Symphysis Pubis Dysfunction (SPD): Discomfort in the Pelvic Region

The pelvis is a protective structure for the internal organs, but it also plays a vital part as a supportive structure for the body particularly in an upright position and with walking.

The ring-shape of the pelvis, along with the support of the pelvic ligaments and pelvic floor muscles, makes it strong and stable. Two joints at the back connect the pelvis to the sacrum (the base of the spine) which are called sacroiliac joints.

At the front of the pelvis, the left and right pubic bones are joined with cartilage to form the pubic symphysis, where only the slightest degree of movement can occur.

Causes of Symphysis Pubis Dysfunction

If an excessive movement occurs at the pubic symphysis, it can become loose. During pregnancy, in particular, normal hormonal changes lead to increased laxity of the ligaments around the pelvis, which can cause the pubic symphysis to widen.

This loosening of the pubic symphysis can be very painful. Due to the nature of the ring structure of the pelvis, laxity at the pubic symphysis can affect the sacroiliac joints, causing an overall instability of the pelvis. Consequently, symptoms can often include low back pain.

Pubic Symphysis pain is most common in pregnant women, however, it can affect anyone engaging in more strenuous physical activity. The most common causes are:

• Symphysis Pubis Dysfunction During Pregnancy

  • Taking large strides or overextending the legs while in the later stages of pregnancy (2nd and 3rd trimesters).
  • Women during and after pregnancy are at increased risk, and even simple movements can cause this issue.
  

• Sporting Injury or Trauma

  • Anyone playing sports can suffer from this injury. A slip, trip, big jump or overloading the pelvis can loosen the pubic symphysis in both men and women.
  • A sporting trauma or activities with postures that put pressure on the pelvis, such as cycling, can also create pubic symphysis loosening, which may lead to pubic symphysis pain and a marked restriction of movement.

Treatment of Symphysis Pubis Dysfunction (Pubic Bone Pain)

Treating pubic symphysis pain is focused on preventing the progression of pubic symphysis loosening and stabilising the sacroiliac joints for pain relief. These range from simple at-home remedies to medical intervention.

• Physical Therapy

  Various therapeutic measures, including chiropractic and physiotherapy treatment, are used to rehabilitate the pelvic muscles through stretching and strengthening. Medical support braces (orthoses) are often utilised to provide support during these activities, to speed up healing and reduce pain. For effective results, therapeutic measures should be initiated as soon as possible and in pregnancy, should be continued after giving birth until stability is regained in the pelvis.

  

• Surgery

  Surgery may be an option for a torn pubic symphysis in more severe cases when such an injury has been medically diagnosed with X-ray or MRI imaging. This is a last case option and is avoided in most instances unless absolutely necessary.

• Bracing

  Medical support braces (orthoses) are effective measures of providing pelvic ring stability in cases of pubic symphysis loosening. Bauerfeind provides bracing options clinically designed and proven specifically for such an injury, such as the SacroLoc.