Symphysite
Last reviewed: 23.04.2024
All iLive content is medically reviewed or fact checked to ensure as much factual accuracy as possible.
We have strict sourcing guidelines and only link to reputable media sites, academic research institutions and, whenever possible, medically peer reviewed studies. Note that the numbers in parentheses ([1], [2], etc.) are clickable links to these studies.
If you feel that any of our content is inaccurate, out-of-date, or otherwise questionable, please select it and press Ctrl + Enter.
Symphysitis is considered a pathology of the lone articulation, which is based on the inflammatory response in response to the effect of the damaging factor. Physiologically, the connection between the pubic pelvic bones of the pelvis is a fixed structure, however, due to various conditions, it is possible to increase its mobility.
This process is caused by a change in the consistency of the ligaments, which acquire a more relaxed form, and also the puffiness of this region. As a result, pubic bones gradually move away from each other, and their articulation acquires greater mobility.
Most often, such changes are observed during pregnancy or after childbirth. In the case of a small discrepancy, an independent restoration of the anatomical location is possible. However, sometimes the distance between the bones exceeds 1 centimeter, which requires complex treatment.
In pregnancy, symphysitis may occur starting from the second half of the term. This is due to the rapid collection of fetal weight and increase in amniotic fluid. As a result - the lumbar joint is constantly affected by force, which contributes to the divergence of the pubic bones.
If symphysitis is observed after childbirth, this is most likely a consequence of the trauma of the joint in the process of labor activity as the fetus passes through the birth canal.
[The causes of symphysitis
The exact cause of the development of pathology is difficult to detect, since several factors can influence simultaneously the appearance of the symphysitis. So, the causes of symphysitis can be the excessive secretion of the hormone relaxin in the course of pregnancy. As a result, the ligaments become more softened and lose the ability to hold the bones tightly at the right distance.
A similar process occurs due to a change in the hormonal background and the imbalance of its components. Also, genetic factors that are inherently transmitted to a woman can contribute to the development of symphysitis.
Such causes of symphysitis, as an insufficient level of calcium and other trace elements in the body of a pregnant woman, can provoke a divergence of the pubic bones.
A high probability of symphysitis development is observed in pregnant women, having a pathology of bones and joints. Do not forget about the course of pregnancy, because severe toxicosis, rapid weight gain, excessive physical activity and improper nutritional diet can lead to an increase in the distance between the pubic bone and excessive mobility of the bony joint.
Pubic symphysitis
The hormonal system is one of the main regulating factors of the functioning of the body. During pregnancy, its restructuring takes place, and the ratio of hormones changes. These processes are necessary to ensure all the necessary conditions for the growth and development of the fetus.
In the process of hormonal changes, the production of certain active substances may predominate. So, with excessive synthesis of the hormone relaxin, pubic symphysitis is observed.
Its development is due to the softening of the ligamentous apparatus, due to which the pubic pelvic bones are at a certain distance from each other. Thus, as the tone decreases, there is a discrepancy in the lobar articulation and an increase in its mobility.
Pubic symphysitis is also possible in diseases of bones and joints, when a woman has a predisposition to develop symphysitis, especially if she has an insufficient level of calcium in the body.
Normally, the distance between the pubic bones increases insignificantly. This is necessary to ensure the passage of the fetus through the birth canal. In addition, the mode of delivery depends on the degree of discrepancy of the genital joint, since natural childbirth with a large distance between the bones can lead to such a complication as ligament rupture.
Symphysitis Symptoms
The beginning of softening of ligaments between the pubic bones can be observed already from the 6th to 7th months, since it is during this period that clinical signs of pathology appear. The symptoms of symphysitis may, in certain adverse circumstances, be disturbed already from the 4th-5th month.
At the initial stage, the pregnant woman feels aching periodic pain in the perineum and pubic area. They disturb when walking or climbing stairs. Further, the pain syndrome is strengthened due to the fact that the mobility between the pubic bones increases.
