Can low testosterone cause joint pain?

This article was reviewed by Felix Gussone, MD.

Low Testosterone and Joint Pain: What’s the Connection?

Your knees, ankles, hips, and shoulders ache, and you don’t know why.

Joint pain can have many causes, from injury to arthritis — and we aren’t your doctor, so we can’t evaluate you. But if you have general joint pain with no obvious culprit, one potentially overlooked factor could be low testosterone. Sometimes called “low T”, low testosterone may influence pain perception, bone health, and joint function. So, how can testosterone and joint pain affect each other?

Testosterone is the main hormone (androgen) in the male body. You may know it plays a role in reproductive health and helps build muscle. But what you might not know is that there are testosterone receptors throughout the body, including in muscles, bones, and joints.

Because of these tiny receptors, low levels of testosterone can cause numerous problems, like modifying pain levels.

Keep reading as we take a deeper look at the connection between testosterone levels and joint pain, including why they may be linked and what you can do about it.

What Does Testosterone Do? Effects of Testosterone

Testosterone production primarily occurs in the testes in men, with smaller amounts produced by the adrenal glands. It’s the main androgen in the male body. This male reproductive hormone plays a role in maintaining several aspects of men’s health.

For testosterone to have an effect in the body, it needs to bind to receptors that allow it to take action. These so-called androgen receptors are found in almost every organ system, including:

• Muscles
• Bone tissue
• The brain
• Fat cells

Testosterone has many essential functions inside the body, such as:

• The development of the privates in the womb
• Triggering male puberty
• Maintaining body hair
• Increasing muscle mass and muscle strength
• Strengthening bones and increasing bone mineral density
• Increasing red blood cell production
• Supporting joint health
• Developing a deeper voice
• Helping burn fat
• Maintaining immune function
• Maintaining (libido)

Levels of testosterone tend to decline with age, starting from about your mid-30s. Having low testosterone is medically known as male hypogonadism.

Total Testosterone vs. Free Testosterone

If you get a blood test to measure testosterone, you may see that the results include “total testosterone” and “free testosterone.”

Free testosterone is all the testosterone in your blood that’s unbound to carrier proteins that your body can readily use. Total testosterone includes this and the testosterone bound to these carrier molecules.

What are normal testosterone levels in men? Our guide has answers.

Testosterone Deficiency and Joint Health

Can low testosterone cause joint pain? Some evidence suggests there might be a connection between the two.

Research consistently shows that testosterone protects against pain in males by limiting pro-inflammatory molecules like tumor necrosis factor α (TNF-α). Pro-inflammatory molecules tell the body to produce inflammation.

Additionally, in males, high levels of testosterone have been shown to increase pain threshold — meaning you’re less sensitive to pain. 

Increased pain related to movement (mechanical sensitivity) has been observed in male rats that produce abnormal testosterone levels. Yes, rat studies have limited application to humans, but they can help guide future human research.

Interestingly, in female rats, fluctuations in estrogen seem to increase pain intensity and perception. While human data are limited, observational studies in men support a link between low testosterone and higher pain scores, but causality has not been proven. Based on that theory, higher levels of testosterone in biological males may (at least partially) explain why they have a lower prevalence of chronic pain conditions than females. 

Along with potentially modifying pain sensitivity, low testosterone may be linked to a higher risk of certain conditions that can cause joint pain, like osteoarthritis, rheumatoid arthritis (RA), and fractures.

Osteoarthritis and Low Testosterone

Osteoarthritis is one of the most common joint disorders, especially in aging adults. It results from cartilage breakdown, inflammation, and wear and tear over time.

Studies suggest that low levels of testosterone may be related to the development of arthritis, but evidence is mostly observational.

Research suggests that low T may accelerate processes like inflammation and cartilage breakdown. And men with lower testosterone levels seem to have higher rates of osteoarthritis.

In a 2025 study, researchers looked at the relationship between osteoarthritis and testosterone levels.

Low testosterone levels were significantly associated with osteoarthritis risk in both males and females. Combined, the risk was reported as 22 percent higher in those with low testosterone. The risk was similar between genders.

In another study, also from 2025, researchers examined the relationship between total and free testosterone and the incidence of osteoarthritis and chronic pain in the knee and hand joints in males and females.

The researchers found that higher free testosterone and total testosterone were both significantly associated with a lower prevalence of knee osteoarthritis in males but not females.

Rheumatoid Arthritis and Low Testosterone

In autoimmune conditions like rheumatoid arthritis, the immune system mistakenly attacks joint tissues. Men with RA often show low testosterone levels. Some researchers believe this hormone imbalance contributes to how much pain and inflammation RA patients experience.

In a 2024 study, researchers looked at data from over 3,000 males in the United States. They explored whether testosterone and a protein it’s often bound to, SHBG, play a role in rheumatoid arthritis.

Of these men, 191 were diagnosed with rheumatoid arthritis, and low testosterone levels were associated with a 2.3 times increased risk of RA.

However, these findings are observational and don’t prove a causal relationship.

Testosterone and Fracture Risk

Lower testosterone levels have been linked to a higher fracture risk in aging men. Fractures near a joint are one potential cause of joint pain, along with related symptoms such as swelling and tenderness.

