The Pain of Symphysis Pubis Dysfunction in Pregnancy

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During pregnancy, your body changes in ways you never could have imagined before you became pregnant. Your blood volume increases, hormones surge, and your skeleton and all your organ systems prepare to be taxed well beyond their usual function. Aches and pains are a common occurrence. But which aches and pains are normal and which aren’t? One source of pain which is not normal is the pain associated with symphysis pubis dysfunction.

What is the pain of symphysis pubis dysfunction?

Many women suffer from the pain of symphysis pubis dysfunction during pregnancy, especially during the second and third trimesters. Symptoms of symphysis pubis dysfunction can include pain that radiates to the upper thigh, pain that radiates to the back, and pain in the perineum. You may also have some tenderness to touch in the area over the pubic symphysis (or the mons pubis). Difficulty walking, climbing stairs, getting up from a chair, and turning over in bed have all been reported as symptoms. Some women even report popping or clicking in the pelvic area or lower back. The pain caused by symphysis pubis dysfunction can last for six months or more after pregnancy and can cause difficulty with walking, bending, squatting, and weight-bearing. This is obviously a troubling issue as women who suffer SPD as a result of pregnancy will be bending and carrying extra weight while caring for a growing infant.

Symptoms of symphysis pubis dysfunction include:

  • Pain in the upper thigh
  • Pain in the back
  • Pain in the perineum
  • Tenderness to touch over the mons pubis
  • Difficulty walking, climbing stairs, turning over in bed
  • Popping or clicking in the pelvis or lower back

What is the pubic symphysis?

The pubic symphysis is a disc made of fibrous cartilage that connects the bone surfaces at the front of your pelvic girdle. It is located on the midline. Also known as the interpubic disc or the interpubic joint, the pubic symphysis is a connection point for several tendons and ligaments. Some people refer to this area of the body as the “pubic bone.” Most joints in the body come with a fair amount of flexibility. As a joint, you would expect the pubic symphysis to be similarly flexible. However, it is not as flexible as most joints. In the non-pregnancy state, it can rotate by only one degree and move by only two millimeters.

Pubic symphysis in pregnancy

During pregnancy, your body releases many hormones. Two of these hormones are progesterone and relaxin. These hormones relax your joints, allow more flexibility, and give your body more stretch to accommodate a growing fetus and delivery. This extra elasticity makes the body more prone to injury and allows the pubic symphysis to move and rotate more than it would in the non-pregnancy state. This new elasticity is good for giving birth, but it can also make it very easy to overstretch the joint, leading to injury and pain.

Other factors that can contribute to symphysis pubis dysfunction in pregnancy include:

Preventing symphysis pubis dysfunction

Having strong muscles in your core and pelvic girdle before you get pregnant is the best way to prevent symphysis pubis dysfunction. Exercise regimens including pilates and yoga, that work to strengthen core muscle as well as pelvic floor muscles are great at developing this essential strength. You can also work your pelvic floor muscles by doing Kegel exercises (the contraction and release of the muscles you would use to stop the flow of urine). Furthermore, after receiving the advice of your doctor, continuing your exercise regimen after you become pregnant is a good idea. This helps keep your muscles strong and prevents excess weight gain.

Treating symphysis pubis dysfunction

If you do develop any of the symptoms mentioned above, be sure to talk with your doctor about it. She may refer you to a pregnancy physiotherapist and/or prescribe a special pelvic support belt to wear that helps you support the weight of your pregnancy and takes the pressure off the front of the pelvis. She may also advise you to take acetaminophen (Tylenol) for pain relief. It’s important to remember NOT to take ibuprofen (Advil) or any other NSAIDs during pregnancy.

Finally, one important thing to remember is that symphysis pubis dysfunction is not harmful to your baby.

Janette DeFelice
Dr. Janette DeFelice is a writer currently focusing on how the changing environment affects our health. She holds a Doctor of Medicine degree from Chicago Medical School where she taught clinical and diagnostic skills to beginning medical students, and a Master’s degree in Humanities from the University of Chicago. She also has a Bachelor’s degree in Political Science. Her writing can be seen online at BeTheChangeMom, ChicagoNow, and Medium, and she’s very excited to have published her first novel, Delia Rising: A Ballet in Three Acts. She lives in Chicago’s west suburbs with her school-age twins, her husband, and a family cat named Clara Barton.

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