Pubic pain in pregnancy is sometimes overlooked and it can be very difficult to deal with. Although many doctors and midwives do not know what causes it or how to fix it, many women are able to get improvement or relief with chiropractic adjustments or osteopathic manipulation. It is not something that you “just have to live with.” And although extra care should be taken during labor and birth in order to prevent trauma, it absolutely does not mean that you must have a cesarean delivery.
The symptoms of Symphysis Pubis Dysfunction (or SPD) vary from person to person, but almost all women who have it experience substantial pubic pain. Tenderness and pain down low in the front is common, but often this pain feels as if it’s inside and the pubic area is generally very tender to the touch. Any activity that involves lifting one leg at a time or parting the legs tends to be particularly painful. Lifting the leg to put on clothes, getting out of a car, bending over, sitting down or getting up, walking up stairs, standing on one leg, lifting heavy objects, and walking tend to be difficult at times. Many women report that moving or turning over in bed is especially excruciating.
Some women experience a “freezing,” where they get up out of bed and find it hard to get their hips moving right away. Or they describe having to wait for it to “pop into place” before being able to walk. The range of hip movement is usually affected, and hip abduction is especially painful. Many women also report sciatica when pubic pain is present. SPD can also be associated with bladder dysfunction, especially when going from lying down (or squatting) to a standing position.
Many women with SPD also report very strong round ligament pain (pulling or tearing feelings in the abdomen when rolling over, moving suddenly, sneezing, coughing, getting up, etc.). Some chiropractors feel that round ligament pain can be an early symptom of SPD problems, and indicate the need for adjustments. Other providers consider round ligament pain normal, part of the body adjusting to the growing uterus. If experienced with pubic and/or low back pain, round ligament pain is probably associated with the SPD.
Indeed, although pubic pain often does go away after pregnancy, many women find that it sticks around afterward, usually diminished but still present. If the underlying causes are not treated, long-term pain usually sticks around. Anecdotally, this often seems to be associated with long-term low back pain or reduced flexibility in the hips.
Although the best idea may be to resolve chronic SPD pain through realigning the pelvic girdle and soft tissues, most women have some residual pubic and low back discomfort sticking around during pregnancy and the early postpartum weeks because of hormones. Therefore, tips for coping with pubic pain tend to be a focus of many SPD websites.
Your chiropractor can help you with suggestions on how to modify activities and how to strengthen your pelvis to encourage proper pubic bone alignment.
Call Dr. Dent today to ask if chiropractic is right for you at
Modified excerpt from: Pelvic Pain: Symphysis, Pubis, Dysfunction by Pamela Vireday. Read more in Pathways: www.pathwaystofamilywellness.org