I – Introduction:
A- Definition of the pubic symphysis:
The symphysis pubis is a joint located at the base of the pelvis, between the right and left pubic bones. It plays an important role in the stability of the spine and in the transmission of forces during movements such as walking, running and jumping. The symphysis pubis is a fibrocartilaginous joint, which means that it is formed of collagen and cartilage fibers that allow flexibility, while maintaining stability. This flexibility is important to allow the bones of the pelvis to deviate slightly during the birth of a child. However, this flexibility can lead to pain and symptoms of dysfunction if the symphysis pubis is overloaded or injured. Consequently,
B- Importance of the pubic symphysis for the human body:
The symphysis pubis is a key element for the stability and movement of the human body. It plays an important role in the transmission of forces from the upper body to the legs and in the distribution of loads on the pelvis and spine. Additionally, the symphysis pubis allows for some flexibility in the pelvis, which is important for activities such as walking, running, and body flexion. The pubic symphysis is also involved in birth, allowing a slight separation of the pelvic bones to facilitate the passage of the fetus.
However, the pubic symphysis can be subject to overload or injury, which can lead to pain and symptoms of dysfunction. Symphysis pubis pain can be especially common in pregnant women, due to changing hormone levels and increased pressure on the symphysis pubis. Accordingly, it is important to understand the importance of the pubic symphysis to the human body in order to properly diagnose and treat problems associated with this joint.
II- Anatomy of the pubic symphysis:
A- Location and structure:
The symphysis pubis sits at the base of the pelvis, between the right and left pubic bones. It is a fibrocartilaginous joint that allows flexibility while maintaining stability of the spine and pelvis. The structure of the pubic symphysis includes a plate of fibrocartilage located between the two pubic bones which is held in place by symphyseal ligaments. These ligaments are sturdy structures that allow some mobility while preventing excessive separation of the pubic bones.
Additionally, the symphysis pubis is surrounded by important muscles such as the rectus abdominis, internal and external oblique muscles, and psoas muscles. These muscles work in tandem to stabilize the symphysis pubis and facilitate body movements, such as walking, running, and bending. By understanding the location and structure of the symphysis pubis, it is possible to better understand its role and importance to the human body.
B- Ligaments and associated muscles:
The ligaments and muscles associated with the pubic symphysis play an important role in the stability and mobility of this joint. The symphyseal ligaments hold the two pubic bones together and allow some flexibility of the symphysis pubis, while preventing excessive separation. The muscles associated with the symphysis pubis include the rectus muscles, the internal and external oblique muscles, and the psoas muscles. These muscles work in tandem to stabilize the symphysis pubis and allow body movement, such as walking, running, and bending.
Also, the strength and stability of the ligaments and muscles associated with the symphysis pubis can be affected by factors such as injuries, altered hormone levels, and age. Therefore, it is important to maintain good strength and stability of these structures to avoid pain and problems in the symphysis pubis. By understanding the ligaments and muscles associated with the pubic symphysis, it is possible to better understand their role and importance for the stability and mobility of this joint.
III- Normal functioning of the pubic symphysis:
A- Flexibility and mobility of the pubic symphysis:
The flexibility and mobility of the symphysis pubis is important to allow normal body movements, such as walking, running, and bending. The pubic symphysis is a fibrocartilaginous joint that allows flexibility, thanks to the fibrocartilage plate and the symphyseal ligaments that hold it in place. However, the symphysis pubis should not be too flexible to maintain spine and pelvic stability.
The mobility of the pubic symphysis is controlled by associated muscles, such as the rectus muscles, the internal and external oblique muscles, and the psoas muscles. These muscles work together to allow normal body movement while stabilizing the symphysis pubis. The flexibility and mobility of the symphysis pubis can be affected by factors such as injuries, altered hormone levels, and age. Therefore, it is important to maintain good flexibility and mobility of the symphysis pubis to avoid pain and associated problems.
B- Role of the pubic symphysis in supporting the spine:
The symphysis pubis plays an important role in supporting the spine. It is part of the pelvic region, which also includes the pelvis, and forms the base of the spine. The symphysis pubis supports the upper part of the body, allowing movement of the body while maintaining stability of the spine.
Additionally, the symphysis pubis also works in conjunction with related ligaments and muscles to control movements of the pelvis and spine, such as walking, running, and bending. The symphysis pubis also helps distribute the load across the body evenly, which helps prevent spinal pain and injury.
However, factors such as injuries, altered hormone levels, and age can affect the stability and mobility of the symphysis pubis, which can lead to spinal problems. It is therefore important to maintain good strength and stability of the pubic symphysis to adequately support the spine and prevent associated pain and injury.
IV- Symptoms and causes of pubic symphysis pain:
A- Pain during pregnancy:
During pregnancy, symphysis pubis pain can be a common problem for some women. This is due to hormonal changes that occur during pregnancy, including the increased production of hormones called relaxins. Relaxins act to soften the ligaments of the symphysis pubis to allow expansion of the pelvis in preparation for childbirth. However, this relaxation can also lead to symphysis pubis instability and associated pain.
