The pelvis is made up of two bones (hemipelvis). The pubic bone, scientifically known as the symphysis pubis, is in reality two bones held together by cartilage. The pain can affect a particular spot, or it may be felt in a wider area, including the clitoris, the perineum, the mons pubis, and the inner thighs. The main symptom is usually pain or discomfort in the pelvic region, usually centered on the joint at the front of the pelvis (the pubic symphysis). Therefore, it is considered advisable to discuss any pain relief medications with a physician, and cease taking any opiates 2–4 weeks before the estimated due date, as advised by a medical professional. Pain can radiate to the abdomen and to the thigh. SPD usually resolves for most pregnant people after delivery, with most returning to normal function by 6-12 months postpartum. Dysfunction and pain of the pubic symphysis is also called pelvic girdle pain. SPD has several possible causes, the most common of which is pregnancy. Symphysis pubis dysfunction (SPD), or pelvic girdle pain (PGP), happens when the ligaments that normally keep your pelvic bone aligned during pregnancy become too relaxed and stretchy soon before birth (as delivery nears, things are supposed to start loosening up). Typical advice usually given to people with SPD includes avoiding strenuous exercise, prolonged standing, repetitive reaching movements, lunges, stretching exercises and squatting. Osteomyelitis pubis should be suspected in patients with acute onset of pubic symphysis pain, fever and systematic involvement. The most common symptoms are difficulty when walking and wrenching pain (as though your pelvis is tearing apart). This is less painful if the pelvis is … Sufferers frequently also experience pain in the lower back, hips, groin, lower abdomen, and legs. Symphysis Pubis Dysfunction (SPD) The pubic symphysis is the joint where the two sides of the pelvis meet in the front, right underneath where your pubic hair grows. A diagnosis is usually made from the symptoms, history, and physical exam alone. "Symphysis Pubis Dysfunction (SPD) in Pregnancy", http://www.pelvicpartnership.org.uk/3208.html, "A Systematic Review of Dextrose Prolotherapy for Chronic Musculoskeletal Pain", "Antenatal care (NICE clinical guideline 62)", "Pregnancy-related symphysis pubis dysfunction management and postpartum rehabilitation: two case reports", Pelvic Partnership (2008) About SPD: A leaflet about Symphysis Pubis Dysfunction and its Management, Crichton, Margaret A. and Wellock, Vanda K. (2007) Understanding pregnant women's experiences of symphysis pubis dysfunction: the effect of pain (Royal College of Midwives Evidence Based Midwifery), BBC Radio 4 - Woman's Hour Health Archive, 21 May 2004, https://en.wikipedia.org/w/index.php?title=Symphysis_pubis_dysfunction&oldid=944419407, Pathology of pregnancy, childbirth and the puerperium, Articles with unsourced statements from April 2017, Creative Commons Attribution-ShareAlike License, Brace the transverse abdominis (lower abdominal muscles) before performing any activity which might cause pain, Sit down for tasks where possible (e.g. Mid pregnancy or later is when some women feel this effect. The severity of the pain can range from mild discomfort to extreme pain that interferes with routine activities, family, social and professional life, and sleep. So hang in there! The symptoms of SPD can be mild or severe. The pain is often more obvious when you’re: walking using stairs putting your weight on one leg turning over in your bed The symptoms one might have with this condition are pain in the pelvis while walking, pain to the pubic region, groin or the inside of the thigh, and clicking or grinding in pelvic area. In some cases, treatment for a separated pubic symphysis may involve surgery to place screws and a plate to realign the pelvic bones. The majority of problems will resolve spontaneously after delivery. When there’s a separation, or widening of the space between the pubic bones, it can come with a lot of pain. Pubic symphysis pain, or anterior pelvic girdle pain, is one of a myriad of musculoskeletal pains that women may experience during pregnancy. Sometimes relaxin does its job too well, loosening the ligaments around your pelvic bone way before baby is ready to come out, which causes movement (and unfortunately, pain) in the pelvic joint. Also known as Pelvic Girdle Pain (PGP), Symphysis Pubis Dysfunction is a condition that causes moderate to severe pain in the pubic area. Most of the pain is typically centered upfront in the pubic bone area, above your mons pubis(below pubic hair). Postpartum follow-up in cases of pregnancy-related SPD may include radiologic imaging, evaluation by a specialist such as an orthopedist or physiatrist, ongoing pelvic floor physical therapy, and assessment for any underlying or related musculoskeletal issues. The pain can worsen when you're walking and doing weight-bearing activities, particularly those that involve lifting one leg like climbing stairs, getting dressed, getting in and out of a car, or even turning over in bed. Diagnosis. A person with SPD may experience pain in the pelvic area. Doesn’t everything ache and hurt ‘down there’ already? The educational health content on What To Expect is reviewed by our medical review board and team of experts to be up-to-date and in line with the latest evidence-based medical information and accepted health guidelines, including the medically reviewed What to Expect books by Heidi Murkoff. Pain while having a bowel movement or urinating 3. Up to 9mm of total width between each side of the pubic symphysis is considered normal for pregnant women. In extreme cases that do not resolve with conservative management, surgery is considered after pregnancy to stabilise the pelvis, but success rates are very poor.[3]. In fact, in a study by Mogren (2006), 50% of pregnant women have some type of pelvic girdle pain prior to 20 weeks gestation. When there is too much laxity there can be instability and pain. If the pubic symphysis has actually separated completely or torn, special treatment is necessary, and it usually involves surgical repair. 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