What to do when the pubic bone hurts during pregnancy. Pubic bone hurts during pregnancy: why it happens, how to eliminate pain

The pubis is a tubercle formed by soft tissues and located in the lower abdomen, above the external genitals. Under the pubis, in the depths of the body, there is the pubic articulation (symphysis), formed by the two pubic bones and the cartilaginous disc connecting them. Pubic pain usually caused by a pathological process not in soft tissues, but in the osteochondral pubic articulation.

Causes of pain in the pubic area

Such reasons can be:

• injury (bruise, fracture) of one or both pubic bones;
• distension of the pubic articulation during pregnancy - symphysitis;
• rupture of the symphysis during childbirth - symphysiolysis;
• anomaly in the development of the pubic bone;
• cancer of the bladder (pubic pain is "reflected" in this case);
• infectious diseases (pubic osteomyelitis, symphysis tuberculosis).

Pubic pain due to injury

Bruises and fractures of the pubic bones most often occur in the event of an accident, with a direct impact or with strong compression of the pelvis. With a fracture of the pubic bone, the victim feels pain in the pubic area, which increases when trying to move his legs. Severe pain does not allow the victim to lift the straightened leg, lying horizontally.

Pain in the lower abdomen above the pubis

Pain in the lower abdomen, localized in the center above the pubis, in women is most often a sign of a gynecological disease (adnexitis, endometriosis, endometritis, etc.). These pains are not constantly present, but they arise from time to time, having a aching, pulling character. Pain can be given to the perineum; they are almost always accompanied by general weakness, and sometimes by chills.

Severe, growing pains above the pubis, accompanied by bleeding, occur in pregnant women with spontaneous abortion.

In men, pain in this area is most often a sign of chronic prostatitis.

Pain to the right or left of the pubis

The concentration of painful sensations to the right or left of the pubis in women is possible more often with gynecological pathology (ovarian tumors, etc.), less often with diseases of the urinary organs (for example, with bladder cancer).

These one-sided pains can be different in nature: sharp, sharp or weak, pulling. They are usually accompanied by general weakness, the presence of discharge from the genitals.

There is reason to suspect an ectopic pregnancy if:
1. Pain to the right or left of the pubis occurs suddenly, increases with body movements, accompanied by increasing weakness, dizziness.
2. Such pain increases rapidly, is cramping in nature.
3. Along with such pain, bleeding from the genitals occurs.

Sharp, sudden, severe pain to the right or left of the pubis after intercourse, accompanied by weakness to fainting and bleeding, is a likely sign of a ruptured ovarian cyst.

Pubic pain

Pain under the pubis, i.e. below the pubis, at the entrance to the vagina, it is noted in the case of abnormal, abnormal development of the pubic bone. This bone forms elongated, partially overlapping the opening to the vagina.

In this case, attempts to carry out sexual intercourse cause a sharp pain in the woman under the pubis, namely, in the urethra, which is under pressure from the sharp edge of the pubic bone. The pain is so strong that the woman categorically refuses sex life.

Pubic pain during pregnancy

Pregnant women often complain of pubic pain. The fact is that, starting from the middle of pregnancy, the hormonal background of a woman is rebuilt. The production of the hormone relaxin increases, which causes softening of the pelvic bones and their joints (including the pubic joint). This is a natural process, necessary for a child to be born, pushing the pelvic bones apart without harm to himself and the mother.

But some women develop excessive softening of the pubic articulation - symphysitis. The pubic bones become too mobile, the pubic articulation area swells. A woman develops a "duck" gait, difficulties in changing the position of the body, when walking up stairs. There are severe pains in the pubic region (sometimes under the pubis, in the lower part of the pubis). The pain increases with pressure on the pubic bone.

The reason for the development of symphysitis can be a calcium deficiency in the body of a pregnant woman, as well as diseases or features of the development of the skeletal system. After childbirth symptoms symphysitis disappear by themselves.

