Symphysis pubis dysfunction is a condition that affects women during pregnancy and childbirth, causing pain and impaired motion in the lower pelvis. It is caused by the secretion of the hormone relaxin, which breaks down collagen in the joint. Treatment involves pain medication and behavior modification, with surgery being a rare option.
Symphysis pubis dysfunction is a condition that most commonly affects women during pregnancy and childbirth. This term refers to movement that occurs in the symphysis pubis, which is a cartilaginous joint located in the lower part of the pelvis. The joint is flexible enough to move during pregnancy and delivery, allowing for delivery. When symphysis pubis dysfunction occurs, the amount of motion the joint can experience is excessive, leading to pain and impaired motion.
The symphysis pubis is held together and strengthened with ligaments and muscles that ensure that the joint remains stable during movement. An adult female has a gap of about five millimeters (0.2 inches) between the two bones in the joint. During pregnancy, this gap can grow up to eight millimeters (0.3 inches) wide without causing any problems. If the gap widens to nine millimeters (0.35 inches) or more, the symphysis pubis joint can become unstable.
This condition is thought to occur due to the secretion of a hormone called relaxin. Among other functions, relaxin is known to break down the collagen in the symphysis pubis joint, which helps the joint soften and allows for the space between the bones to stretch. It is not known exactly why the joint overextends in some women. It is possible that some women are more sensitive to relaxin or produce more of the hormone than normal. Other factors such as lack of exercise or excessive exercise, excess weight gain, and poor posture may also play a role in developing the condition.
The most common symptom experienced by women with symphysis pubis dysfunction is pain in the lower part of the pelvis. The nature of the pain can vary, with women reporting burning, stabbing, and shooting pains, as well as ongoing pain or discomfort. Pain can extend from the lower pelvis to the abdomen, back, groin, perineum, and thighs. Consequently, impaired walking is common. Women who suffer from this condition tend to have particular difficulty climbing stairs, standing or propped up on one leg, and getting up from a seated position.
Up to 25% of women experience symptoms of symphysis pubis dysfunction during pregnancy. For most women, symptoms go away within a few days of birth, but about 7 percent of women with the condition continue to be affected. A woman who continues to experience pain after giving birth may find it difficult to care for her newborn and is at risk of depression.
Treatment of symphysis pubis dysfunction during pregnancy usually involves a combination of pain medication and behavior modification. Medications such as codeine and acetaminophen, also called acetaminophen, are usually recommended during pregnancy. Women can also work with a physical therapist to help her with strategies to avoid pain and reduce pelvic stress. For women who continue to experience pain after childbirth, bed rest followed by prolonged physical therapy and pain management is usually recommended. It is rare for a woman to require surgery to correct the problem.
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