Stiffness or loss of motion of the hip.<\/li>\n<\/ul>\n\n\n\nSymphysis Pubic Dysfunction Risk Factors<\/h2>\n\n\n\n There are certain factors which increase the risk of symphysis pubic dysfunction : <\/strong><\/p>\n\n\n\n\nExperiencing pelvic pain in a previous pregnancy.<\/li>\n\n\n\n Having an injury to the pelvis.<\/li>\n\n\n\n Previous pelvic or back pathology or trauma.<\/li>\n\n\n\n Lack of regular physical exercise.<\/li>\n\n\n\n Postpartum breastfeeding.<\/li>\n\n\n\n Rheumatological disorder.<\/li>\n\n\n\n Macrosomia.<\/li>\n\n\n\n Tightness of muscles.<\/li>\n\n\n\n Weak adductor strength.<\/li>\n\n\n\n Forces that occur during sports such as kicking, acceleration & deceleration.<\/li>\n\n\n\n Limited internal hip rotation.<\/li>\n\n\n\n Sacroiliac joint fixation.<\/li>\n\n\n\n Lower limb biomechanical abnormalities.<\/li>\n\n\n\n An elevated BMI (Basal metabolic rate)<\/li>\n<\/ol>\n\n\n\nSymphysis Pubic Dysfunction Symptoms<\/h2>\n\n\n\n The severity of symptoms of symphysis pubic dysfunction may range from mild discomfort to severely debilitating pain. Symptoms of symphysis pubic dysfunction are –<\/p>\n\n\n\n
\nThe most common symptom is a sharp pain in the pelvic area that includes the front of the pubic bone & lower side.<\/li>\n\n\n\n Shooting or aching pain felt in the lower pelvis area.<\/li>\n\n\n\n Reduce & difficulty of mobility due to the pain.<\/li>\n\n\n\n Sometimes the presence of pain felt in the perineum area or over the coccyx.<\/li>\n\n\n\n A clicking or popping or grating sound in the pelvis.<\/li>\n\n\n\n Waddling walking gait is adopted.<\/li>\n\n\n\n A gap is palpable in the pubic symphysis.<\/li>\n\n\n\n Tenderness to palpation of the pubic symphysis.<\/li>\n\n\n\n Hip joint pain.<\/li>\n\n\n\n Sacro – iliac joint pain.<\/li>\n\n\n\n Pain worsened with stretching activities.<\/li>\n\n\n\n Suprapubic edema & swelling present.<\/li>\n\n\n\n Pain in a prolonged sitting position.<\/li>\n\n\n\n Pain relief when resting.<\/li>\n\n\n\n Pain is exacerbated during walking, climbing stairs, or getting out of bed, single-leg stance.<\/li>\n\n\n\n Decreased unilateral hip range of motion.<\/li>\n\n\n\n Urinary incontinence in rare cases.<\/li>\n\n\n\n Weakness when bending the hip or kicking.<\/li>\n<\/ul>\n\n\n\nSymphysis Pubic Dysfunction Diagnosis<\/h2>\n\n\n\n Symphysis pubic dysfunction is diagnosed by a combination of patient descriptive symptoms & a series of tests designed to look at the stability, movements, pain in the structure surrounding the pelvic joints. Early diagnosis, patients have much less pain & improve more quickly. There are following methods are using for diagnosis of pubic symphysis dysfunction –<\/p>\n\n\n\n
\nPhysical examination – it is done by health professionals to rule out other lumbar spine problems. Physical examination shows tenderness to palpation directly over the pubic symphysis.<\/li>\n\n\n\n Imaging – It is the only way to confirm the diagnostic tool for pubic symphysis dysfunction. It’s also a useful tool for monitoring the progress of pubic symphysis dysfunction. There are many imaging tests such as X-ray, CT scan, ultrasonography, MRI may help the physician confirm a diagnosis of pubic symphysis dysfunction. Plain radiographs are used to assess vertical mobility. Computed Tomography (CT), Magnetic resonance imaging (MRI) & ultrasound scans are used to assess the misalignment of pelvic bones.<\/li>\n<\/ol>\n\n\n\nX-rays<\/h3>\n\n\n\n It is a useful measurement tool for the diagnosis of pelvic instability. Pubic symphysis dysfunction are frequently identified by x-ray (single leg & flamingo stress type).<\/p>\n\n\n\n
\nPhysician detects soft tissue calcification & assesses premature degenerative change in pubic symphysis by single-leg x-ray. It is a simple, inexpensive, diagnostic tool.<\/li>\n\n\n\n Physician measured the amount of vertical displacement of pubic symphysis by Flamingo stress types x-ray. It also helps to assess passive ligamentous stability.<\/li>\n<\/ul>\n\n\n\nHigh-Resolution Ultrasound<\/h3>\n\n\n\n It is a simple, safe tool for assessing symphyseal widening in pregnancy & the puerperium. It may also help to rule out other conditions. Transvaginal or trans-perineal types of ultrasonography are used to measure the interpubic distance. It also uses to detect para – symphysial tendonitis, abnormal pubic symphysis & changes of pubic apophysitis.<\/p>\n\n\n\n
Magnetic Resonance Imaging<\/h3>\n\n\n\n It is used to detect disco capsular tear in pubic symphysis & para symphysial tendonitis. It also helps to detect any bony changes, joint irregularity & fluid imbalance in the joint.<\/p>\n\n\n\n
Isotope Bone Scan<\/h3>\n\n\n\n It is used to assist the exclusion of other musculoskeletal causes of groin pain. It also helps to assess poor test sensitivity of pubic symphysis. For detecting increased radiotracer uptake in pubic symphysis, it also performed.<\/p>\n\n\n\n
Symphysis Pubic Dysfunction Treatment<\/h2>\n\n\n\n In severe cases where extreme pain is present & the patient can’t be able to move around easily & dressing difficulty also present, the patient needs to consult with his \/ her physician as soon as possible.<\/p>\n\n\n\n