Pubic pain after childbirth

In some cases, even if a woman did not have symptoms of symphysitis during pregnancy, she may experience pubic pain after childbirth. The reason for this is symphysiolysis (a strong divergence of the pubic bones or a complete rupture of the symphysis, pubic articulation). Most often, this phenomenon is observed with rapid childbirth and large sizes of the fetus.

Symphysiolysis, especially the rupture of the symphysis, is accompanied by sharp painful sensations in the pubic region and in the sacroiliac joints. In this case, the woman in labor needs rest, the pelvic bones must be fixed with a special pelvic bandage.

With subsequent pregnancies and childbirth, the recurrence of symphysiolysis is likely.

Pubic pain in men

In men, unilateral pain to the right or left of the pubis is most often associated with the presence of an inguinal hernia. The cause of pain in the center of the pubis may be chronic prostatitis. Pain in prostatitis is multivariate: it can affect the entire lower abdomen, pubis, sacrum, lower back, etc. Sometimes these pains have a clear localization, and sometimes it is difficult for the patient to determine exactly where he is in pain.

Pubic pain with osteomyelitis

Pubic osteomyelitis causes inflammation of the symphysis (pubic symphysis), so its symptoms are similar to symptoms of symphysitis in pregnant women:

• painful sensations in the pubis and in the lower abdomen, aggravated by pressure on the pubic bone;
• waddling, "duck" gait;
• difficulty walking and changing position;
• pain on the inner side of the thigh.

Osteomyelitis can also be caused by the causative agent of tuberculosis.

Which doctor should i contact for pubic pain?

If you experience pain in the pubic area, the following specialists can help:

• surgeon;
• traumatologist;

So, if a woman or a man has a "duck gait", difficulty walking up stairs, pubic edema, severe pubic pain, aggravated by pressure on the pubic bones, then you should contact to a traumatologist (sign up) or osteopath (sign up), since in this situation we are talking about symphysitis. If pubic pain occurs in a woman after childbirth or during pregnancy, then this indicates symphysitis / symphysiolysis, and in this case, you should first contact gynecologist (sign up), who, after preliminary diagnosis, will refer the patient to a traumatologist, since it is this specialist's competence to diagnose and treat various injuries to the structures of the musculoskeletal system, including the pubic joint.

Pubic pain in infectious diseases (tuberculosis of bones or osteomyelitis) in its manifestations is very similar to symptoms of symphysitis / symphysiolysis (that is, a person develops a "duck gait", difficulty walking up stairs and changing body position, pain in the pubis, lower abdomen and along the inner thigh), but with them, in contrast to inflammation and discrepancy of the pubic symphysis, there are still signs of intoxication, such as low-grade fever, malaise, general weakness, fatigue, sweating at night, etc. Therefore, if symptoms of symphysitis / symphysiolysis appear in combination with signs of intoxication, you should contact phthisiatrician (sign up) and a traumatologist at the same time. This is due to the fact that osteomyelitis is diagnosed and treated by a traumatologist, but it can be a consequence of tuberculosis, and in such a situation it is necessary to simultaneously treat both bone inflammation and tuberculosis infection.

If pain in the pubic area appeared as a result of trauma (fall, impact, bruise, severe compression of the pelvis, etc.), then you should consult a traumatologist or surgeon (sign up), since in this case we can talk about a bone fracture or about symphysitis / symphysiolysis.

If a woman has severe pain under the pubis during intercourse, then this may indicate an abnormality in the development of the pubic bone, and in this case, you should consult a traumatologist or surgeon.

If a man has pains in the center of the pubis, and also possibly pains in the lower abdomen, sacrum, lower back, and pains of any specified localization are combined with urination disorder and erectile dysfunction, then most likely we are talking about prostatitis, and in this case, you should contact to urologist (sign up).

If pubic pain is present almost constantly, combined with the regular presence of blood in the urine, painful and frequent urination, pain in the groin, perineum and sacrum, then most likely we are talking about bladder cancer, and in this case, you should contact oncologist (sign up).