The pain acquires a permanent character and is observed not only with motor activity, but at rest or a change in the position of the body. In addition, there is a discomfort in the area of the lone articulation. Later, the pregnant woman acquires a "duck" gait. She helps her to use the pubic joint less in walking, thereby reducing pain impulses.
Symptoms of symphysitis become more pronounced in the last month of pregnancy, when the acting force on the pubic bone is maximal. Pain can extend to the femoral, lumbar, inguinal and gluteal regions.
Symphysitis of pregnant women
The process of bearing a fetus is a serious strain on the woman's body. During this period there is a restructuring of the hormonal system, which can exacerbate the existing concomitant pathology of the endocrine system.
In addition, the body of the pregnant woman undergoes loads from the fetus, as an additional circle of blood appears, as the fetus increases, the uterus gradually rises and lastly reaches the diaphragm, making the woman increasingly difficult to breathe (the respiratory volume of the lungs decreases).
The enlarged uterus also prevents a normal outflow of venous blood from the lower extremities, affecting the blood vessels. In general, the body undergoes major changes and should not be surprised if somewhere a small glitch is possible.
Thus, symphysitis of pregnant women is a rather common pathology, based on the relaxation of the ligamentous apparatus connecting the pubic pelvic bones. The diagnosis is made with the help of symptoms and the results of additional instrumental studies.
Postpartum symphysitis
During pregnancy, many factors influence the ligamentous apparatus between the pubic pelvic bones of the pelvis, as a result of which it loses its tonus and the ability to keep them at a certain distance.
In case of discrepancy of bones no more than 1 centimeter, it is possible to carry out delivery through natural ways. Sometimes it happens that the distance between the pubic bones increases after delivery.
Postpartum symphysitis occurs as a result of factors influencing both the fetus and the pregnant one. Excessive sprain of the ligaments is facilitated by a large fetus, a narrow pelvis of a woman, severe toxicosis, a previous pathology of joints and bones, and many other factors.
If the discrepancy occurred a few centimeters, then with the help of special exercises and a bandage, you can get rid of Symphysitis symptoms or even himself in the near future.
Postpartum symphysitis, due to the considerable distance between the pubic bones, requires complex treatment, which includes medical therapy, physiotherapy, wearing a bandage and physical exercises.
Where does it hurt?
Complications of Symphysitis
The discrepancy of the pubic bones can have a different degree, the most serious complications of symphysitis occur when the distance between the bones exceeds 1 cm. Beginning with the first stage, there is a pain syndrome, which worries periodically and has a nagging character.
At this stage, the pregnant woman can fight the pain with the help of special physical exercises and pain medications. However, as the process progresses and the distance between the bony bones increases, the pain syndrome becomes permanent, regardless of the activity of the woman.
Since the pain is observed even at rest, a psychoemotional condition is broken in the pregnant woman, she becomes irritable and whiny. In addition, the nervous system undergoes hormonal effects, which significantly changes during pregnancy.
Such complications of the symphysitis, as an excessive divergence of the pubic bones until the rupture, are severe consequences of the pathology of the ligaments. As a result, the lone articulation loses its connection between its structures, which leads to the lack of the ability to walk, stand or lift legs.
Symphysitis Diagnosis
The diagnosis process involves a thorough questioning of a woman about her complaints, the duration of the illness, and the identification of provoking factors that have caused the development of the symphysitis.
The diagnosis of symphysitis consists of additional instrumental research methods that are applied depending on the position of the woman. That is, if a woman is pregnant, then some studies, such as X-ray, computer or magnetic resonance imaging, are not allowed. In this case, it is recommended that she exclusively perform ultrasound diagnosis.
In the case of the development of pathology after childbirth, then the diagnosis of symphysitis can use all the methods that are necessary for the diagnosis. With their help is determined not only the discrepancy of the bones of the pubic joint, but also the distance between them is estimated.
As a result, after further studies, further therapeutic tactics are determined. Based on ultrasound diagnosis of a pregnant woman, the method of delivery is determined based on the degree of divergence of the pubic bones.