Symphysis pubis pain can be felt in the pubic area, lower back, and hips. It can be bothersome and affect daily activities, such as walking and sleeping. It is important to see a medical professional to assess the pain and provide appropriate treatment, such as physical therapy exercises, pain management techniques, and positioning advice.
It is also important to maintain a healthy weight during pregnancy and to practice proper exercises to help prevent symphysis pubis pain. If the pain persists, it may be necessary to see a doctor to assess the condition and determine the most appropriate treatment options.
B- Symptoms associated with pubic symphysis dysfunction:
Dysfunction of the pubic symphysis can lead to various associated symptoms. The most common symptoms include pain in the pubic area, pelvis, and hips. The pain may be felt all the time or only during activities such as walking, running, or bending. Other symptoms include instability of the symphysis pubis, difficulty moving normally, and increased tenderness in the pubic area.
Additionally, symphysis pubis dysfunction can also lead to postural issues, such as sagging pelvis or increased lordosis. This can cause pain in the lower back and other areas of the spine. Additionally, symphysis pubis dysfunction can also lead to pain in the legs and hips, as well as difficulty performing activities such as getting out of bed or climbing stairs.
It is important to consult a healthcare professional if you experience symptoms associated with symphysis pubis dysfunction. A medical professional can assess your condition and provide appropriate treatment to relieve pain and improve mobility. Treatment options include manual therapies, physical therapy exercises, pain management techniques, and posture counseling.
C- Common causes of pubic symphysis pain:
Symphysis pubis pain can have many different causes. Some of the most common causes include inflammation, trauma, ligament damage, pregnancy, and postural disorders.
Inflammation can be caused by conditions such as arthritis, tendonitis, or bursitis. Trauma such as blows, falls or car accidents can also lead to damage to the symphysis pubis. Ligaments can also wear down over time, which can lead to pain in the symphysis pubis.
Pregnancy is a common cause of symphysis pubis pain in pregnant women. This is due to the added pressure placed on the pubic area as the baby grows and the pubic symphysis becomes more flexible to allow for easier delivery. Postural disorders such as scoliosis or pelvic droop can also lead to symphysis pubis pain.
It’s important to see a healthcare professional if you experience symphysis pubis pain to determine the underlying cause and get proper treatment. Treatment options include pain relief medications, manual therapies, physical therapy exercises, and posture counseling.
V- Treatment of pubic symphysis pain:
A- Medical treatment:
Treatment for symphysis pubis pain depends on the underlying cause. Some of the common treatment options include:
1- Anti-inflammatory medications: Medications such as ibuprofen or naproxen can help relieve pain and inflammation associated with the symphysis pubis.
2- Physiotherapy: Physiotherapy exercises such as stretching and muscle strengthening can help improve the flexibility and mobility of the symphysis pubis and relieve pain.
3- Manual Therapies: Manual therapies such as chiropractic, osteopathy, and massage therapy can help improve symphysis pubis function and relieve pain.
4- Injections: In some cases, injections such as corticosteroids or lubricating agents can be used to relieve symphysis pubis pain.
5- Surgery: In case of severe damage to the symphysis pubis, surgery may be required to correct the condition.
It’s important to see a healthcare professional to assess the cause of symphysis pubis pain and develop a treatment plan tailored to your individual needs. Early treatment can help prevent pain progression and speed up recovery time.
B- Surgical treatment:
Surgical treatment for symphysis pubis pain is considered an option of last resort for severe cases of symphysis pubis dysfunction that do not respond to other forms of treatment. Common types of surgery include:
1- Arthroscopic reduction: This minimally invasive intervention involves reduction of the articular surfaces of the symphysis pubis and fixation of the joint with screws and plates.
2- Symphyseal osteotomy: This more invasive procedure involves cutting and fixing the pubic bone to realign the pubic symphysis joint.
3- Symphyseal fusion: This intervention consists of removing the articular surface of the pubic symphysis and replacing the joint with a metal plate and screws to fix the pubic bones together.
The choice of surgical procedure depends on the severity of the symphysis pubis dysfunction and the patient’s medical history. After surgery, an extended recovery time is needed to allow the joint to stabilize and heal. Physiotherapy and rehabilitation are generally recommended to improve symphysis pubis function after surgery. It’s important to talk with your doctor to determine if surgery is the best option to treat your symphysis pubis pain.
C- Alternative therapies:
Alternative therapies can offer a gentle approach to treating symphysis pubis pain without resorting to drugs or surgery. Some of the most common therapies include:
1- Massages: Massages can help relieve pain and improve blood circulation to speed healing.
2- Exercise: Exercises to strengthen the muscles of the pelvic girdle and the spine can help improve the stability and mobility of the symphysis pubis.
3- Acupuncture: Acupuncture can help relieve pain by using needles to stimulate acupuncture points associated with pain.
4- Manual therapy: Manual therapy may include manipulative techniques of the spine and pelvic region to help improve the function of the symphysis pubis.
