Pubic bone pain is very common during pregnancy also called as “symphysis pubis diastasis”. Again the hormones are to be blamed particularly “relaxin” which causes pubic bone to loosen. There is misalignment of pelvis and excessive movement of pubic symphysis. Gap between pelvic bones is increased. This when exaggerated causes pain in pelvis particularly during walking, standing or other movements. It is located right around the mons pubis. Gait also changes during pregnancy called as “waddling gait” due to relaxing and loosening of pelvic ligaments.
Diagnosis is made clinically on the basis of symptoms. X Rays are usually not done.
- Pubic bone pain
- Swelling in pubic bone
- Waddling gait
- Feel or hear a clicking noise while walking or moving legs
- Routine movements become difficult
Treatment- It is usually relieved after delivery.
- Stabilise your pelvis as much as possible by a maternity binder. Flexible belt or binder works better. It will stabilise pelvis and prevent further injury
- Physiotherapy helps
- Avoid the situation that causes pain. You can change your posture or stance
- Avoid standing for long periods
- Use proper supporting shoes
- Hot water bottle can help a lot. It is safe and can be done 3-4 times daily
- Exercise can help. Swimming is beneficial
- Sleep on your side with legs bent and a pillow between your legs
- Sitting on a birth ball or getting down on your hands and knees helps to take weight off the pelvis
- Don’t do heavy lifting or pushing
- Climb stairs one step at a time
- Find out your “pain free range of movement” and move within that range only. Don’t try to open your legs wider than this
- Pain medication can also be taken if there is too much discomfort. Local pain relievers can also be applied
- Multiple gestation
- Second, third or higher order pregnancy
- Large baby
- History of pubic pain in previous pregnancy
Normal delivery can be done if you suffer from this but certain precautions are to be taken so that the pain doesn’t worsen. It can make the basic tasks also very difficult so take help to minimise pain. After delivery once the hormones come to normal levels, you will be also normal. Building muscle strength around the pelvic bones can help.