately, that remains our goal:

Build strength and keep moving.

Putting It All Together

One of the most important messages from this series is that there probably isn't one treatment for Musculoskeletal Syndrome of Menopause.

Musculoskeletal pain is complex.

Hormonal changes may be part of the picture, but so can muscle loss, previous injuries, inflammation, metabolic health, poor sleep, stress, reduced movement and changes within the nervous system.

This is why an individualised approach makes sense.

For one woman, a heat pack, Epsom salt bath and regular strength training may be enough.

Another may benefit from acupuncture or massage to help manage pain while rebuilding strength.

Someone else may explore PEMF, photobiomodulation or whole-body vibration alongside their exercise and nutrition programme.

You don't need to do everything.

Instead, ask:

What is stopping me from moving comfortably and confidently — and what might help me overcome that barrier?

Because the therapies we've discussed in this article shouldn't replace the foundations.

They should help support them.

When Pain Needs Further Investigation

While aches and pains become increasingly common through the menopausal transition, we shouldn't automatically blame every new symptom on menopause.

Persistent or unexplained pain deserves investigation, particularly if you experience significant joint swelling, redness or heat, prolonged morning stiffness, unexplained muscle weakness, neurological symptoms, severe night pain or rapidly worsening symptoms.

There may be other factors to consider, including osteoarthritis, inflammatory or autoimmune conditions, thyroid dysfunction, nutrient deficiencies, previous injuries and changes in bone health.

Understanding why something hurts remains an important part of deciding what to do about it.

Coming Next: Natural Support for Pain and Inflammation

Next week, we're going to take the conversation in another direction.

What about natural compounds for pain?

I'll be taking a closer look at palmitoylethanolamide (PEA), a naturally occurring fatty-acid compound that has attracted considerable interest in chronic and neuropathic pain research.

We'll also explore curcumin, one of the key active compounds found in turmeric, and what clinical research tells us about its potential role in joint pain and inflammation.

We'll look at where the evidence is strongest, how these compounds may work and where they may fit into a broader approach to musculoskeletal health.

Because pain during menopause may be common.

But common does not mean it's normal.

References

1. Wright VJ, Schwartzman JD, Itinoche R, Wittstein J. The Musculoskeletal Syndrome of Menopause. Climacteric. 2024;27(5):466–472. doi:10.1080/13697137.2024.2380363.

2. French SD, Cameron M, Walker BF, Reggars JW, Esterman AJ. Superficial heat or cold for low back pain.Cochrane Database Syst Rev. 2006;(1).

3. Bai R, Li C, Xiao Y, et al. Effectiveness of spa therapy for patients with chronic low back pain: An updated systematic review and meta-analysis. Medicine (Baltimore). 2019;98(37).

4. Merhi Z, et al. Ozone Sauna Therapy (OST) and Pulsed Electromagnetic Field Therapy (PEMF) delivered via the HOCATT machine could improve endometriosis pain along with lowering serum inflammatory markers. Am J Reprod Immunol. 2023;89(4).

5. Espírito Santo J, Moita J, Nunes A. The Efficacy of Manual Therapy on Musculoskeletal Pain in Menopause: A Systematic Review. Healthcare. 2024;12(18):1838. doi:10.3390/healthcare12181838.

6. Vickers AJ, Cronin AM, Maschino AC, et al. Acupuncture for Chronic Pain: Individual Patient Data Meta-analysis. Arch Intern Med. 2012;172(19):1444–1453.

7. Jia Y, et al. Effects of Cupping Therapy on Chronic Musculoskeletal Pain and Collateral Problems: A Systematic Review and Meta-analysis. BMJ Open. 2025;15.

8. Efficacy and Safety of the Pulsed Electromagnetic Field in Osteoarthritis: A Meta-analysis. BMJ Open. 2018.

9. Effectiveness of Photobiomodulation in Reducing Pain and Disability in Patients With Knee Osteoarthritis: A Systematic Review With Meta-Analysis. 2024.

10. Therapeutic Effects of Whole-Body Vibration on Postmenopausal Women With Osteoporosis: A Systematic Review and Meta-analysis. 2024.