5- Chiropractic: Chiropractic involves manual adjustments to align the spine and pelvic region to improve the function of the symphysis pubis.
It’s important to talk with your doctor to determine the best approach to treating your symphysis pubis pain, including alternative therapies. In general, alternative therapies are considered safe and can help improve symphysis pubis function alongside other forms of treatment.
VI- Prevention of pubic symphysis pain:
A- Muscle strengthening exercises:
Muscle-strengthening exercises can help improve the stability and mobility of the symphysis pubis, which can reduce pain and the risk of injury. Key exercises include:
1- Kegels: Kegels aim to strengthen the muscles of the pelvic floor by contracting and relaxing the muscles of the bladder and anus.
2- Plank Exercises: Plank exercises aim to strengthen the core muscles, including the abdominals and lower back muscles, to help improve spinal stability.
3- Squats: Squats can help strengthen the muscles of the hips, thighs and glutes to improve the stability of the symphysis pubis.
4- Deadlift: Deadlifts are a great way to strengthen the muscles of the back, hips, thighs and glutes.
5- Yoga and Pilates: Yoga and Pilates practices can help strengthen the core muscles and improve the stability and mobility of the spine and symphysis pubis.
It is important to consult a doctor or physical therapist before beginning any exercise program for symphysis pubis pain to determine the best exercises for your condition. Also, it’s important to start slowly and progress slowly to avoid the risk of further injury.
B- Avoid movements that cause pain:
To avoid symphysis pubis pain, it is important to limit or avoid movements that can cause pain or discomfort. Movements to avoid include:
1- Lifting heavy objects: Avoid lifting heavy objects, especially those carried by one hand, as this can cause excessive load on the pubic symphysis.
2- Running: Running can cause excessive pressure on the symphysis pubis, so it is better to choose a gentler form of exercise, such as walking.
3- Sitting on hard seats: Sitting on hard seats can put pressure on the pubic symphysis, so it is better to choose a comfortable seat or a seat cushion.
4- Using high heels: High heels can cause excessive load on the symphysis pubis and can increase pain. It is best to wear shoes with low or flat heels.
5- Turning rapidly: Avoid rapid twisting movements of the spine, as this can cause an excessive load on the pubic symphysis.
Finally, it is important to listen to your body and exercise caution with any movement that may cause pain or discomfort. If you feel any pain or discomfort, it’s best to stop and see a doctor for proper diagnosis and treatment.
C- Avoid excessive overweight:
To avoid pain in the symphysis pubis, it is important to avoid being excessively overweight. Being overweight can cause an excessive load on the pubic symphysis, which can increase pain and tenderness. It is therefore recommended to maintain a healthy weight.
If you’ve been diagnosed with being overweight, it’s important to follow a healthy diet and exercise regularly. Aerobic exercise, such as walking, can help burn calories and control weight. Practicing muscle-strengthening exercise can also help strengthen the muscles that support the symphysis pubis, thereby reducing pain.
It is also important to pay particular attention to the diet. Eating a balanced diet with enough fruits, vegetables, protein, and healthy fats can help control weight and reduce pain associated with symphysis pubis.
Finally, it is important to consult with a doctor or dietitian to develop a personalized eating plan that takes into account your individual weight and nutritional needs. It is best to get professional advice to avoid dietary mistakes that can cause additional health issues.
VII- Conclusion:
A- Importance of recognition and treatment of pubic symphysis pain:
Recognition and treatment of symphysis pubis pain is extremely important for the health and well-being of the affected person. Symphysis pubis pain can be very debilitating and can negatively impact daily living, mobility, and daily activities. If left untreated, it can get worse over time and cause additional problems.
This is why it is important to see a doctor as soon as symptoms of symphysis pubis pain appear. A doctor can diagnose the underlying cause of the pain and recommend appropriate treatment. This may include medication, alternative therapies, muscle-strengthening exercises, or surgery if needed.
Early treatment can help reduce pain and prevent potential complications. It can also help improve quality of life and allow sufferers to regain their mobility and functionality.
It’s important not to ignore symphysis pubis pain or try to manage it on your own. Early and appropriate treatment is the key to improving health and well-being. In case of persistent pain, it is best to consult a doctor to develop an individualized treatment plan that meets your individual needs.
B- Summary of key information about the pubic symphysis and its function:
The pubic symphysis is a joint located between the two pubic bones at the level of the pelvis. It plays a crucial role in the stability of the spine, helping to support body weight and absorb shock from walking and other physical activities. The pubic symphysis is also important for pregnant women, as it must be able to expand to allow the baby to pass through during delivery. Symphysis pubis pain can be caused by a variety of factors such as being overweight, strenuous physical activities, poor posture, or structural abnormalities. Treatment depends on the severity of the pain and may include alternative therapies such as osteopathy, muscle strengthening exercises, lifestyle changes to avoid excessive weight and movements that cause pain, or surgery in severe cases. It is important to recognize and treat the symptoms of symphysis pubis pain in order to maintain a good quality of life and normal mobility.
