July 10, 2023

What Is Symphysis Pubis Dysfunction?

pelvic pain from symphysis pubis dysfunction

Clinically reviewed by Cindy Richardson, CMPE

Symphysis pubis dysfunction (sometimes referred to as pubic symphysis dysfunction) is pain or discomfort in the pelvic area that can develop in pregnancy. It occurs when the pubic symphysis — the joint connecting the left and right pelvic bones — allows more movement than usual.

The pain typically resolves on its own after the baby is born. However, you should talk with your doctor about pubic symphysis pain and discomfort if it becomes bothersome during your pregnancy. 

While symphysis pubis dysfunction is common in pregnancy (affecting approximately 30% of pregnant people), it can also develop due to injuries, infections, inflammatory conditions, osteoarthritis, and other causes. 

SPD in Pregnancy: What Causes It?

Symphysis pubis dysfunction (SPD) occurs when normal hormonal changes during pregnancy encourage the ligaments in this area (and others) to loosen so the pelvis can widen for vaginal delivery. 

Specifically, the aptly named hormone relaxin causes ligaments to relax. Relaxin production can increase as early as 10 weeks after conception, and SPD symptoms can persist for a time after you give birth. 

SPD in Pregnancy: Pain, Discomfort, and Looseness

If you develop SPD, you may experience general symptoms that include:

  • Minor discomfort
  • Sharp, sudden pain coming from the front or back of your pelvis
  • Persistent pain in your back, groin, lower abdomen, perineum, or thighs
  • Looseness in the pelvis
  • Clicking or grinding sound with some movements

Some people have pain that worsens with specific positions or activities, including:

  • Bending forward
  • Using stairs
  • Repositioning in bed
  • Walking 
  • Getting into and out of a chair, bed, or vehicle
  • Standing with weight primarily on one leg
  • Lifting one leg

In more severe cases, SPD can also cause:

  • Problems urinating or defecating 
  • New or worsening fatigue
  • Mental health challenges from the ongoing pain and discomfort

SPD in Pregnancy: Treatments

Doctors diagnose SPD by asking about your symptoms, reviewing your medical history, performing a physical exam, having you report your pain with specific movements, and possibly using imaging procedures focused on the pubic symphysis.

Based on your diagnosis, your doctor may have you try some or all these measures:

  • Wearing comfortable, supportive shoes
  • Avoiding triggering activities
  • Wearing a pelvic support belt
  • Applying ice or heat to the affected area
  • Sleeping with a pillow between your legs
  • Doing Kegel and pelvic tilt exercises to strengthen your pelvic muscles
  • Getting physical therapy, including instruction on how to move in ways that don’t aggravate your condition

Preventing Pubic Symphysis Dysfunction

There’s no way to anticipate who will experience pubic symphysis dysfunction or prevent the condition entirely. However, you can take care to protect your pelvic area from injury by not overexerting yourself during pregnancy. You should also wear supportive shoes. 

Pubic Symphysis Dysfunction vs. Pubic Symphysis Diastasis

Pubic symphysis diastasis is a very rare condition where the pubic symphysis joint separates completely. This can occur due to pressure on the joint during childbirth if forceps used during delivery rupture the joint or if your doctor has to sever it to allow the baby to pass through (a symphysiotomy). Pubic symphysis diastasis may require medical intervention.  

Get World-Class Mother and Baby Care from Baptist Health

Pregnancy causes many changes in the body and various aches and pains. But if you experience pain in your pubic symphysis that adversely affects your quality of life, you should talk with your Baptist Health doctor. They can advise you on the best way to treat the condition and minimize your discomfort. 

Learn More.