If persistent pain is felt by a man to the right or left of the pubis and is combined with a visible protrusion in the groin fold, then we are talking about an inguinal hernia, and in such a situation, you should consult a surgeon.

If a woman has pain above the pubis, to the right or to the left of the pubis, is pulling, aching or sharp, combined with general weakness, malaise, possibly chills, as well as pathological vaginal discharge (purulent, cheesy, bloody, unpleasant smelling, etc.) then this indicates a disease of the genitals, and in such a situation, you should consult a gynecologist.

What tests and examinations can a doctor prescribe for pubic pain?

Since pubic pain can be triggered by various reasons, when they appear, various lists of examinations and analyzes are assigned to diagnose and assess the state of the body tissues, depending on which pathology is suspected as a causative factor of pain in the pubis. In each case, the list of tests is determined by the accompanying symptoms, since it is their combination that makes it possible to suspect which disease caused the pubic pain.

If a woman or a man has acquired a "duck" gait (waddling from foot to foot), it is difficult for them to climb stairs because of pain in the legs and pubis, there is swelling in the pubic area and a rather severe pain is felt, then the doctor suspects symphysitis, and may prescribe the following examinations:

• Ultrasound of the pubis;
• X-ray of the pubis;
• Computer or magnetic resonance imaging (sign up) pubic area.

Ultrasound (sign up) carried out if for any reason a woman or a man is contraindicated x-ray (sign up) and tomography (for example, several x-rays of various parts of the body or organs have already been taken during the year). In principle, this method makes it possible to diagnose symphysitis with a sufficiently high accuracy. However, doctors prefer to prescribe X-rays or computed tomography (if there are no contraindications to them), which have approximately the same diagnostic value and are considered better than ultrasound methods, if they suspect symphysitis. Therefore, any one of these two studies is selected, depending on the technical capabilities of the medical institution. Magnetic resonance imaging for suspected symphysitis is prescribed very rarely, only if it is necessary to assess the condition of not only the bones and the distance between them, but also the soft tissues of the pubic symphysis.

If pubic pain in combination with a "duck gait" and difficulty climbing stairs or changing posture occurs in a pregnant woman, the doctor suspects symphysitis, and in this case, usually only an ultrasound of the pubic symphysis is prescribed, since X-rays and tomography are undesirable during pregnancy. However, pregnant women should not worry, since an ultrasound scan is quite possible to establish a diagnosis of symphysitis without harm to the fetus and the expectant mother herself.

When severe pubic pain, combined with the difficulty of climbing stairs and changing posture, as well as the inability to lift a straight leg up in the supine position, occurs in a woman after childbirth, symphysitis or symphysiolysis is suspected, and in this case the doctor prescribes an X-ray or computer tomography, which allow you to accurately diagnose. Moreover, only one study is performed - either X-ray or tomography, since their diagnostic value in detecting symphysitis and symphysiolysis is approximately the same. And the choice of the examination method depends on the technical capabilities of the medical institution and the availability of the necessary specialists. Magnetic resonance imaging is rarely prescribed when it is necessary to assess the condition of the soft tissues of the pubic symphysis.

