What is symphysis pain, and what causes it?
The symphysis pubis (medically known as the symphysis pubica) is the cartilaginous joint between the two pubic bones. Together with the sacroiliac joints, it provides stability and mobility in the pelvis. If the ligaments and cartilage are subjected to excessive strain or stretching, for example during pregnancy, this can be very painful. If a tear (rupture) of the pubic symphysis occurs due to trauma or extreme stress, specialists refer to this as a symphysis rupture.
Pregnancy and other causes of symphysis pubis pain
A common cause of pubic symphysis pain is pregnancy: hormonal changes cause the ligaments and cartilage in the pelvis to soften in order to facilitate childbirth. In addition, a woman’s weight and center of gravity shift. As a result, the pubic symphysis may widen by a few millimeters—especially in the case of multiple pregnancies. If a pregnant woman complains of persistent pain, it is essential to have this evaluated by a doctor, as it may indicate symphysis pubis diastasis. With measured, adapted movements, targeted exercises, and special aids, the symptoms can usually be managed effectively. After pregnancy, the symptoms typically resolve on their own. If the pain persists after childbirth, the pubic symphysis can be relieved through therapeutic intervention.
Other risk factors and causes:
- Slipping, tripping, or jumping too high or too far
- Severe obesity, heavy lifting, and weak pelvic floor muscles
- Overuse or improper strain, for example among cyclists and horseback riders
- Accidents can lead to a symphysis pubis diastasis.
Can symphysis pain be prevented?
Targeted measures can significantly reduce the risk: Regular pelvic floor exercises strengthen the muscles and stabilize the pelvis. If you have an anatomical or hormonal predisposition, you should avoid sudden movements, taking long strides, or standing on one leg. Maintaining a consciously stable pelvic posture while sitting and standing up can be helpful. Physical therapy can help prevent improper strain.
Symptoms: What does symphysis pain feel like?
Whether pregnancy-related or not, pain in the pubic bone is accompanied by significantly reduced mobility: movement causes tension on the highly sensitive periosteum. Typical symptoms include a pulling or stabbing pain in the area of the pubic bone and sacrum, especially during movement—such as walking, bending over, or climbing stairs.
The pain often radiates to the hip or even down into the thigh. Mobility is restricted, and the pelvis feels unstable. The pain frequently occurs when lying on one’s side, turning over in bed, or standing on one leg. A symphysis pubis diastasis causes acute, severe pain and pelvic instability. Walking is often barely possible.
Medical Diagnosis: How Is Symphysis Pubis Pain Diagnosed?
The diagnosis of symphysis pain or a symphysis separation involves several steps: First, a doctor will ask about symptoms, the course of the condition, and possible triggers. During the physical examination, tenderness over the pubic symphysis—as well as when lifting the leg—and limited mobility indicate a symphysis separation. Imaging techniques provide a view of the symphysis: This allows for determining whether the condition is symphysis loosening, overstretching, or a tear. Additionally, other causes of pain in the pelvis or groin can be ruled out, such as SI joint issues or a hernia.
- Ultrasound or MRI reveal changes in ligaments and cartilage without radiation exposure—ideal during pregnancy.
- X-rays are only used if a symphysis rupture or more severe pelvic injury is suspected.
Treatment: Pubic symphysis pain – what can be done?
In any case, patients with symphysis pubis pain should take it easy and stabilize the pelvic ring. At night, placing a pillow between the knees can help stabilize the pelvis. Heat therapy (consult a doctor if you are pregnant!) and gentle massage are sometimes recommended.
In addition:
- Iontophoresis* with diclofenac gel
- specialized pelvic floor exercises for muscular stabilization
- orthoses for stabilizing the pelvic ring.
* Delivery of medicinal substances through the skin using a weak direct current.
If the patient goes into shock due to a symphysis rupture, the pelvic ring must be closed and stabilized as quickly as possible, as massive blood loss in the pelvic region is likely.
Exercises for symphysis pain
Specific exercises for symphysis pubis pain help stabilize the pelvic ring. They also strengthen the pelvic, back, and pelvic floor muscles. This reduces tension on the symphysis pubis and alleviates pain. Pregnant women should consult their midwife or gynecologist for advice.
Which doctor treats symphysis pain?
Depending on the situation, the first place to go is a general practitioner’s, gynecologist’s, or orthopedist’s office.
Medical devices for symphysis pain
Braces (such as Lumbamed Maternity or Lumbamed Sacro) can be used to stabilize the pelvis and relieve pressure: They take pressure off the pelvic ring and can help alleviate pain. Pillows or positioning aids are also recommended for use at night to relieve pressure on the symphysis pubis.
Pregnancy
medi Lumbamed sacro
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Health personnel will make the diagnosis and can prescribe medical aids, e.g. from medi if necessary.
Your medical retailer will fit them individually for you.
