Physio Blog

PUBIC SYMPHYSIS PAIN – WHAT IS IT AND HOW CAN YOU GET RELIEF?

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 The 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 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:

  1. When moving from one position to another keep knees together
  2. Reduce your step size when walking
  3. Learn techniques of getting and out of a car – see our video below
  4. Sexual intercourse try to keep legs as close together as possible
  5. Learn techniques of getting down and up from a mat – see our video below
  6. Sometimes a pillow between your legs can help when sleeping
  7. When going up and down stairs aim to do one step at a time

 

How Can Physiotherapy Help My Pubic Symphysis Pain?

First of all your physio 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.

Why Is It Not Advised To Not Just Follow Exercises Off The Internet?

Exercise can be of great help as we try and strengthen up your pelvic muscles. A professional assessment is essential before undertaking any programme of this nature, 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.

AN IMPORTANT NOTE

Any pelvic girdle pain which initiates during pregnancy tends not to recover spontaneously and gradually increases in intensity as the pregnancy progresses. Seeking timely treatment, therefore, helps maintain the pain at its early levels, thereby achieving the best possible outcome.

How Health2mama Can Help You?

In Singapore and UK our Women’s Health Specialist physiotherapists can visit you at home or see you in our clinic and provide assessment and treatment as above.

Online consultations by our physiotherapists are also offered where we can provide education, advice and demonstrate exercises and or correcting you doing the exercises which will help bring relief

If you are keen to continue exercising but not wanting to aggravate your condition our physio trainers who also specialise in exercise for mums can take you through the normal exercise programmes you like to do but adapt the exercises to prevent any pain or your condition getting worse. See more about the exercise programmes we offer under Health2mama by clicking here.

We really hope this blog has provided some help to you.

 

Written By 

Laura O’Byrne 

Womens Health Specialist Physiotherapist