When pubic pain is combined with a "duck gait", difficulty walking up stairs and changing body position, pain in the lower abdomen and the inner thigh, as well as symptoms of intoxication (low-grade fever, malaise, general weakness, fatigue, sweating at night etc.) - an infectious lesion of the pubic bones (osteomyelitis, bone tuberculosis) is suspected. In this case, first of all, the doctor prescribes an X-ray or computed tomography, since it is these methods that make it possible to diagnose osteomyelitis and suspect bone tuberculosis, as well as distinguish these pathologies from each other. After that, the diagnosis of tuberculosis is mandatory, even if osteomyelitis was detected, since this inflammation of the bone can be provoked by a tuberculosis infection in the lungs. To diagnose tuberculosis, a general analysis of blood and urine is first done, sputum microscopy is performed to identify mycobacteria. Then either test Mantoux (sign up) or diaskin test (sign up) or quantiferon test (sign up), or an analysis of blood, sputum, bronchial lavage, lavage fluid or urine for the presence of mycobacterium tuberculosis by the method PCR (sign up)... Moreover, depending on the capabilities of the institution, only one of the four tests indicated for the detection of Mycobacterium tuberculosis in the body is selected. After these analyzes, either fluorography (sign up), or computed tomography, or chest x-ray (sign up) from which only one study is also selected. These tests are usually sufficient to diagnose tuberculosis. But if, according to the research results, it was not possible to exclude tuberculosis, then an additional study of washing water from the bronchi is prescribed, bronchoscopy (sign up) or thoracoscopy (sign up)... And if these additional methods did not allow to exclude or identify tuberculosis, then it is prescribed and performed lung biopsy (sign up), the result of which is considered the final diagnosis.

When pain in the pubic area appears as a result of injury or is felt during intercourse, the doctor prescribes a computed tomography or x-ray of the pelvic bones to identify the resulting traumatic injuries or structural abnormalities.

When a man has pains in the central part of the pubis and, possibly, in the lower abdomen, in the sacrum, lower back, and pains of any specified localization are combined with urination disorder and erectile dysfunction - the doctor suspects prostatitis, and in this case, first of all, he performs a rectal examination of the prostate with sampling of prostate juice. Next, a bacteriological culture of urine and prostate juice is prescribed, as well as study of prostate juice (sign up) under a microscope in order to detect the inflammatory process and identify the causative agent of inflammation. Other studies may not be prescribed if the diagnosis of prostatitis is confirmed. However, in some cases, ultrasound is additionally prescribed to exclude the presence of tumors, cysts, adenomas and other structural changes in the prostate.

When pubic pain is felt constantly, combined with the regular presence of blood in the urine, painful and frequent urination, pain in the groin, perineum and sacrum, then bladder cancer is suspected, and in such a situation the doctor prescribes the following tests and examinations to confirm the tumor and distinguish her from other diseases:

• Manual gynecological examination (sign up) in women and rectal examination in men (with such a study, the tumor can be felt with your hands);
• General blood analysis;
• General urine analysis;
• Cytological examination of urine sediment for the presence of atypical (cancer) cells;
• Bacteriological urine culture;
• BTA antigen test;
• Ultrasound of the bladder (sign up), kidney (sign up) and the ureters through the anterior abdominal wall or rectum;
• Cystoscopy (sign up);
• Histological examination of a biopsy taken during cystoscopy;
• Cystography (sign up)(not necessarily carried out);
• Excretory urography (sign up)(not necessarily carried out);
• Venography;
• Lymphangioadenography;
• Computed tomography or magnetic resonance imaging.

Usually, all of the listed studies are prescribed, except for those near which it is indicated in brackets that they are not mandatory. You also need to know that to assess the presence of metastases in the lymph nodes and nearby tissues, either tomography or a combination of venography with lymphangioadenography is used.

When a man has a painful sensation to the right or left of the pubis, which is combined with a visible protrusion in the groin fold, the doctor diagnoses an inguinal hernia. In such a situation, either no other examinations are prescribed at all, since the diagnosis is already obvious on the basis of symptoms, or sometimes an ultrasound scan is performed if the doctor has doubts.

When a woman feels pain above the pubis, to the right or left of the pubis, which has a pulling, aching or sharp character, combined with general weakness, malaise, possibly chills, as well as pathological vaginal discharge (purulent, cheesy, bloody, unpleasant smelling, etc.) then the doctor suspects any gynecological disease and prescribes the following tests and examinations:

• Gynecological two-handed examination;
• Vaginal smear for flora (sign up);
• General blood analysis;
• General urine analysis;
• Analysis of scrapings from the urethra, blood, or vaginal discharge for genital infections (sign up) by PCR or ELISA;
• Ultrasound of the pelvic organs (sign up).

