- Definition: what is the pubic symphysis?
- What does the symphysis pubis do?
- Symphysis pubis: why can it hurt during pregnancy?
- Symphysis pubis diastasis: what symptoms?
- Diastasis of the pubic symphysis: how to diagnose it?
- What is the treatment for diastasis of the pubic symphysis?
- Symphysis pubis: possible problems outside of pregnancy
Definition: what is the pubic symphysis?
The symphysis pubis is a joint symphyseal cartilaginous which joins the two iliac bones. These two bones are located at the level of the pelvis and form the pelvic girdle. Their rear rallying point is the sacrum, and their front rallying point is the famous pubic symphysis – formed by a thin layer of hyaline cartilage.
What does the symphysis pubis do?
The symphysis pubis doesn’t move much, but it’s not a bone. It is a joint made up of three ligaments, which give it a certain elasticity. Its role is to support and stabilize the pelvis. It is a kind of shock absorber for the latter, for many movements that can compress it, exert pressure or even require it to pull. It is a key element in the biomechanical chain of the pelvis. It acts as an anchor point for muscles and ligaments, thus contributing to the transmission of forces during body movements.
During pregnancy, this joint undergoes hormonal and physiological changes to allow flexibility, which facilitates the passage of the baby during childbirth. The body of the future mother produces a hormone called “relaxin”, which softens the tendons and ligaments of the pelvis, making it more mobile.
Symphysis pubis: why can it hurt during pregnancy?
As the baby grows, the pelvis gradually widens. And it’s there pubic symphysis which brings elasticity and movement to the pelvis to give more space to the fetus. The ligaments that make it up are “softened”, first by the weight of the baby. Then, thanks to two hormones: relaxin and progesterone, when the time comes to give birth. This relaxation helps widen the passage for the unborn baby. It is therefore crucial.
But the symphysis pubis should not deviate too much. The limit of the so-called “inter-symphyseal joint” enlargement level should be below 10 millimeters. If this laxity is excessive (and therefore the joint deviates by more than 10 mm), pain of varying intensity may occur in this region, ranging from mild discomfort to acute, disabling pain. Simple activities such as walking, climbing stairs, standing or turning in bed can become uncomfortable and painful. We then speak of “diastasis of the pubic symphysis” Or “pubic symphysitis“.
Besides hormonal changes, other factors can contribute to the onset of pain in the symphysis pubis during pregnancy. For example, the weight gain and the pressure exerted on the pelvis can increase stress on the joint, causing pain. Moreover, the baby’s position in the womb can also influence feelings of discomfort. If the baby is in a low position, he can press on the pubic symphysis, thus aggravating the pains.
Symphysis pubis diastasis: what symptoms?
Symphysis pubis diastasis can cause the following symptoms:
- Pain, usually felt in the pubic area – just above the pubis. This pain can sometimes radiate to the groin, buttocks, back of the legs, or front of the legs. The pain can be mild to severe, and exacerbated by movements such as walking, climbing stairs, turning when lying down, or getting up from a chair.
- Feeling unsteady or weak at the level of the pelvis, impression that the legs are not firmly anchored.
- Walking difficultiesdue to pain and unsteadiness, or even lameness or abnormal gait to avoid putting weight on the painful joint.
- Cracking or popping sensations at the level of the pubic symphysis, by performing certain specific movements or by changing position.
- Discomfort during daily activitiessuch as bending over, lifting heavy objects, coughing or sneezing.
Diastasis of the pubic symphysis: how to diagnose it?
If you have symptoms such as persistent pain or instability in the pubic area, it is important to consult a health professional: doctor, midwife, physiotherapist… Describe your symptoms in detail, including their intensity , their location and the activities that exacerbate them. The diagnosis is based on symptom assessment And physical examination : palpations to locate painful points, evaluation of gait and execution of certain movements. Possible tests include the modified Trendelenburg test: the patient is asked to stand on one leg, while the healthcare professional carefully observes the movements of the pelvis.
The healthcare professional will also collect information about your medical background, including any recent pregnancy, difficult childbirth or previous injury to the pelvis. This information helps to better understand the context of the condition. In some cases, Additional tests may be necessary to confirm the diagnosis of diastasis of the pubic symphysis and eliminate other possible pathologies: X-ray, ultrasound or MRI.
What is the treatment for diastasis of the pubic symphysis?
Treatment for pubic symphisitis aims to relieve symptoms, promote healing, and strengthen the pubic joint. Here are some approaches that can be recommended:
- Avoidance of activities that exacerbate symptoms, such as repetitive movements or carrying heavy loads. Also avoid spreading your legs, take small steps when walking and prefer cycling to walking. While sitting, try not to cross your legs. While standing, do not rest your body weight on one hip.
- Physiotherapy : the physiotherapist can suggest specific exercises to strengthen the muscles of the pelvic floor, abdomen and lower limbs. These exercises help stabilize the pubic joint and reduce pain. The practitioner may also use joint mobilization techniques or treatment modalities, such as heat or ice therapy, to relieve pain.
- Wearing a support belt : thinner and narrower than the lumbar belt, the pelvic support belt may be recommended in certain cases. It provides additional support and compression to the pelvic joints, reducing symptoms of pain and instability.
- Apply cold or heat You can try applying an ice pack wrapped in a clean cloth or a warm compress to the painful area (decide what works best for you).
- Taking painkillers : Outside of pregnancy, nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, may be prescribed to relieve pain and reduce inflammation. However, they are not recommended during pregnancy. We then prefer soft methods, such as osteopathy or acupuncture.
Symphysis pubis: possible problems outside of pregnancy
Most commonly, pain occurs during pregnancy. The signals are: the expression of a pain in the pubic area. These can go down to the level of the legs, touch the lower back or cause discomfort in the groin. In case of pain of this type, consult a doctor, a gynecologist or a midwife. There are several methods, including osteopathy and physiotherapy to relieve. Also note that pubic symphysitis can also occur outside of pregnancy, in athletes or people practicing intense physical activity.
The symphysis is described as a “left behind” part of the anatomy, explains EM radiology journal consults. But it can harbor many complications, apart from pregnancy. For example, it may be affected by rheumatological issues, insofar as it is a joint. Can also accommodate infections and tumorsor even trauma. These can be identified via an X-ray, CT scan, MRI, ultrasound, etc.
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