Researchers are continuing to evaluate whether testosterone replacement therapy (TRT) might help undo (or lower) the risk. But right now, it’s still unclear.

In one 2024 study published in the prestigious New England Journal of Medicine, researchers found that testosterone treatment didn’t result in lower fractures compared to a placebo in a group of men who:

• Were between 45 and 80 years of age
• Had preexisting (or a high risk of) cardiovascular disease
• Had one or more symptoms of low testosterone
• Had two morning testosterone concentrations of less than 300 nanograms per deciliter (ng/dL)

Learn more about testosterone replacement therapy in our blog.

Symptoms of Low Testosterone

The best way to find out if you have low testosterone levels (known as male hypogonadism) is through a blood test, ideally measured on multiple mornings. 

Normal ranges can vary slightly depending on the lab, but for adult men, a typical total testosterone range is roughly 300 to 1,000 ng/dL. The American Urological Association defines low testosterone as a total testosterone level of less than 300 ng/dL.

Symptoms of low testosterone can be subtle but may include:

• Low libido
• Infertility
• Mood changes, such as irritability
• Reduced muscle mass and strength
• Weight gain and higher body mass index (BMI)
• Fatigue
• ED
• Reduced quality of life

Low testosterone is formally diagnosed after two morning blood tests on separate days show low levels, and you experience signs or symptoms of deficiency.

Treatment Options for Low Testosterone

Low testosterone may be caused by a combination of factors, such as:

• Genetics
• Lifestyle habits
• Underlying medical conditions

Depending on the cause, a treatment plan may include:

• Hormone therapy, like testosterone replacement therapy
• Lifestyle changes, such as getting better sleep and increasing physical activity
• Treating underlying health conditions

If you think you might have low T, it’s a good idea to speak to a licensed healthcare professional for a proper evaluation and testing.

Testosterone Replacement Therapy (TRT) and Joint Pain

TRT involves taking a synthetic form of testosterone to help replenish hormone levels. If you have low testosterone, it may help improve aspects of your health, such as your:

• Energy levels
• Muscle strength
• Mood
• Drive

Common forms of TRT include:

• Injections
• Gels
• Patches
• Pills
• Pellets, which are placed under the skin by a medical professional and release testosterone slowly

Research is still ongoing to see if testosterone replacement therapy can help reduce chronic pain or conditions that can potentially lead to joint pain, such as fractures.

Other Causes of Joint Pain

Of course, hormonal fluctuations aren’t the only potential cause of joint pain. People experience pain for lots of other reasons (which may or may not be indirectly linked to low testosterone). This includes:

• Injuries, such as sprains, bursitis, or fractures
• Osteoarthritis
• Other forms of arthritis, such as rheumatoid arthritis
• Unexplained pain syndromes like fibromyalgia
• General myalgia (muscle pain) caused by infections such as the flu
• Joint infections
• Serious medical conditions like cancer

If you’re unsure of what’s causing your joint pain, it’s a good idea to talk to a healthcare professional for a proper evaluation, especially if you’ve recently had a traumatic injury such as a fall or car accident.

Lifestyle Changes for Joint Pain

Making lifestyle changes might help reduce joint pain, depending on the underlying cause. Here are a few ways you can support your joint health.

Physical Activity and Exercise

Regular physical activity can support both testosterone levels and joint health. Strength training can help you gain or maintain muscle mass, while weight-bearing exercises may help increase bone density and prevent osteoporosis.

If your joints are actively bothering you, get in touch with a healthcare professional before starting a new exercise program. They can tell you whether it’s safe and how to modify the workout if needed.

Nutrition and Supplements

Proper nutrition can help support hormone levels, muscle and bone health, and overall health. General tips include:

• Get plenty of protein, especially after exercising.
• Eat lots of nutrient-dense foods with anti-inflammatory properties like dark leafy greens.
• Aim to get enough vitamin D and calcium.
• Reduce your intake of ultra-processed foods, which often contain pro-inflammatory oils and low nutrient-density.
• Consider eating more fatty fish to increase your intake of omega-3s, or take a fish oil supplement.

Weight Management and Obesity

Obesity is a risk factor for low testosterone levels. It also places excess strain on joints, potentially contributing to or worsening joint pain.

Weight loss or maintaining a healthy body weight may help improve your hormone levels and joint health.

Joint Pain and Low Testosterone: Key Takeaways

Low testosterone and joint pain might be connected — at least indirectly. Men with lower testosterone levels may have:

• Greater pain sensitivity due to the activation of pro-inflammatory pathways
• A higher chance of overweight or obesity, which can put excess stress on joints
• A higher risk of conditions that can contribute to joint pain, such as osteoarthritis or bone fractures

Testosterone replacement therapy may improve muscle mass and bone health for some men. It’s unclear if it can reduce the rates of bone fractures in men with low testosterone, but research is ongoing. 

If you’re experiencing symptoms of low testosterone and joint pain, talk with a healthcare professional about your treatment options and natural ways to increase testosterone. Restoring healthy hormone balance may not only help you improve your joint health but also your overall well-being.

• Related: Testosterone Replacement Therapy: Benefits, Side Effects, and What You Need to Know
• Related: Does Testosterone Make You Gain Weight? How the Two Connect

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This article originally appeared on Hims.com and was syndicated by MediaFeed.org.