These examinations are the main ones in gynecological practice, as they allow to identify many pathologies of the genital organs. However, if necessary, the gynecologist may prescribe other various gynecological examinations, for example, hysteroscopy (sign up), colposcopy (sign up), salpingography, etc. Before use, you must consult a specialist.

The body of the expectant mother is undergoing great changes, which are reflected in her well-being. If a woman is expecting her first baby, some of these changes may be puzzling or even frightening. Although experienced mothers are often worried, discovering "something is wrong" in their well-being. Such manifestations, characteristic of the period of bearing a child, include pubic pain during pregnancy. They are familiar to many expectant mothers, and if some of these phenomena occur occasionally, then others can cause a lot of trouble. Consider why the pubis hurts during pregnancy and how to minimize this feeling.

Natural pain in the pubic area during pregnancy

Mild and short-term pain that occurs in the pubic area during pregnancy is a completely physiological phenomenon. In this way, the female body prepares for the upcoming birth, preparing the mother's birth canal for the child to move along them.

The pubic bone is made up of two parts that are connected by the pubic symphysis (pubic joint). It is in the pubic symphysis that the cause of the pain syndrome is often hidden.

Why is this happening? The main culprit of this condition is the altered hormonal background of a woman, or rather, an increase in the level of the hormone relaxin. This hormone is able to soften joints and ligaments, which is necessary for greater elasticity of the birth canal. Usually, pain in the pubis during pregnancy is observed in the second half of it, and becomes a little more frequent as the date of birth approaches.

But that's not all. Experts, answering a woman's question why the pubis hurts during pregnancy, often note the pressure of the fetus on the pubic bone. This pain, as a rule, is not severe, but it is constant and aching in nature. Pregnant women who are expected to have twins or a large baby especially suffer from it. This pain intensifies in the last months of pregnancy.

Improper diet is the cause of pain

It would seem that everyone already knows about the importance of proper nutrition during pregnancy. However, recent research indicates that most moms-to-be do not eat well. Often, a woman expecting a baby does not introduce enough protein, vitamins and minerals into her diet.

As a result of a lack of certain necessary substances in the menu, pain in the pubic area may appear during pregnancy. First of all, this condition can provoke a calcium deficiency in the female body. A symptom of this phenomenon is pain not only in the area of ​​the pubic articulation, but also in other bones, as well as frequent leg cramps.

A woman should understand that calcium is important not only for her, but also for the formation of the fetal skeleton. Its deficiency can provoke the development of muscle weakness in the child and other, more severe, pathologies.

Symphysitis sign

Symphysitis is a pathological condition during pregnancy, when the pubic bones and pubic articulation soften too much, become hypermobile and stretch. This leads to discomfort, pain and swelling of the pubis.

Causes

Experts cannot come to a consensus on what causes the development of symphysitis in expectant mothers. Possible reasons include:

• hormonal disorders;
• problems of the musculoskeletal system;
• hereditary factors;
• fast weight gain of a pregnant woman;
• excessive physical activity;
• calcium deficiency.

Symptoms

The first symptoms of symphysitis appear in a woman in the third trimester, and sometimes in the second trimester of pregnancy. First, pain in the pubis during pregnancy occurs during climbing stairs, walking. Then pain begins in a sitting position, and later in a lying position. The pain is especially aggravated when turning the body in the supine position, lifting the legs. In addition, the woman develops pubic edema and duck gait.

The main danger of symphysitis is that during childbirth, the pubic symphysis can break. Treatment in this case is rather complicated and lengthy. Therefore, in most cases of this pathology, doctors recommend delivery by cesarean section. The indications for surgical delivery are the following conditions accompanying symphysitis:

• the pubic articulation is more than 10 mm apart;
• large fruit;
• breech presentation of the fetus;
• a narrow pelvis in the mother.

