Menopause and Back Pain: What's the Link?

Hormones and vitamin D play a role.

Peer Reviewed

Menopause: Hot flashes, mood swings, trouble sleeping, changes in libido. A drop in levels of the hormone estrogen causes all those “fun” symptoms. But falling estrogen levels can also tank levels of vitamin D, which can be downright painful if you don’t address it.

Menopause and back painFalling estrogen levels from menopause can make you more susceptible to back pain.

A February 2020 study in Menopause explored the relationship between low back pain and menopause. The authors wrote that vitamin D deficiency is related to increased severity of lower back pain and degenerative disc disease in postmenopausal women.

What is Degenerative Disc Disease?

In between each vertebra of the spine are fibrous discs that act as shock absorbers for the spine. Discs also function to support and stabilize your spine, allowing you to move more freely and maintain pain free movements. The health of your spine is an essential part of your well-being and provides the freedom to bend, lift, twist, and do your normal activities without pain.

Over time, these discs begin to dry out and lose some of their flexibility and elasticity. Discs drying out (called desiccation) is a natural process that happens with aging and does not always result in symptoms. They become thinner and less able to absorb shock, which may lead to pain and stiffer movements. This loss of elasticity and height in the discs is called degenerative disc disease

Stenosis and Compression

When you have degenerative disc disease, sometimes your body tries to compensate for the loss of stability by trying to produce more bone to stabilize the spine. These bone growths, called bone spurs or osteophytes, may crowd the spinal canal, a condition called stenosis. Stenosis can put pressure on the nerve roots that branch off the spinal cord. Symptoms of this compression may manifest as a pins and needles sensation, muscle spasms, reduced sensation to touch, weakness and pain, either in the back or radiating down the arms or legs.

Spinal stenosis osteophytesAbnormal bone growths can crowd the spinal canal and compress nerve roots, a condition called stenosis.

Treatments for degenerative disc disease include therapy and surgical options. Many cases are treatable without surgery through physical therapy, occupational therapy, exercises for strength and flexibility, injections, and supplements. In cases that don’t respond to conservative treatments, surgery may be considered to make more room in the spinal canal, relieve nerve compression and reduce pain.  

What Is Vitamin D and How Does It Affect Bone Health?

Vitamin D is a fat-soluble vitamin that has multiple functions in the body. Vitamin D is produced by your body after exposure to sunlight, and can also be found in certain foods and supplements. One of the main functions of vitamin D is to support bone health.

The body needs vitamin D to absorb calcium and phosphorus, both of which are essential for bone production. Calcium is stored within the bones. When the body is deficient in calcium, it breaks down your bone to pull the calcium back into the blood. Without adequate Vitamin D, the body is not able to absorb enough calcium to prevent this bone breakdown.

Vitamin D deficiency at an early age can lead to low bone density and diseases such as rickets, osteopenia, and osteoporosis. Osteoporosis is a condition where the bone gradually weakens and more easily breaks. Osteoporosis can cause painful vertebral compression fractures, where the vertebrae crack because the bone tissue is no longer strong enough to support the body’s weight and fight gravity.

Osteoporosis of the spineOsteoporosis makes vertebral bones porous and spongy.

Two of the main causes of osteoporosis include nutrient deficiencies and hormone imbalances, such as lower estrogen production after menopause. Adequate vitamin D intake, along with calcium, is essential for preventing and reducing bone loss that could lead to osteoporosis and increased lower back pain.

How Does Estrogen Affect Bone and Spine Health?

Estrogen plays a role in both male and female bone health. It promotes the activity of osteoblasts, which are the cells in the body that produce bone. Estrogen helps slow the breakdown of bones and encourages bone growth.

Because of this, drops in estrogen levels over time compromise the health of bones. People with chronic hormone imbalances and postmenopausal women are both frequently affected by bone disease such as osteoporosis and osteopenia (a precursor to osteoporosis). Studies show that the risk of developing osteoporosis is higher in postmenopausal women. Lower estrogen levels lead to the loss of bone density over time.

Estrogen also helps to maintain tissues that contain collagen, which can be found in intervertebral discs. Research has associated the lower estrogen levels that follow menopause to more severe lumbar disc degeneration and increased lower back pain in women when compared to men of a similar age.

The associations found in these studies demonstrate the importance of monitoring changes in lower back pain for women after menopause.

How Does Vitamin D Affect Discs?

According to a study published in Menopause, there is a relationship between increased low back pain in postmenopausal women and severe vitamin D deficiency. Using supplements to correct a vitamin D deficiency may help to reduce your low back pain and promote bone health.

Vitamin D and bone healthYou can get vitamin D from the sun, food or supplements.

Studies suggest postmenopausal women are especially at risk for vitamin D deficiency. Vitamin D and calcium supplementation can be used in combination for treating osteoporosis and low back pain from degenerative disc disease. It can stop the breakdown of bone and promote the strengthening of bone tissue to reduce back pain over time.

"Low back pain due to degenerative disc disease is nearly ubiquitous in patients over age 65," says Choll W. Kim, MD, PhD, an orthopaedic surgeon at Spine Institute of San Diego.  "This is in addition to the risk of bone fractures due to osteoporosis, which often require surgery. It is important to remind healthcare professionals and patients that these major health concerns can be helped through simple vitamin supplementation, exercise, and a healthy diet."   

You can slow down bone loss with tactics ranging from changing your diet to prescription medication. Check out these tips for treating osteoporosis nonsurgically.  


Updated on: 05/07/20
Continue Reading
Soy Foods May Build Better Bones in Early Menopause: True or False?
Alan H. Daniels, MD
Choll W. Kim, MD, PhD
Continue Reading:

Soy Foods May Build Better Bones in Early Menopause: True or False?

A diet rich in soy with isoflavones may provide beneficial effects on bone health in older women, according to results of a recent study.
Read More