Having difficulty walking and feeling wrenching pain, as though your pelvis is tearing apart, can really disrupt your life! If your job is very active, SPD can negatively affect your income. SPD can also keep you from enjoying your favorite sport, or even quickly running to the grocery store for a forgotten item. 

That shooting or aching pain in your pelvis can be a symptom of Symphysis Pubis Dysfunction (SPD). The pubic symphysis joint is between your left pelvic bone and your right pelvic bone. Its job is “to help your pelvis absorb some of the weight from your upper body before it travels to your lower body. It also helps separate your pelvic bones to prepare for vaginal childbirth.” When this joint is misaligned, your lower body movement is severely limited.   

SPD has a few causes. 

SPD occurs when this joint becomes misaligned from pregnancy, injury, or pelvic imbalances brought on by certain conditions. Chiropractic adjustments and other non-invasive interventions can help relieve the pain of SPD and keep you moving. 

How does pregnancy cause Symphysis Pubis Dysfunction?

SPD can happen to anyone who is pregnant, or was pregnant. This is a fairly common complaint in pregnancy, but we see this often in postpartum women as well.

Why do pregnant women experience pelvic pain?

The ligaments keeping mom's pelvic bone aligned become relaxed and stretchy as delivery nears. What makes it easier to deliver a baby also makes it easier to get SPD. During pregnancy, the body secretes the hormone relaxin. Relaxin makes the ligaments in your body more stretchy so that your pelvis opens and baby has an easier time getting out into the world. Sometimes relaxin does its job too well, loosening the ligaments around your pelvic bones before baby is ready to come out. This is what causes movement (and unfortunately, pain) in the pelvic joint.

Pelvic imbalances can also cause issues with the pubic symphysis joint.

Also known as a tilted pelvis, issues with your legs, hips or spine can lead to a pelvic imbalance. Conditions like uneven legs, spinal scoliosis, and muscle imbalances or muscle contractures contribute to pelvic imbalances, which can also encourage misalignment of the pubic symphysis.

Symphysis Pubis Dysfunction can also be caused by injury and disease.

Sports injuries can cause you to jam or dislocate your pelvic bones around the joint area.

I recently experienced SPD while ski touring in fresh snow. The weight of my ski and the weight of the snow strained one of the muscles that attaches to the front of my pelvis. I had difficulty climbing stairs, getting out of my car, putting on pants and rolling over in bed. Dr. Michaela adjusted my sacrum and my pubic symphysis, it helped so much!

Osteoarthritis: The cartilage in your pubic symphysis joint can wear down over time, resulting in less support for your pelvic bones. 

Osteitis pubis: Infections and inflammatory conditions in the surrounding tissues can harm the pubic symphysis joint.

What are the symptoms of Symphysis Pubis Dysfunction?

Usually our patients with SPD point to the front of their pelvis and describe a pain at the pubic joint. SPD is primarily experienced in your pelvis, but can spread to other areas of your lower body. SPD pain can manifest in your groin, abdomen, upper thighs, lower back, and perineum. There may also be tenderness at your pubic bone. 

Other SPD symptoms include a clicking sound in the pelvis with walking or spreading your legs apart. SPD pain can worsen when you're walking and doing weight-bearing activities, particularly those that involve lifting one leg. Climbing stairs, getting dressed, getting in and out of a car, or even turning over in bed can be quite painful with SPD.

Chiropractic & pelvic support can help keep you working if you've got SPD.

Sometimes you can't take time off to deal with the effects of SPD, that's where we can help.

I once had a patient who experienced a rare pubic symphysis dislocation during the birth of her first child. At about 4 months along with her second child, her birth provider wanted to put her on bed rest once her pubic symphysis pain started. Her work was very physical and she came to me for support.

As I was performing a pelvic balance assessment, I found a significant imbalance stemming from her pubic symphysis. I performed an instrument assisted activator adjustment to her elevated pubic rami (a group of bones that make up part of the pelvis).

The patient instantly felt waves of relief from pain and waves of calmness to her body. She wore a Serola Belt for the duration of her pregnancy to support her pelvis. And she was able to continue working up to the end of her pregnancy.

How does chiropractic help with Symphysis Pubis Dysfunction?

When your joints move properly, your muscles are strong but supple, and your ligaments are released, your pelvis can function optimally!

At Golden Chiropractic, treatment can include:

• soft tissue therapy
• pregnancy support belt
• side-lying mobilizations
• pelvic blocks
• instrument-assisted pubic symphysis adjustments

We use various chiropractic treatments for your pelvic area.

We may use the Webster Technique to address the pelvic bones, muscles, and ligaments of pregnant women.

For all SPD related pain, we start by assessing and treating the sacrum (your tailbone). We then assess and treat the piriformis muscles—these go from your hips to your tailbone. Finally, we assess the sacrotuberous ligament which attaches your sit bones to your tailbone.

Next, we move onto the pubic bones (where your pelvic bones attach in the front). Then your psoas muscles (hip flexors), and your round ligaments (the ligaments that support your uterus) are assessed and treated.

How many chiropractic visits do you need for Symphysis Pubis Dysfunction?

Chiropractic care helps to balance the pelvis and relieve the pain. The number of visits any one patient needs depends on the causes of their SPD. Chronic conditions will require regular maintenance visits to manage pain. SPD pain from acute injuries will have a shorter timeline.

A note for those experiencing symphysis pubis pain from pregnancy:

For pregnancy, the good news is that the pain usually goes away after the baby comes. The pain and discomfort can take a toll on your mental health, however. 

Symphysis pubis pain may contribute to symptoms linked to postpartum depression after your baby’s born. It’s a good idea to talk to your provider about behavioral health support if you’re experiencing symptoms associated with depression.

What is the best self-care for Symphysis Pubis Dysfunction?

Avoid triggers as much as you can.

Sit down to get dressed, and avoid heavy lifting and pushing. Climb stairs sideways to avoid pushing down on the painful side.

Apply a heating pad or ice pack to your pubic bone.

If you're pregnant and using a heating pad, don’t leave it on for more than 10 minutes at a time—more than 10 minutes can raise your baby’s temperature. You can safely cycle the pad on and off every 10 minutes.

Wear a pelvic support belt.

A Serola belt, or a pregnancy support belt can be helpful to act as a girdle to hold the pelvis together.

Do your Kegels and pelvic tilts.

Doing exercises and stretches helps strengthen the muscles of the pelvic floor.

Follow your treatment plan.

Schedule the recommended chiropractic appointments at the suggested intervals. Do the exercises recommended.

Consider pelvic floor physical therapy.

Your chiropractor can help you decide if it's a good option. 

Is pubic pain disrupting your life?

Come see our chiropractors here in Aptos! Our chiropractic team really can help you get out of—and stay out of—Symphysis pubis pain. Make your appointment online. 

Wondering about chiropractic care throughout all pregnancy stages?

Read up on Prenatal Chiropractic Care by Trimester.