What to do

Unfortunately, symphysitis is not treated, it goes away on its own, but after childbirth. To relieve pubic swelling and reduce pressure on the bones, a woman is advised to wear a special bandage.

In especially severe cases, the pregnant woman is hospitalized. In the hospital, she is given anesthetic and anti-inflammatory therapy, physiotherapy. Sometimes your doctor will prescribe an epidural.

Prevention of pain

It is almost impossible to completely stop pain in the pubic region during pregnancy, but it is quite possible to reduce its intensity and frequency. To do this, the expectant mother should listen to the simple advice of experts:

• You need to try not to gain excess weight during pregnancy. Large body mass increases the load on muscles and bones, including the pubic bone.
• Reduce stress on the hip joint. To do this, it is good to lie in bed with a pillow or rolled up blanket under the basin. Thus, the bones and muscles of this area of ​​the body will rest.
• As prescribed by the doctor, it is necessary to take medications with calcium. Calcium is better absorbed in combination with vitamins D and C, so you need to choose such vitamin preparations, where all these elements will be.
• A good effect is given by special gymnastics for the hip joints and muscles. First, it is performed under the supervision of a specialist, then a woman can do these simple exercises on her own at home.
• It is very important in the last months of pregnancy to wear a properly fitted brace, which will reduce the stress on muscles and bones.

Pubic pain during pregnancy is a fairly common occurrence, so do not be afraid of them. Timely appeal to the doctor and the implementation of all his recommendations will make it possible to carry the child and safely give birth to him.

Pregnancy is the most important event in a girl's life. As childbirth approaches, constant changes take place in the female body, both hormonal and physical.

Unusual sensations can catch up with fear and plunge into panic, which is unlikely to have a positive effect on the baby. In most cases, pelvic pain is a normal physiological phenomenon, which may or may not be present during pregnancy. It is necessary to consider the trimesters by week to find out possible causes and eliminate unnecessary fears.

Possible causes of pubic pain

The causes of pain in the pubic bone vary depending on the length of pregnancy.

TO main symptoms relate:

• Symphysitis: severe dehiscence of the pelvic bones.
• Lack of calcium and other essential elements in the body.
• Physical injuries in the pelvic area (blunt blow, trauma, compression in an accident).
• The beginning of labor: contractions, attempts, the moment the baby's head passes through the hole in the pelvic floor.

Secondary symptoms

Knowing the secondary symptoms that accompany pain in the pubic joint during pregnancy will help to recognize the correct location of pain.

Secondary symptoms:

• Change in gait, a characteristic "pregnant gait" appears: wide leg spread and slight swaying. This is due to the slight divergence of the pelvic bones.
• Dull pain with strong pressure on the pubic region and above.
• Pain in the lower spine, in the coccyx and sacrum.
• Numbness of the lower extremities.
• Difficulty raising legs, alternately.

Early term is considered the interval from conception to the end of the first trimester or the middle of the second. Any painful sensations in the early stages of pregnancy should be alerted.

A visit to the gynecologist is a must, since only a qualified specialist can correctly diagnose the localization and the exact cause of the pain.

If pubic pain accompanied by bleeding and pulling pains in the lumbar region, call an ambulance immediately, as the risk of miscarriage remains high until 3 months of pregnancy.

If the pain is localized only in the pubis, do not worry, exclude the load on the spine and remain calm during the day, the painful symptoms should subside. Perhaps the lack of calcium in the body affects the pain in the pelvic region, consult a specialist about the possibility of taking a vitamin complex.

Pubic pain at 28 weeks gestation

At 28 weeks, the gestation period exceeded half, which means that the meeting with the baby will take place very soon. At the 7th month, a woman already in full force begins to feel all the delights of her "position". The weight becomes more and more and, therefore, the load on the spine increases.

Any changes in the spine, especially in the lumbar region, affect the condition of the pelvic bones. The pubic bone is a supporting one, therefore painful sensations are localized, most often, in it.

