Pubic Symphysis Pain & Pubic Symphysis Loosening - Specialists and Information

The symphysis refers to a joint formed by two bones connected by fibrous cartilage. In humans, the pubic symphysis is the joint that connects the two halves of the pelvis at the front. 

It allows for a certain degree of pelvic mobility and is therefore involved in most movements, such as walking, lying down, sitting, and climbing stairs.

If the symphysis loosens, overstretches, or tears, this leads to pain in the pelvic area during movement. 

These symptoms often occur during and after pregnancy. They are usually triggered by hormonal changes and by excessive or improper strain on the pelvis. With targeted exercises and specialized therapies, symphysis pain can generally be treated effectively.

The symphysis (pubic symphysis) is a cartilaginous joint located at the front center of the pelvic ring @ pikovit /AdobeStock

A loose symphysis manifests as sharp, dull pain in the pubic bone region, usually on the left and right sides of the front of the pelvis. 

While an occasional pulling sensation in this area is not unusual for pregnant women, others suffer greatly from symphysis pain. 

The discomfort can spread from the hips down to the legs. It can also lead to lower back pain. 

The pain is more pronounced during the following movements:

• Climbing stairs
• Standing on one leg
• Lifting a leg
• Spreading the legs or one leg
• Tying your shoes

90 percent of those affected are pregnant women or women who have recently given birth. This is primarily due to the hormonal changes associated with pregnancy. 

To prepare the pelvis for the upcoming birth, the hormone relaxin increases in the body. This ensures that the pelvis opens wide enough for the newborn’s head to pass through. 

The hormone relaxin makes the ligaments, tendons, and cartilage in the pelvis more flexible. An excessive or premature release of relaxin can lead to painful symphysis pubis diastasis before childbirth. After childbirth, the symptoms usually subside and the pain eases.

Sometimes, however, the symptoms do not subside, leading to persistent pain or instability.

Accidents can also sometimes trigger symphysis pain. 

These include, in particular:

• Slipping
• Long jumps
• Tripping

Prolonged improper loading of the pelvis can also loosen or overstretch the symphysis. People with physically demanding jobs, as well as riders, runners, and cyclists, are also among those who suffer from symphysis pain.

After taking the patient’s medical history, the doctor first thoroughly examines the patient for range of motion and pain sensitivity. This often involves tests in which the patient must, for example, stand on one leg. 

If the doctor is still unable to make a diagnosis at this stage, imaging tests are used in the next step. 

These include:

• X-ray diagnostics
• Magnetic resonance imaging
• Ultrasound

Since problems with the pubic symphysis can occur during and after pregnancy or as a result of an accident, there are no preventive measures. 

However, strenuous physical activity, being overweight, and smoking increase the likelihood of symphysis pubis diastasis.

In cases of symphysis pain during pregnancy, the symptoms usually resolve on their own after childbirth. 

If pelvic pain persists after pregnancy or is caused by an accident, there are various treatment options. 

These aim to stabilize the pelvic muscles, which helps relieve pressure on the symphysis. The most appropriate therapy depends on the individual’s symptoms and the results of imaging tests. 

Depending on the patient, a doctor may recommend the following therapeutic measures:

• Back exercises and pelvic floor exercises
• Specialized physical therapy to stabilize the pelvis
• Heat therapy
• Shockwave therapy
• ACP injections, prolotherapy
• Infrared therapy
• Massage
• Targeted pain relief with ointments and medications

Heat and infrared treatments, as well as massages, help with symphysis pain @ WavebreakMediaMicro /AdobeStock

If you have symphysis pubis dysfunction, be careful not to move too abruptly. Also, avoid twisting your legs or hopping. 

To help stabilize your pelvis at night, it’s best to place a pillow between your knees. You can also start doing exercises to strengthen your pelvic muscles during pregnancy. Ask your midwife for advice.

If you have a symphysis pubis diastasis, the priority is to immobilize the pelvis. A medical belt (orthosis) stabilizes the pelvis so that the symphysis can heal and grow back together. In some cases, surgery may also be necessary.

Although symphysis loosening and overstretching can be very painful at times, they can be effectively treated with exercises and symptomatic treatment. 

You can therefore assume that no lasting pain will remain. Only if the symphysis is severely damaged due to a tear is long-term treatment sometimes necessary.

Pubic symphysis pain is caused by loosening or overstretching of the symphysis, a joint in the front of the pelvis, and/or inflammation of the pubic bone. 

The typical stabbing pain in the pelvis or legs is a common symptom of pregnancy in 90 percent of cases. 

After childbirth, the pain often subsides, though not in every case. Pelvic floor exercises and other measures to stabilize the pelvis relieve pressure on the symphysis and alleviate the pain. 

If symptoms are severe or there is no improvement, a special belt can help stabilize the pelvis. It is essential to have any long-term symptoms evaluated by a healthcare professional.