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They’ll send you home with activities to perform regularly and symptom patterns to watch for between sessions. These activities are designed to help you better tolerate day-to-day activities and teach you how to manage symptoms on your own.

If you’re not sure how to describe your pain, try keeping a symptom tracker for about a week before your first appointment to give them the best information possible. Your physical therapist will check in on symptoms every session, so keeping the tracker during your rehabilitation is helpful.

Regular exercise can help your spine stay strong and flexible through menopause, making it less likely that you’ll have back pain. Exercise guidelines recommend:

• Endurance activity — At least 150 minutes per week of moderate-intensity exercise or 75 minutes of vigorous endurance exercise, like walking or jogging
• Strength training — At least two days per week of moderate to high-intensity muscle-building exercise, like lifting weights or using resistance bands

Research suggests that postmenopausal women benefit most from weight-bearing endurance workouts and resistance exercises.

In other words, prioritize exercises that challenge your muscles and make your body work against gravity. These exercises help build bone and prevent spinal fractures better than nonweight-bearing activities, like swimming and biking.

You can start prioritizing these exercises now to manage discomfort and prevent future spine-related issues.

But what about exercise if you already have back pain? Talk with a physical therapist or a personal trainer about a safe exercise plan for you. Exercise therapy for low back pain has been shown to reduce pain and get people back to their usual activities faster.

Many ThisIsMenopause members report problems sleeping. “I can’t stay asleep. Sometimes I wake up too early and stay awake,” wrote one member. Others say they have trouble falling asleep. Poor sleep and tossing and turning in bed can make fatigue and low back pain worse.

Research shows that people who don’t sleep well are at greater risk for having back pain and for it taking longer for that back pain to go away.

Poor sleep and constant back pain are a cycle: when you can’t sleep well, your pain tolerance decreases, which affects how well you can sleep. You can break this cycle by improving your sleep hygiene, which means making small changes during the day to help you slumber at night.

Consider applying one or two of these changes first to see if they help:

• Set a schedule — Try going to bed and waking up at the same time every day, aiming for seven to nine hours of sleep. Add a wind-down routine that helps you relax, like a skin care ritual or reading a chapter of a good book.
• Avoid screen time — Remove screens from your bedroom unless you’re using them for guided meditation or calming sounds.
• Exercise early — Do your exercise earlier in the day. Physical activity, especially in the sun, is a good way to support a natural sleep cycle, but doing it too late can make some people restless at bedtime.
• Watch caffeine intake — Drink your coffee in the morning and avoid it later in the day. Drinking liquids in the evening may lead to more bathroom trips, while caffeine can make it harder to fall asleep.

If you’re struggling with getting good rest, talk to your healthcare provider about additional ways to improve your sleep.

Perimenopause is a new and sometimes overwhelming phase of life. “I’m stressed because I don’t feel good, I’m in pain, and I can’t seem to understand my body,” wrote one ThisIsMenopause member. Other life factors, like moving or caregiving, can add more emotional (and physical) load.

Stress can cause the same cycle as sleep problems. Not only is managing back pain stressful, but the stress can also make you more sensitive to pain.

Ask your doctor for mental health resources, including a referral to a psychologist. They can teach you ways to cope with stress and anxiety, which may help lower pain levels. Also try mind-body strategies, like meditation or yoga, to help you feel calmer.

If you’re not getting relief from lifestyle adjustments, it may be time to talk to your doctor about pain medications. Your doctor may suggest over-the-counter medications, including nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen. Be sure to ask how much medication to take and for how long.

Growing research is exploring if menopause hormone therapy (hormone replacement therapy) can help manage pain during menopause. The theory is that replacing estrogen can help improve inflammation and curb muscle and bone loss, which could decrease musculoskeletal pain. There is controversy over whether menopause hormone therapy may prevent or treat osteoarthritis, a frequent cause of menopausal back pain.

Health experts aren’t sure how well hormone therapy works for pain management, but it’s worth discussing with your doctor.

When To Talk to Your Healthcare Team

If you’re experiencing new or worsening back pain during perimenopause, don’t wait to talk to a doctor. They can rule out serious causes of back pain. They can also help you start addressing symptoms, so you can take back control over your body.