Joint pain: Why it’s worse for women

Published September 2024 | 6 min read 
Expert contributors Dr Sam Whittle, president, Australian Rheumatology Association; Adnan Asger Ali, musculoskeletal and pain physiotherapist, Australian Physiotherapy Association (APA)  
Words by Beth Wallace 

If your creaky ankles, knees or hips make everyday tasks a challenge, here are some simple ways to ease your joint pain and get your life back on track. 

Joint pain, including joint pain from osteoarthritis, affects millions of Aussies every year – the majority of them women. It can be debilitating and can make daily activities challenging. Even climbing stairs, dressing or getting out of bed can become tough.  

Often felt in the elbows, wrists, shoulders, base of the spine, knuckles, hips, knees or ankles, joint pain falls into two main categories: acute and chronic. Acute joint pain can be brought on suddenly by injury, overuse or by an infection or illness, and doesn’t typically last long. Chronic joint pain, on the other hand, doesn’t go away quickly. 

What causes chronic join pain?

One of the many rheumatological conditions that cause chronic joint pain is arthritis, which impacts around 17% of female Aussies, compared with 12% of males.

There are more than 100 varieties of arthritis, with some of the most common being:

• osteoarthritis, which contributes to damage of the whole joint, including bone, cartilage, ligaments and muscles
• rheumatoid arthritis, where your immune system attacks healthy tissues, commonly targeting the lining of the joints
• ankylosing spondylitis, in which the joints of the neck, back and pelvis (and sometimes other parts of the body) become inflamed
• gout, which occurs when small crystals form in and around the joint, leading to inflammation, pain and swelling.

While it’s not known what causes many forms of arthritis, there are several risk factors that increase your chances of developing it, with menopause, genetics, family history, age, excess weight, insufficient physical activity, joint injury or strain and unhealthy behaviours like smoking all potentially playing a part.

Does joint pain affect women more?

Many of the common forms of arthritis tend to affect women more than men, especially knee osteoarthritis, says Dr Sam Whittle, president of the Australian Rheumatology Association. In 2019, studies showed there were 5,731 cases of knee osteoarthritis in Aussie women, as opposed to 4062 cases in Aussie men.

“The reasons for this remain unclear but there are likely to be a number of complex factors including genetic, immunological, anatomical and societal contributors,” he explains.

For example, researchers from the University of Alberta have identified a genetic difference in the meniscus (a kind of cartilage in the knee that acts as a load distributor for the body’s weight), which makes about 50% of females more vulnerable to knee osteoarthritis.

Moreover, it’s estimated more than 50% of women experience arthralgia (joint pain) or arthritis during menopause, likely due to a decline in oestrogen, which normally keeps inflammation at bay.

Another cause of joint pain, lupus, also disproportionally affects women; of those who have the condition, nine out of 10 are female. Like rheumatoid arthritis, it occurs when your body’s immune system attacks healthy tissues and organs, leading to inflammation and damage to the skin, joints, kidneys, heart, lungs or brain. Again, the underlying cause is unknown, though it’s most likely triggered by a combination of genetic, hormonal and environmental factors.

Relieving joint pain through exercise

While you can usually treat acute joint pain using the PRICE method (Protect, Rest, Ice, Compress, Elevate), one of the best ways to alleviate chronic joint pain is to maintain an active lifestyle, suggests Adnan Asger Ali, an Australian Physiotherapy Association (APA) musculoskeletal and pain physiotherapist.

“Sometimes pain can limit people, but it's important to focus on what you can do, not what you can't do,” he says.

Walking, cycling, swimming, Pilates, yoga and tai chi can be low-intensity exercises that are gentle on your joints. Similarly, resistance and strength training increase muscle mass as well as bone mineral density, which helps protect your bones and joints.

“But really, the overarching theme is keeping active throughout your lifespan,” says Adnan. “Sometimes it might mean that you change how you do a certain activity and working with your physio is important to find tips for working around your current issue.”

A holistic approach to joint pain relief

Just as maintaining a healthy weight contributes to your overall wellbeing, it’s also a key factor in managing joint pain. When it comes to overweight and obese adults with knee osteoarthritis, for every 1kg of weight loss, four times that amount of pressure is removed from the knees.

Likewise, a few diet tweaks can relieve joint pain stemming from specific conditions.

For example, foods that contain omega-3 fats, like oily fish, linseeds and linseed (flaxseed) oil, canola (rapeseed) oil and walnuts, have been found to reduce the inflammation associated with some forms of arthritis. And menopausal and perimenopausal women are sometimes advised to take magnesium supplements to reduce inflammation.

Beyond maintaining a consistent exercise regimen and a healthy diet, people with joint pain are encouraged not to smoke (with tobacco smoking linked to an increased risk of joint disease) and get a good night’s sleep, as poor sleep can make your symptoms worse.

Evidence also suggests various mind-body therapies can help manage persistent pain.

One study found that cognitive behavioural therapy (CBT), a form of psychological treatment, offers a promising alternative or complementary intervention for patients with knee or hip osteoarthritis, especially against pain and insomnia.

Plus, Arthritis Queensland suggests relaxation techniques like deep breathing, progressive muscle relaxation (PMR) and meditation can help manage stress and consequently lessen arthritis symptoms.

How is joint pain treated?

The treatment approach for joint pain will depend on the cause. Osteoarthritis, for instance, isn't directly related to inflammation in the joints, so the treatment is different to inflammatory and autoimmune forms of arthritis, says Dr Whittle.

“Unfortunately, we still don't have a treatment that can cure or reverse osteoarthritis, but there are a number of treatment strategies that may be effective, including exercise, weight loss and some medications,” he explains.

Musculoskeletal Health Australia says the most common types of medications used to treat arthritis include:

• pain relievers (or analgesics)
• creams and ointments 
• non-steroidal anti-inflammatories (NSAIDs)
• corticosteroids
• disease-modifying anti-rheumatic drugs (DMARDs)
• biologics and biosimilars (bDMARDs).

In extreme cases of osteoarthritis, surgery may be considered “at the end of the treatment spectrum”, says Adnan, when patients haven’t responded to other approaches.

When surgery is recommended, eligible members^* can access HCF’s No-Gap Joints program, which gives you access to primary hip and knee replacements with no out-of-pocket costs through participating private hospitals and clinicians in NSW and Victoria.

When to seek help for joint pain

According to Adnan, it’s time to see a healthcare professional when your joint pain starts interfering with day-to-day activities.

“That’s when you’d get a physio to do an assessment, find your impairments and come up with a plan collaboratively to get you back to what you love doing,” he says.

If joint pain and swelling are left untreated, it can lead to irreversible damage, so it pays to seek treatment as soon as possible, adds Dr Whittle.

In particular, he encourages people with symptoms that might suggest an inflammatory form of arthritis – like swelling, stiffness in the joints each morning that lasts for 30 minutes or more, or other symptoms like a rash, fever or unexplained weight loss – to see their GP as soon as possible.

And, if you’re ever unsure about a diagnosis, or just want reassurance that your condition is being managed correctly, eligible members can access a free, confidential second opinion through HCF’s Second Opinion service^{^}.

A helping hand with your nutrition

If you’re wanting to reset your eating habits to effectively manage your weight, we can help. Eligible members can get free access to our Osteoarthritis Healthy Weight for Life program to help reduce the pain and burden on your joints, increase mobility, and improve your overall quality of life. This program is available to members who are overweight and have osteoarthritis⁺.