The Perimenopause Pain Alarm: Why Your Joint Pain Might be Neurological
As a woman in midlife, you are likely at the height of your career. You know how to lead, how to get results. You’re used to pushing yourself and until now, you’ve been able to trust your body to keep up. You have probably noticed that the things you’ve done in the past to feel your best, aren’t working so well. And the nagging pain in your hip. back, neck, shoulder don’t seem to be improving with intervention, but actually getting worse. You are not alone! 60-80% of women will experience joint pain during the perimenopause transition.
You are probably wondering, is this just how it is now?
If you are like most of the high performing women I work with, you’ve probably done all of the scans, the courses of PT, and dozens of tactics to mask the pain. Perhaps you’ve been told that “there’s nothing wrong” or that you’ve exhausted your options.
Though this pain is bewildering and frustrating this is definitely NOT just “how it is now”. Let help you understand here why the biomedical model has been failing you so that you can understand the real cause of your symptoms. Because you’ve likely addressed your joints and tissues, to no avail. Now it’s time to talk about perimenopause joint pain. Because a significant part of your pain issue lies not in the joint itself, but in the brain’s interpretation of signals.
Why the Alarm is Blaring: Menopause and Nervous System Regulation for Pain
As hormonal levels fluctuate dramatically during perimenopause, the nervous system can become sensitized. Think of it like a security light outside of your home. When it functions properly, the light only goes off when someone approaches the house. But imagine a light that is turning on for non-threatening objects, like your neighbors cat, or a leaf. Or, as is the case for many of my clients, for no reason at all. The light is flashing, responding to stimuli that are actually harmless. This is often described as neuroplastic pain, or central sensitization. And though it feels the same as acute pain, it’s actually very different and must be treated differently.
Estrogen plays a key role in dampening pain signals and regulating mood. As it drops, the body’s natural “sensitivity mechanism” for pain is essentially broken, similar to the security light example above. Your nervous system shifts into a state of “Overdrive,” interpreting everyday sensations as a threat. This leads to increased muscle tension, stiffness, and chronic, persistent aches that feel very real, but have no clear structural damage. Over time this can lead to a host of issues such as sleep disruption, brain fog, low energy, pain that spread inexplicably, and unfortunately loss of function and even disability. So even though the pain is in your nervous system, the consequences are very real.
The connection between menopause and nervous system regulation for pain is powerful. It means that the best solution isn’t always another X-ray or physical therapy session focused solely on the joint. Imagine that you changed the bulb on your rouge security light. Would that fix the fundamental problem that the mechanism is too sensitive? No! In the same way, more interventions to address your joints will not reduce your pain. But addressing the hypersensitive mechanism will.
The Somatic Solution: Signaling Safety to Your System
The good news is that we can teach your body and brain to recognize safety again. We can “down-regulate” this alarm through pain education, somatic movement and intentional mindset shifts. Evidence based pain care utilizes a variety of techniques that calm the system that is currently on high alert, help you embody comfort and confidence in movement, and allow you to return the full and active life that you deserve.
Here is one tiny somatic tip you can use immediately to signal safety to your brain:
Action Step: Shift into Relaxation
This is my favorite go to embodiment practice that will help you shift from the fight or flight that so many high performing women find them selves stuck in. In just 60 seconds, you can provide the physiological signal that your nervous systems need to shift into a rest and digest mode. Known as parasympathetic activation, it’s the nervous system platform that allows you to relax, sleep, be present and most importantly, heal.
Instructions:
- Observe, for a moment how you are feeling in your body. Soft, tight, wired, heavy etc…
- Take a ¾ deep inhale, without exhaling, take another short (but calm) inhale.
- Exhale as slowly as possible, as if you are exhaling through a cocktail straw. If you feel anxious, try a smaller inhale and imagine exhaling through a slurpee straw instead.
- Repeat for several breaths.
- Observe your body again. Does everything feel exactly the same? Or has anything shifted.
Do this practice a few times a day. Over time, your nervous system will develop more flexibility to activate and also to relax.
Could your pain be neuroplastic pain?
The first step to the relief you need is to determine if your pain is neuroplastic. Science tells us that most pain that has lasted beyond normal tissue healing time (3-6 months) is neuroplastic in nature. But it may be helpful to review a list of symptoms and signs to determine if a neuro-centric approach is right for you.