Ultrasound with symphysitis
During pregnancy, it is necessary to exclude all factors that may have a negative effect on the fetus. So, it is allowed to use exclusively ultrasound diagnostics with various purposes (for control of the fetus and amniotic fluid state, as well as the determination of pathology from the pregnant one).
Ultrasound with symphysitis is the only method that can be used without harming the fetus or the future of the mother. This method is used to determine the degree of divergence of the pubic bones and measure the distance between them.
Thus, using ultrasound with symphysitis, it is possible to reveal the first degree of discrepancy, which is characterized by a discrepancy of the pubic bones no more than 5-9 millimeters. In the second stage, the distance from one centimeter is observed, and in the third one - more than 2 centimeters.
With the third degree of symphysitis, a woman can not walk, sit and raise her legs, as all these actions cause severe pain. Based on the data obtained after the ultrasound, further tactics of the woman's management, as well as therapeutic directions, are determined.
What do need to examine?
Who to contact?
Symphysitis treatment
Depending on the degree of divergence of the pubic bone and the clinical manifestations of pathology, the treatment of symphysitis may include various methods of care.
A prerequisite for therapy is the performance of specially designed physical exercises that reduce the intensity of the pain syndrome, strengthen the gluteal, perineal, femoral and lumbar muscles. Thanks to them, the structure of the pelvis restores its physiological position.
Treatment of symphysitis involves the implementation of some recommendations. Among them it is necessary to distinguish: a decrease in physical activity, in particular, climbing stairs and fast walking, not sitting in one posture for a long time (more than 1 hour), in a sitting position, do not place one foot on the other, and also stand evenly to load on both feet.
In addition, you need to monitor your diet and eat more foods that contain calcium - dairy products. Also, calcium can be taken in a tablet form. It is necessary to control your weight, since excess weight predisposes to the appearance of severe pain syndrome.
From medicamentous preparations it is necessary to note anti-inflammatory agents and complexes of vitamins and microcells.
Bandage with symphysitis
Therapeutic tactics are determined in each case individually, taking into account the degree of divergence of the pubic pelvic bones and the severity of the clinical manifestations of symphysitis. Despite the distance between the bones of the lone articulation, there are some therapeutic methods that must necessarily be used.
A special complex of physical exercises and a bandage are those obligatory components of the medical complex. The bandage with symphysitis is used to maintain the pelvic structures in a physiological location and to prevent further divergence of the pubic pelvic bones.
Bandage with symphysitis is a bandage of dense material, which is able to keep the pelvic bones in a certain position.
However, there are some peculiarities. So, the bandage is necessary to select each pregnant woman or puerperal individually, in the process of which she needs to try it on and determine how comfortable it is.
First, the bandage should be worn in a lying position, while fastening rather tight, leaving room for the entry of the palm. Secondly, when lifting, it is necessary to assess how tightly it is located and supports the pelvic structures.
And, finally, thirdly, the bandage should be used not around the clock, but only if it is necessary to stand or walk for a long time. At night, the bandage is removed to avoid excessive compression of the internal organs.
Exercises with symphysite
Excessive physical activity is strictly prohibited, as it contributes to an even greater divergence of pubic pelvic bones and increased pain syndrome.
On the other hand, specially selected exercises with symphysitis allow not only to reduce the severity of pain, but also to strengthen the ligament and improve the tone of the muscles of the perineum, buttocks, thighs and waist.
Exercises with symphysitis should be performed several times a day, especially with severe pain syndrome. The complex includes several exercises that can help in the fight against symphysitis.
First you need to take a recumbent position and position your feet as close to the buttocks. Then slowly dilute the knees to the sides, hold them in the maximum permissible position and again cover them. You can repeat from 5 to 10 times, gradually increasing the number of exercises.
Next, you should put your feet slightly from the buttocks, so that the shin forms a right angle with the floor, and raise the pelvis until you get a straight line with the body of the body. However, you need to control the height of the elevation in order to avoid uncomfortable sensations. Repeat up to 6-10 times.