Month 7 marks the beginning of the third trimester, which means that the body begins to prepare for childbirth. Bones can change their structure and become softer, just such a restructuring causes unpleasant and sometimes painful sensations. To avoid complications, it is recommended not to miss scheduled examinations by a gynecologist.

34 weeks is equivalent to 8 months from the moment of conception. The girth of the waist continues to increase, the stomach makes the penultimate jerks in growth. During the last month of pregnancy, the baby gains from 1 to 1.5 kg, which affects the condition of the expectant mother. Under the pressure of the fetus and the off-scale levels of the hormone relaxin, pelvic bones begin to prepare for childbirth.

If a woman has narrow hips (anatomically narrow pelvis), the pain will be most pronounced. The pelvic bones begin to shift and transform in the middle of the third trimester. Do not worry, this does not mean that bones can break or be damaged - nature has foreseen everything. After the baby is born, the bones will get stronger again and the discomfort will be eliminated.

At 38 weeks

At such a late date, the pelvic bones are ready for childbirth. Pain in the pubic area is completely normal as the fetus reaches its maximum weight and begins to descend in the pelvic area.

When the pelvic bones diverge at a distance of more than 1 centimeter, a condition (disease) occurs symphysitis or symphysiopathy.

It is necessary to listen carefully to your own painful sensations and not to miss the development of this pathology. With symphysitis, natural delivery is highly discouraged; a cesarean section is performed. If this measure is neglected, childbirth will be more painful and cause complications in subsequent pregnancies.

Severe pubic pain may indicate about the beginning of labor... Contractions are accompanied by a pulling back pain, contraction of the uterus, slow movement of the fetus along the birth canal, which in turn leads to the maximum discrepancy of the pelvic bones.

If the frontal articulation diverges by more than 1 centimeter, it is recommended to observe complete rest: do not play sports, exclude the lifting of heavy objects, reduce long walks and climbing stairs. At 39 weeks, labor can begin at any time.

Whenever possible, you should visit a gynecologist to make sure that the frontal dehiscence is not critical and a cesarean section is not required. If you neglect additional research (when indicated), pain in the frontal joint will accompany you for a long time after childbirth.

Pain above the pubis

Pain above the pubis may indicate contraction of the uterus, which should alert a pregnant woman. If the contractions of the uterus (or as doctors call them - hypertonicity) last more than one day, it is recommended to call an ambulance or urgently visit a gynecologist, as there is a risk of miscarriage or premature birth. In this case, the pregnant woman is kept and monitored for several weeks.

When the doctors are convinced that the danger has passed, the woman will be sent home. Also, pain above the pubis may appear due to squeezing of the bladder and other abdominal organs. In this case, you should not worry, it is enough to inform your doctor about new sensations.

Outpatient treatment requires only a bruise in the pubic bone. In this case, the patient needs complete rest under the supervision of a traumatologist. It is important not to harm the fetus by incorrect selection of drugs and procedures. Physiological pain (symphysitis) with the divergence of the pelvic floor bones can only be prevented or anesthetized.

When planning and in the early stages, it is necessary to take vitamin complexes with calcium content. All vitamins and dietary supplements are taken strictly in consultation with the doctor leading the pregnancy. Exacerbation of symptoms of symphysitis can contribute to too large a fetus.

If, when registering, a clinical narrow pelvis of the second degree or more was registered, it is necessary to carefully monitor the diet in order to avoid excessive weight gain in the baby. It is recommended to avoid additional stress on the spine: lifting weights, stooping, spending a long time “on your feet”.

Pubic bone it is one of the three bones that form the pelvic bone during fusion. Steam room; the two pubic bones, forming the pubic articulation, form the anterior wall of the pelvis. Consists of a body and two branches. The branches and body of the pubic bone form an obturator opening, closed locking membrane.

