Why your sciatica might flare up during peri/menopause - and what low oestrogen has to do with it

Have you ever noticed that nerve pain shooting down your leg just as you’re dealing with other menopause symptoms? You might think it's unrelated, but menopause can be sneaky like that. Sciatica, which many women experience, could be one of those unexpected symptoms showing up at the same time. But what does one have to do with the other? It turns out, quite a bit - and a key part of the puzzle is the hormone oestrogen.

For many women, the onset of menopause introduces new aches and pains in joints, bones, and nerves, particularly in the lower back and legs. Sciatica, that familiar pain radiating from the lower spine down the leg, could suddenly become worse, or even appear for the first time. The connection lies in how declining oestrogen levels affect our muscles, bones, and nerves.

What sciatica feels like—and why it's common in menopause

Sciatica is the result of irritation or compression of the sciatic nerve, the longest nerve in the body. This nerve runs from the lower back down each leg, and when something presses on it - like a herniated disc or a narrowing of the spine (spinal stenosis) - you might feel sharp, shooting pain, tingling, or numbness in the affected area.

But why does sciatica sometimes show up or worsen during menopause? This is where the conversation about oestrogen, bone health, and nerve sensitivity comes in.

The hidden role of oestrogen in pain and nerve health

Oestrogen does much more than regulate reproduction. It’s a multi-tasker, playing a role in bone health, muscle function, and even how we perceive pain. Here’s how low oestrogen levels could be influencing your sciatica:

1. Bone health: Oestrogen is crucial in maintaining strong bones. When levels drop during menopause, bone density declines, leading to conditions like osteopenia or osteoporosis. Weakening bones in the spine increase the risk of conditions like spinal disc degeneration, which can press on the sciatic nerve.

2. Muscle and joint function: Declining oestrogen levels can lead to a reduction in muscle mass and joint lubrication. Weakened muscles around the spine may not provide as much support, putting additional pressure on the discs and nerves.

3. Increased nerve sensitivity: Oestrogen helps modulate pain receptors, so when levels fall, nerves can become more sensitive to pain. This might explain why some women feel more intense nerve pain during menopause, such as sciatica.

Sciatica, inflammation, and menopause

Another less talked-about factor is the increase in inflammation during menopause. The hormonal changes that come with this life stage can trigger inflammation throughout the body, making conditions like sciatica worse. Inflammation can irritate the sciatic nerve or aggravate underlying issues, leading to more frequent or intense episodes of pain.

Additionally, menopause often coincides with other changes that don’t do your back any favours. Many women experience weight gain during this time, which places extra stress on the lower back and hips. This added pressure can exacerbate sciatic pain, especially if you're already prone to musculoskeletal issues.

How to manage sciatica during menopause

If you’re finding that sciatica pain is flaring up alongside other menopause symptoms, there are several approaches you can take to alleviate the discomfort:

1. Exercise: Even gentle, low-impact exercise like walking, swimming, or yoga can strengthen the muscles that support your back and reduce pressure on the sciatic nerve. Stretching and movement also help combat inflammation.

2. Physical therapy: A physical therapist can show you exercises to improve posture, strengthen the core muscles that support your spine, and reduce nerve compression.

3. Pain relief: Over-the-counter non-steroidal anti-inflammatory drugs (NSAIDs) can help manage the pain and reduce inflammation. In more severe cases, your doctor might suggest stronger medications or even injections.

4. Posture adjustments: Paying attention to your posture and ergonomics at home or work can make a big difference. Avoid sitting for long periods, and make sure your workspace is set up in a way that supports your spine.

5. Hormone Replacement Therapy (HRT): While HRT isn’t for everyone, it could be an option if your sciatica pain is linked to low oestrogen levels. By restoring oestrogen, HRT may help improve bone density and reduce nerve sensitivity, potentially offering relief.

Sciatica and menopause: when should you see a doctor?

If your sciatica doesn’t improve with these lifestyle changes or becomes so severe that it interferes with daily life, it’s important to seek medical advice. Persistent or worsening sciatica may need further investigation, such as an MRI, to determine if there’s a more serious underlying cause, like a herniated disc. Depending on the diagnosis, your doctor might recommend more intensive treatments, such as physical therapy, steroid injections, or in extreme cases, surgery.

A holistic approach to menopause and sciatica

Navigating menopause is challenging enough without the added pain of sciatica. The key to managing these two issues together lies in a holistic approach. By understanding how menopause can impact nerve pain, and making a few lifestyle adjustments, you can regain control over your symptoms.

Balancing oestrogen levels, maintaining an active lifestyle, eating anti-inflammatory foods, and caring for your bone health can go a long way in relieving pain and improving quality of life. If sciatica is impacting your day-to-day, remember that you're not alone, and solutions are available—don’t hesitate to explore different treatment options with your healthcare provider.