WHAT IS PUBIC SYMPHYSIS PAIN?
WHAT IS THE PUBIC SYMPHYSIS?
The pelvis is made up of three bones. This circle of bones is shaped like a bowl with a hole and it has three joints. The joint in the front, which joins the front pubic bones together is known as the pubic symphysis (PS). It is the most stable joint in the pelvis.
WHERE DO YOU FEEL THE PAIN FROM PUBIC SYMPHYSIS?
It is important to understand that pain around the pelvis can sometimes be a bit confusing, as there are many umbrella terms and different names which can refer to several areas in the pelvis from which the pain might be arising.
Pain from the pubic symphysis is generally felt in the front part of the pelvis, right at the joint, just above the genitals. It can radiate outwards into the hips (on one or both sides), into the groin and and/or genitals.
However, it can be described under a group of symptoms, which can be referred to as Symphysis Pubis Dysfunction – this also includes pain originating from the joints at the back of the pelvis, from an area known as the Sacroiliac Joints (SIJ). It can also be referred to as pelvic girdle pain, or symphysis pain syndrome, to name a few.
WHY DOES THE PAIN HAPPEN?
Your hormones change a great deal throughout the course of your pregnancy, as well as after it. During pregnancy, the pubic symphysis joint softens. It needs to be more mobile to allow for the baby to pass through it during the birthing process. This increase in mobility can affect different women in different ways as it has an impact on the muscles, ligaments and nervous system.
Because the ligaments provide a passive form of support as they soften, some of the muscles and tendons will increase their workload to try and compensate for this. These muscles and tendons can then become fatigued and tired, resulting in spasm, which can cause pain.
As the hormones affect the whole nervous system, a sensitisation of the nervous system occurs, which can result in an increased pain response to normal movement.
WHAT CAN YOU DO ABOUT MANAGING THE PAIN?
The key to successfully managing Pubic Symphysis Pain is to try and avoid activities that make the pain worse and at the same time build strength around your pelvis. Things that make pain worse are often causing a shearing like force over the joint.
Some good pointers to help stop this joint shearing stress therefore stop the pain from happening:
- When moving from one position to another keep knees together
- Reduce your step size when walking
- Learn techniques of getting and out of a car – see our video below
- Sexual intercourse try to keep legs as close together as possible
- Learn techniques of getting down and up from a mat – see our video below
- Sometimes a pillow between your legs can help when sleeping
- When going up and down stairs aim to do one step at a time
HOW CAN PHYSIO OR OSTEOPATHY HELP WITH MY PAIN?
First they will take a thorough history from you and do a full examination of your posture, strength, flexibility and pelvic floor core strength. They will then be able to determine the issues that are causing the pain. They will advise you on lifestyle modifications and then devise an individualised treatment plan which may include the following:
- Hands on treatment which when done correctly can be highly effective at relieving pain
- Custom designed exercise programme to be followed at home which will help address the issues relating to strength – with Health2mama access to our app with clear exercise videos to follow will be provided.
- Different modalities like hot and cold treatments or sometimes electrical pain relieving devices may be prescribed
- Various taping techniques or prescription of a bump belt support – which will be determined during your exam where the physio will take you through some specific functional stability tests.
EXERCISES TO PRACTICE AT HOME
Exercise can be of great help as we try and strengthen up your pelvic muscles. A professional assessment is advised before starting any exercises, as the pelvis is the attachment site for 35 different muscles and it is important to establish exactly which exercises will benefit you. Some of the more commonly used exercises are reviewed below.