Medication<\/h3>\n\n\n\n Over-the-counter drug & pain relievers medications help to ease the symptoms of pubic symphysis dysfunction. It is advisable to discuss with a physician about pain relief medications. NSAID is used to relieve pain, but it is not usually advisable to take NSAID in pregnancy. Take an anti-inflammatory medicine such as ibuprofen or other medicine for pain relief. Consider local corticosteroid injection in acute cases.<\/p>\n\n\n\n
Physical Therapy Management of SPD<\/h3>\n\n\n\n In most cases of SPD, physical therapy is the first course of treatment. The aim of physical therapy is to minimize pain, improve muscle function, improve pelvic joint position & stability. Physical therapists use different types of modalities to increase, restore mobility & help return patients to their pre-injury level of activity. Physical therapy may include –<\/p>\n\n\n\n
\nElectrotherapy – <\/strong>Various types of modalities are used to relieve pain. e.g. Transcutaneous electrical nerve stimulation (TENS).<\/li>\n\n\n\nManual therapy –<\/strong> different types of hands-on treatment are given to the muscles & joints for gently mobilize or move the joints to get them back into position & help them move normally again. It can also help to correct stiffness or imbalance.<\/li>\n\n\n\nExercises prescribed for SPD-<\/strong><\/li>\n<\/ul>\n\n\n\n\nTo strengthen the pelvic floor, back & hip muscles. e.g. strengthening exercises.<\/li>\n\n\n\n To realizing contracted muscles.e.g. stretching exercises.<\/li>\n\n\n\n To improve muscle balance & posture g. stabilizing exercises.<\/li>\n\n\n\n Learning about position & movements that can make the pain worse. Advice on avoiding movements that may be exacerbated the pain.<\/li>\n\n\n\n A warm bath, an ice pack or heat pack apply to the pubic symphysis or surrounding musculature to reduce pain & muscle spasm & inflammation.<\/li>\n\n\n\n Exercise in water (hydrotherapy) can help but avoid lots of swimming.<\/li>\n\n\n\n Postural correction & re-education of body biomechanics.<\/li>\n\n\n\n Uses crutches, walkers, or other walking aids in severe cases.<\/li>\n\n\n\n Learning relaxation techniques.<\/li>\n<\/ol>\n\n\n\n
<\/figure><\/div>\n\n\nExercises for SD<\/h4>\n\n\n\n There are different types of exercises are recommended for reducing pain, improving stability & correction of abnormality. The success of exercise depends on individual training, use of training daily.<\/p>\n\n\n\n
\nStrengthening exercises – kegel exercise, pelvic tilt, upper body bending, forward bending exercises are given to the patients to strengthen weak muscles. Exercise has done 10 – 15 minutes\/day & 3 – 5 repetitions per exercise & every alternate day is performed for both sides of the body.<\/li>\n\n\n\n Stretching exercises – stretching of hamstring, adductor groups, quadriceps & side waist muscle. It recommended for reducing muscle spasm. These exercises are performed – 2 times per day & three times per week & 10 – 20 seconds each session.<\/li>\n\n\n\n Stabilization exercises – it includes strengthening of abdominals, latissimus dorsi, gluteal, pelvic floor & hip adductor muscles. It helps to reduce stress on the joint & improve stability & motor control.<\/li>\n\n\n\n Aerobic exercise – it includes brisk type walking with medium intensity. It’s performed 25 minutes\/day on every alternate day.<\/li>\n\n\n\n Supine squeeze – patient lies on prone, lying with knees up & feet on the floor. Then the patient will place a pillow between knees & hold a &static squeeze between the buttocks for 30 seconds.<\/li>\n\n\n\n Deep Abdominal Exercise – it’s performed for increasing core stability & to prevent pelvic or back pain during pregnancy. It started with a few repetitions & gradually increasing. Initially contraction of the transverse abdominals done for the strengthening of deep abdominals.<\/li>\n\n\n\n Lateral pulls – it’s performed by grasping a door handle & gently pulls it towards himself or<\/li>\n\n\n\n Kegels’ exercise – patient lie on supine lying, patient gently contracting pelvic floor as if the patient are trying to stop the flow of urine. It helps to strengthen the pelvis & core muscles of the body.<\/li>\n<\/ol>\n\n\n\nOther therapies<\/h4>\n\n\n\n There are some other therapies are recommended for the relief of pain. Such as osteopathy, chiropathy, aromatherapy, acupuncture, hydrotherapy, prolotherapy, and a warm bath.<\/p>\n\n\n\n
Symphysis Pubic Dysfunction Support Belt<\/h3>\n\n\n\n It uses to manage pelvic joint pain during pregnancy. It significantly reduces sacroiliac joints mobility. It is most beneficial in the later stage of pregnancy. It provides an external force that stabilizes & reduce pressure on the pelvic joints & reducing pain. It also helps to align pelvic bones. It stabilizing tension by dual tension system. This belt must be positioned just cranial to the greater trochanters. It is designed to be flexible to a range of body shapes. It is not recommended for long-term uses due to the weakening of the core muscles.<\/p>\n\n\n\n
Home Remedies for SPD<\/h2>\n\n\n\n There are some home remedies that reduce pubic symphysis dysfunction related symptoms.<\/p>\n\n\n\n