Pubic Symphysis Pain in Pregnancy

The pubic symphysis joint, circled in the front of the pelvis

​I created a handout on pubic symphysis pain in pregnancy while waiting for a patient to arrive for their appointment. Pregnancies can be very different between people and not all pregnant people have pubic pain. For those who do, I hope this information is helpful!








​



​

What is the pubic symphysis?

• The name of the joint in the front of the pelvis, where the pubic bones come together, connected by thick, supportive fibrocartilage
• Thought to be painful in 1/3 of pregnancies, with increasing awareness of symptoms by providers
• A strong, load-bearing joint

What are symptoms of pubic symphysis pain in pregnancy?

• Shooting pain in the front of the pelvis
• Radiating pain into the lower abdomen, back, groin, perineum, thighs
• Pain with walking, placing more weight on one leg, lifting a leg out to the side in a standing or side lying position
• Pain with activities like bending forward, getting up from a chair, going up or down stairs, turning in bed
• Pain relieved by rest

Why can this joint be painful during pregnancy?
​
​We don’t entirely know, but some of the leading hypotheses include:

• Biomechanical strain (loading of the joint)
• Metabolic and hormonal change in pregnancy leading to ligament laxity
• Muscle weakness
• Weight gain during pregnancy
• Other predisposing factors (having > 1 birth, genetics, family or personal history, hypermobility disorders, lack of regular exercise, history or back or pelvic injury, history of low back pain, psychosocial factors)

What can I do to manage a painful pubic symphysis during pregnancy?​

---

What do I need to do to manage pubic symphysis pain in the long term?

Pubic symphysis pain often resolves post-birth, and you can return to normal activity as tolerated. Another pregnancy following one with pubic pain does increase the likelihood of having pubic pain again, but it’s not guaranteed. For optimal health, continue to exercise and stay strong:

• Try for moderate intensity aerobic exercise for 30 minutes, most days/week
• Engage in whole body strengthening exercises 3 x weekly
• No need to focus specifically on stretching

Sources: 
​
Howell ER. Pregnancy-related symphysis pubis dysfunction management and postpartum rehabilitation: two case reports. J Can Chiropr Assoc. 2012 Jun;56(2):102-11. PMID: 22675223; PMCID: PMC3364059.

Leadbetter RE, Mawer D, Lindow SW. Symphysis pubis dysfunction: a review of the literature. J Maternal-Fetal Neonatal Medicine. 2004;16:349–354. 

Leadbetter RE, Mawer D, Lindow SW. The development of a scoring system for symphysis pubis dysfunction. J Obstetrics Gynecology. 2006;26(1):20–23.

#Pubicsymphysis #pregnancyjointpain #pubicpain #paininpregnancy #exerciseinpregnancy #crotchpaininpregnancy #pregnancywellness #exerciseduringpregnancy # pregnancy groin pain