The third exercise is known as a "kitty." It implies performing on your knees and leaning on your palms arching your back, while lowering your neck and head. In this case, the muscles of the press should be strained. So you should stay 5 seconds and repeat 3 times.
Treatment of symphysitis by alternative means
The pathology of the divergence of the pubic pelvic bones is based on the influence of pathogenic factors that contribute to increasing the distance between the bone structures.
To combat symphysitis, non-medications are used primarily, especially in the first stage, and folk. Treatment of Symphysitis with alternative means includes the performance of a set of specially selected physical exercises, the observance of a proper diet, and the use of a bandage.
The effectiveness of these methods depends directly on the woman and the seriousness of the approach to treatment. So, regularly doing exercises, it will soon strengthen the muscles of the buttocks, perineum, waist and hips, which is necessary to restore the physiological location of pelvic structures.
In addition, thanks to daily exercises, the multiplicity of which reaches 3-4 times a day, contribute to a decrease in the intensity of the pain syndrome.
Also, the treatment of symphysitis by alternative means involves eating foods that contain a high percentage of calcium. As for the bandage, it is an integral part of the treatment and is necessary to maintain the pubic pelvis in a normal position, gradually bringing them closer together.
Symphysitis Prevention
The identification of the main influencing factor on the development of the symphysite is a rather problematic task. In connection with this, the prevention of symphysitis also can not be clearly marked.
Adhering to some rules and recommendations, it becomes possible to reduce the risk of pathology. So, first you need to reduce the number of workloads and perform special physical exercises. Such a course should be selected by a specialist individually for each woman, taking into account her concomitant pathology and contraindications.
In addition, the prevention of symphysitis is to maintain a proper diet and lifestyle. It is necessary to eat foods with calcium and spend enough time in the fresh air.
As for pregnant women, they are advised to register on time, regularly visit a doctor, adhere to dietary nutrition and avoid the influence of stress factors.
In addition, pregnant women should wear a bandage to maintain the physiological location of bone structures and internal organs, and do not neglect the performance of special exercises.
Symphysite Forecast
The discrepancy of the pubic pelvic bones is observed in almost 50% of all pregnancies. It was noted that every subsequent pregnancy is increasingly predisposed to the development of symphysitis. So, if during the first bearing of the fetus the softening of the ligamentous apparatus was already revealed, subsequent pregnancies will also be accompanied by this process.
The prognosis of symphysitis depends on the degree of divergence of the pubic bone and the clinical manifestations that disturb the woman. If time is taken to solve this problem, then the symphysis forecast is quite favorable.
In addition, during pregnancy, a woman is under the constant supervision of a doctor who follows the development of the symphysitis and decides on the choice of the method of delivery. Pathology does not have a negative impact on the state of women's health, provided they control the symphysitis.
After birth, there is a stabilization of the hormonal background, a decrease in edema of the pubic joint and a decrease in the severity of the pain syndrome.
Symphysitis occurs in half the cases of all pregnancies, but with due attention to pathology and the selection of effective treatment, a woman can not remember the symphysitis within a few months after birth.
Symphysitis and sex
As already mentioned, symphysitis develops as a result of the influence of various provoking factors, which leads to a softening of the ligamentous apparatus between the pubic pelvic bones.
Divergence of bones is accompanied by pain syndrome, which makes symphysitis and sex mutually exclusive processes. Pain prevents the woman from relaxing and getting pleasure, which leads to more nervous tension and irritability.
Even if symphysitis is at the first stage of development and there are no painful sensations in the course of sexual activity, the likelihood of their appearance after sex is still high.
As for the second and more stages of pathology, here sex will help to strengthen the pain syndrome, which is constantly accompanying the woman. Especially it concerns active sex and intense movements.
Of course, with symphysitis physical activity is necessary, only in the form of special exercises aimed at the gradual strengthening of the ligament apparatus and muscles. They are carried out slowly and do not deliver painful sensations to a woman, but, on the contrary, contribute to a decrease in their severity.