Does your hip pain keep you up at night?
If you’re experiencing hip pain during perimenopause or after menopause, it may be related to hormonal changes. Reduced estrogen levels can increase your risk of developing a condition known as gluteal tendinopathy. Lower estrogen may also contribute to osteoarthritis, affecting various joints, including the hips.
While certain types of exercises can help alleviate symptoms, engaging in too much or inappropriate activity may worsen the condition. Even simple habits, such as how you sit or stand, can contribute to hip pain. Depending on the underlying cause, your hip pain may be particularly severe at night, and adjusting your sleeping position could provide relief.
Pain medications may help in some cases, but you might need a prescription for stronger options. Research also suggests that collagen supplements might improve symptoms of tendinopathy.
Menopause, Hip Pain, and Gluteal Tendinopathy
The primary cause of menopause-related hip pain is gluteal tendinopathy. Similar to many symptoms experienced during perimenopause and menopause, this condition is more common during this time due to hormonal fluctuations.
Gluteal tendinopathy results from strain on the tendons that connect your gluteal muscles (the muscles in your buttocks) to the top of your femur (the upper leg bone). The tendons attach at the broadest part of your hip, known as the greater trochanter. You may also hear gluteal tendinopathy called greater trochanteric pain syndrome (GTPS) or trochanteric bursitis.
This condition can occur due to overuse of your tendons, such as exercising frequently without adequate recovery time, or due to gradual strain from weight gain. It can also result from underuse, where a lack of movement causes the tendons to deteriorate and weaken. Additionally, a fall directly onto your hip or specific postures that pressure the tendons, such as standing with more weight on one leg or sitting with your legs crossed, may worsen the situation.
The tendons in your hips are constantly undergoing cycles of strain and repair. If they wear out faster than the body can repair, they will weaken and lead to pain.
Symptoms of Gluteal Tendinopathy
The main symptom of gluteal tendinopathy is pain on the outside of your hip or upper leg. However, this pain can radiate to other areas, including:
The side of your thigh down to the knee
The groin
The lower back
The buttock
The pain may worsen in specific situations and postures, such as:
Lying on the affected side
Walking uphill or climbing stairs
Standing on one leg
After prolonged periods of rest
Experiencing stiffness during the first few steps after standing
Engaging in activities that involve squatting
After impact exercises like running or jumping
Why Is Gluteal Tendinopathy More Common During Menopause?
The risk of developing gluteal tendinopathy increases with age, with 1 in 4 women over 50 experiencing this condition. While some of this may result from increased wear and tear, hormonal changes play a significant role.
As women enter perimenopause, levels of reproductive hormones like estrogen fluctuate and gradually decline. Estrogen is crucial for collagen production, the main component of tendons, including those in the hips. Lower estrogen levels make it harder for the body to replace collagen in the tendons and repair wear and tear.
Studies indicate that lower estrogen levels are linked to reduced collagen production, weaker and thinner tendons, and faster deterioration of tendon tissue.
Thus, menopause can exacerbate the strains that tendons already experience.
How to Treat Hip Pain from Gluteal Tendinopathy
Firstly, see an orthopedist for imaging and diagnosis.
Exercises to Strengthen Your Hip: See a physical therapist who can design a program of specific exercises that will help strengthen the muscles around your hip and gradually increase the load on your tendons. According to the NHS, exercises can take 6 to 12 months to alleviate gluteal tendinopathy symptoms.
Stay Active but Listen to Your Pain: Complete rest won't resolve gluteal tendinopathy, so staying active is essential. However, excessive exercise can worsen the condition. The NHS advises that "mild discomfort that eases after exercise" is acceptable, but regular "moderate to severe pain" may indicate overexertion. Short, flat walking can be a good alternative.
Massage, but Only in the Right Areas: Massaging your glutes might help relieve hip pain, but avoid massaging the painful area on your hip, as this could place additional pressure on the tendons and exacerbate the condition. It is best to see a professional for manual therapy.
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