Medical Q&As

Pubic pain - pregnancy related?

Is pregnancy the only cause of symphysis pubis? I was involved in an accident 4 years ago, and suffered a soft tissue injury to my back for which I am still receiving physiotherapy. During my last pregnancy two years ago I suffered terrible back pain for the first month or so and then I suffered symphysis pubis very severely. I had to use a walking frame and also had to use a wheelchair. I suffered excruciating pain for several months. Is it possible that the injury I received in the accident could have contributed to the severity of this condition?

Symphysis pubis or pubic symphysis is an anatomical term and not the name of a condition. The condition you refer to is known as symphysis pubis dysfunction or diastasis symphysis pubis. The car accident you experienced several years ago could certainly have contributed to your recurrent back pain but I don’t believe that it could be in any way responsible for the pubic symphysis dysfunction. That condition is peculiar to pregnancy and is due to the action of various hormones that soften and stretch various ligaments in the body. The pubic symphysis is the area where the two pubic bones meet. These bones are bound together by a strong ligament. Due to the action of various hormones during pregnancy the ligament softens, which permits a certain degree of stretch or “give” between the pubic bones. If this slight stretching effect were absent and the pubic bones were strongly cemented together the emerging baby could have difficulty fitting through the mother’s pelvis as it was pushed down through the birth canal. However, in your situation the softening process has gone too far and the pubic symphysis has become too lax. In some cases the two pubic bones can become detached giving rise to a click, which can be both heard and felt. Walking, climbing stairs and even turning in bed can be very painful. In those situations the pubic symphysis is usually very tender to the touch. Physiotherapy can be of help in relieving some of the discomfort. There are special support belts available that can also give relief. A small number of women may actually require surgery in order to fuse the pubic bones back together again however, I would stress that such procedures are reserved for extreme cases. There is a UK based support group for sufferers of the condition where you can obtain further information about the condition. Their website can be accessed through the following link: