The Symphysis pubis is a joint at the front of the two large pelvic bones. The bones are separated by a small oval disc of cartilage about three to four centimetres long and are held together by ligaments.
The symphysis joint is like a hard bump under the pubic hair and just above the woman's clitoris.
Why does symphysis pubis pain occur?
The pregnancy hormones progesterone and relaxin soften and relax the symphysis ligaments. This allows the pelvis to become a lot more 'elastic' so that the pelvic bones have the ability to stretch and open more easily to make way for the birth of your baby. It can also cause pain at the joint if the pelvic bones move. This is usually more common for women having their second or subsequent baby.
What does it feel like?
Symphysis pubis pain can range form being an annoying twinge to a debilitating pain. The discomfort is usually felt low, in the middle at the front, just below the pubic hairline. Some women will experience pain or discomfort in the Symphysis during their pregnancy, in labour and / or after the birth (if the symphysis joint is very loosened). This can be felt as an ache, sharp pain, 'clicking' sensation or a shooting pain into the clitoris. Often movement will aggravate it and sometimes the position of the baby will affect the level of discomfort, especially if the baby's head is engaged.
For women having their second or subsequent pregnancy (and the sibling is a toddler), try to avoid lifting and carrying them as much as possible. The movements involved when lifting and the continued carrying can cause, or inflame, pain in the Symphysis Pubis. If you need to pick up or carry your toddler, be aware of your posture.
Treating symphysis pubis pain
If you are experiencing symphysis pubis pain you should let your caregiver know. Some approaches to treating symphysis pain can include:
Seeing a physiotherapist
Your hospital may have a free service you can access for advice. They may offer you a pelvic girdle to stabilise your joints. This is like a large elastic corset worn around the hips. If it is extremely debilitating you may need a walking frame to help you get around.
Day to day activities should include:
Avoid twisting the body.
Avoid standing on one leg only. Stand with equal weight on both feet.
Avoid sitting with crossed legs, or in the 'tailor' position (sitting on the floor with legs crossed). Sit symmetrically on the chair.
Putting a pillow between your knees when turning in bed.
Avoid lifting and carrying heavy objects or your toddler (if possible).
Avoid vacuuming (yeh!).
Adapting your stride length to your pain. Walk with very small steps if you have a lot of pain.
Taking one step at a time on stairs. Often it helps to do this sideways.
When getting in and out of cars, sit down backwards on the seat and turn around to the front of the car with the knees and ankles together. Do the reverse when getting out. Do not kick open the car door with one foot.
Avoid squatting and if swimming, avoid breaststroke. These encourage the pelvis to move open more and aggravate Symphysis pain. Sleeping with pillows between the legs can help. Yoga may be beneficial.
Lying on your back for sexual intercourse may be painful. Try alternative positions such as sidelying.
Seeing a chiropractor or an osteopath specialising in pregnant women for a manipulation.
Having some acupuncture, Shiatsu or a massage.
Rest and medication
Avoid painkillers and sedatives unless absolutely necessary. Be advised by your caregiver. A heat pack to the affected area may help.
Herbal or homoeopathy
Your herbalist or Homoeopath may recommend a remedy.
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