One of the common occurrences during pregnancy is the pubic bone pain. This condition is referred to as 'Symphysis Pubis Dysfunction' or SPD. This usually occurs during the later period of the pregnancy, when a woman is far along into her third trimester. At the later stages of pregnancy, the hormone relaxin makes the pelvis loosen, especially the pubic bone.
Loosening of the pelvis is a good sign as this makes the process of birthing easier for both the mother and the baby. However, the separation might get exaggerated causing the pubic bone region to become extremely painful for the pregnant lady. This pain can also continue during the early postpartum period.
Is It Normal To Feel Pubic Pain During Pregnancy?
This kind of pubic bone pain is extremely common during the final stages of pregnancy. A pregnant lady usually experiences this kind of pubic bone pain while standing, walking or when trying to move the legs apart. The pain is centred right at the front of the pubic bone area. This annoying pain is associated with the loosening and relaxation of the pelvic ligaments.
As X-rays are not recommended during pregnancy, diagnosis of SPD is usually done through an ultrasound. This scan focuses on monitoring and observing the space between the bones of the pregnant lady's pelvis. Nevertheless, your doctor could also begin the treatment just by observing your symptoms. In case you continue to have the pain even post delivery, then an X-ray would usually be recommended.
What Are The Symptoms Of SPD?
Pubic bone pain is the most common symptom of SPD. There could be swelling around the region of your pubic bone. You may notice that you find it difficult to bring your legs together. You might notice waddling when walking. You might also hear a mild clicking noise when walking or trying to move your legs.
There could be certain movements that can turn out to be extra painful when you have SPD. Activities like getting out of the bed, getting into the bathtub or car, putting on your pajamas, or sitting for long hours, can be quite painful around your pubic bone indicating the presence of SPD.
Causes Of Pubic Pain During Pregnancy
During the later stages of pregnancy, your body begins to prepare itself for childbirth. When preparing for childbirth, your body begins to release a hormone, relaxin. This hormone softens and loosens the ligaments. When ligaments turn loose, the pelvic outlet begins to widen so that space can be created for the baby's head for delivery. During this process, plenty of ligaments in the pelvis begin to stretch. The most stretched ligament is the one present at the centre of the pubic bone or otherwise referred to as pubic symphysis.
In general, the pubic pain during pregnancy occurs when there is a misalignment of the pelvis and a great amount of movement of the pubic symphysis.
Ideally, the midline cartilaginous joint is able to create a 2 to 3 mm of gap between the bones. But, when pregnancy happens, these become quite flexible making the connective tissues to widen up as much as 9 mm. This ligament stretching in itself causes a lot of pain and discomfort. The increasing weight of the baby also puts additional strain on the muscles causing ample pain in the front area of the pubic bone. At times, the ligaments can also stretch such that it becomes unbearable to bear the pain caused due to the growing weight of the baby.
How To Manage And Treat SPD?
Usually, all your issues with SPD are sorted once you deliver the baby. Nevertheless, there are some methods that you can consider to treat and ease the symptoms.
• Use a pregnancy binder to stabilize your pelvis. A flexible binder is recommended than a rigid one. It works like an ankle or knee brace that are used to keep joints in place.
• Your doctor can suggest physical therapy.
• Do not swing over both your legs together.
• Avoid standing for long periods of time at a stretch. Wear good shoes when walking around.
• You can use a hot water bag to provide heat to your pelvis to ease the pain. You can do this multiple times in a day. You can also use a rick sock as a heating pad.
• There are certain exercises that when done during pregnancy can ease a lot of aches and pain. You can reach out to a professional to acquire knowledge about pelvic floor exercises that can be performed during pregnancy.
• In case the pain is severe, your healthcare provider might prescribe painkillers. But ensure to never take over-the-counter medication as this could cause life-threatening effects. The most common pain relievers prescribed are anti-inflammatory drugs and analgesics.
• Prefer sitting down on a chair when dressing. Do not try dressing while balancing on one leg.
Risk Factors Associated With SPD
Pubic pain is more when one is carrying multiples or if it's the second or third baby. Other reasons could be a very large baby or if you had SPD in your previous pregnancy. However, as the production of relaxin stops after delivery, there are chances that this form of pubic bone pain would also subside. In case your condition does not improve post delivery, you would need to consult your practitioner so that additional screening could be performed. Additional therapies might be required to build up muscle strength in the pubic bone region.
Public bone during pregnancy can make some of the day-to-day tasks difficult to perform. Talk to your doctor to find out ways by which the pain can be reduced so that you can perform the normal life activities with more ease and smoothness. Including physical therapy in your daily routine can help you immensely in sorting out the pubic bone pain during pregnancy. It is important that you take ample rest during pregnancy and do not stress over minor things.
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