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During pregnancy, certain hormonal changes occur in your body to make your pelvic muscles more flexible to ease childbirth. Sometimes, this relaxation can become exaggerated, causing pain in your pelvic region, especially the pubic bone, during the later stages of pregnancy. This is known as symphysis pubis diastasis (SPD) or pelvic girdle pain (PGP). While this condition does not pose any threat to your baby, it can be extremely painful for you and affect your mobility. Severe pain can also result in depression which negatively impacts your baby, and therefore, timely diagnosis and treatment are essential. Read more to find out the meaning, causes, symptoms, diagnosis, and treatment of SPD.
What Causes Pubic Bone Pain in Pregnancy?
The connective tissue, i.e., the ligament that attaches the two pubic bones, is called the symphysis pubis. During the latter stages of the pregnancy, a hormone called relaxin is released in order to increase the range of motion in the body, preparing it for childbirth. SPD commonly occurs during later pregnancy; however, you should immediately consult your health practitioner if you experience pubic bone pain during early pregnancy. This hormone causes the symphysis pubis ligament to stretch and relax. When the ligament becomes too relaxed, it can make the pubis unstable, causing pain in the pubic bone. In certain cases, there can be a complete separation of the pubic bone, causing severe pain. However, such cases are highly uncommon, occurring only in less than 1% of pregnancies.
What Are the Risk Factors?
Any pregnant woman can develop SPD, but certain factors can increase its risks, and if not addressed as early as possible, it may become debilitating. While it does not pose any harm to the baby, it can be extremely painful for you and hinder your motion. The risk factors include previous pelvic injuries, a history of SPD, having a large baby, and excessive weight gain. During pregnancy, a 25-35 pounds gain in weight is considered normal, and it exaggerates the curvature of the spine. As a result, increased pressure is applied to the pelvic region, and excessive weight gain further increases this pressure, worsening the SPD symptoms.
Signs and Symptoms of Pubic Bone Pain While Pregnant
Too much relaxation in the symphysis pubis causes instability and pain, mostly in the pubic bone area above the mons pubis, i.e., below the pubic hair. The symptoms of SPD usually vary in terms of both presentation and severity. Pain in the front center of the pubic bone during the third trimester of pregnancy is a common symptom, along with pain in between the anus and vagina, i.e., the perineum and in the lower back. This pain can also radiate to your thighs, legs, or abdomen. The pain may especially aggravate while performing certain movements like spreading your legs, putting your weight on one leg, walking, climbing up the stairs, or turning over in your bed.
How Is It Diagnosed?
Seeking timely diagnosis is important, not only for treating SPD but also for ruling out other conditions like a urinary tract infection, ectopic pregnancy, or pelvic inflammatory disease. An early diagnosis can help you manage SPD, and your doctor can suggest how to relieve pubic bone pain during pregnancy. Since x-rays are not advisable during pregnancy, your doctor may rely on an ultrasound to look at the space in between the pelvic bones to detect SPD. However, it is more common to diagnose SPD based on the symptoms themselves. If the pain persists even after the pregnancy, an x-ray will be taken to diagnose SPD.
How Is Pubic Bone Pain During Pregnancy Treated?
SPD symptoms usually subside after the pregnancy, but there are certain measures you can take during pregnancy to manage the pain and improve movement. It is also important to remain fit prior to the pregnancy to strengthen the muscles. Here are some measures to help alleviate the symptoms of SPD:
1. Physiotherapy and acupuncture
You can ask your doctor to recommend a good physiotherapist or acupuncturist who can come home for treatments and help reduce your discomfort. These treatments can minimize pain, strengthen muscle function, and improve pelvic joint stability and position. In addition, manual therapy from a physiotherapist will ensure better pelvic movement.
2. Pelvis and lower back support
Stabilizing your pelvis with a maternity binder can aid in relieving back pain. Studies have shown that flexible belts or binders are more efficient and also prevent further injuries to the unstable pelvis.
It is important to avoid painful activities, like standing for long periods or wearing pants while sitting down. Also, you should wear comfortable shoes and move around instead of standing in a single place for too long.
On the recommendation of your doctor or physiotherapist, certain exercises can help alleviate pain or increase pelvic stability and strength. They may also suggest swimming as buoyancy can relieve pain.
Pain medication can be taken only under the supervision of a doctor. In addition, some medicines can complicate pregnancy and affect lactation, and therefore should be taken only as per a prescription.
While SPD is extremely painful, it is common, with 1 in every 5 pregnant women experiencing its symptoms. It does not harm the baby and can be managed and passes once the pregnancy is complete. Be sure to stay fit and healthy and take the necessary measures to alleviate pain.