The pubic bone in women with the correct physique has the shape of a roller about the thickness of the thumb, which is curved and forms pubic eminence. This bone overhangs in a kind of arch over the entrance to the vagina, merging with the edges of the pelvic bones, and does not represent an obstacle during coitus.

The pubic bone is one of the components the pelvic bone. It is paired and, connected by a cartilaginous disc, the bones form a symphysis (pubic articulation). Pain in the pubic bone is often caused by the ongoing pathological processes in the joint, and not in the soft tissues.

Causes of pubic bone pain

If during pregnancy, especially in the second half, you have acute pubic pain, it became difficult to walk up the stairs, turn from side to side on the bed and rise from the couch, and your gait changed and became like a duck symphysitis.

This disease is associated with softening of the pelvic joints and stretching of the pubic joint (which is also called the symphysis - it is a sedentary joint and connects the pubic bones) under the influence of the hormone relaxin. The process of softening the interosseous joints is natural, it helps the child to pass more easily through the bone pelvis during childbirth.

But in the case when the pubic articulation swells, stretches strongly, becomes mobile, and the frontal bones, accordingly, diverge excessively - pain appears and a diagnosis of symphysitis is made. The reasons why this disease occurs are not completely clear. Some scientists are inclined to the version of a lack of calcium in the body of a pregnant woman, some associate the disease with increased concentration of relaxin. Perhaps symphysitis is caused by the individual characteristics of the woman's body structure, hereditary characteristics or her pre-pregnancy problems with the musculoskeletal system.

Women begin to complain of pelvic pain after childbirth due to symphysiolysis. The syndrome consists of symphysiolysis proper, symphysis rupture and pain in the pelvic bones... Symphysiolysis is characterized by a discrepancy between the two pubic bones and instability.

Acute rupture of the symphysis is very painful, and in this case, rest and a pelvic bandage are necessary. Pain in the pelvic bones is characterized by soreness of the symphysis and sacroiliac joints. Complaints usually recur after the next pregnancy.

Pubic bone fractures usually occur with a direct blow to the pubic bone or with compression of the pelvis. More often than not, they are not accompanied by significant displacement. Patients complain of pain in the pubic bone, aggravated by movement of the legs or palpation.

In the supine position, the patient cannot raise a straight leg. This symptom is called a stuck heel symptom. Fractures of the pubic bone may be accompanied by a bruised bladder. Then there are disorders of urination, pain when urinating.

In some women, the pubis has the shape of a flat saber-shaped bar 3-4 fingers wide, almost half covering the lumen of the vaginal vestibule. With this shape of the pubic bone, its lower edge becomes an obstacle, causing sharp pain when trying to insert the male penis into the vagina.

It is especially felt when the penis presses on the periosteum and presses the urethra against the sharp edge of the pubic bone. Painful sensations when pressing on the periosteum is very painful and is repeated, as a rule, with each attempt to resume intercourse. All this contributes to the consolidation of a protective conditioned reflex and a woman's negative attitude towards sex life. In case of pain in the pubic bone, you should contact your gynecologist and traumatologist.

Treatment

Treatment for this pain in the pubic region necessarily includes special gymnastic exercises, focused on the muscles of the abdomen and pelvic floor. For example, to perform one of the exercises, you need to get down on all fours and, keeping your back straight, take a breath. Exhaling, the pelvic floor muscles should be squeezed and not unclenched for 5-10 seconds. You should not hold back your breath, and you should also not move your back. At the end of the exercise, the pelvic muscles must be slowly relaxed. This and similar exercises strengthen the muscles of the back and pelvis.

Also, patients are prescribed manual therapy which gently affects the muscles of the pelvis, hips and back. Water exercise is also effective. For pain in the pubic region, treatment is prescribed by a gynecologist. In some cases, he will prescribe the following ways to get rid of pain:

Acupuncture. This procedure allows you to relieve pain in the pubic bone not only for women, but also for men. The procedure is almost painless, but very effective. The only thing to consider when agreeing to acupuncture is to trust your body only to a doctor who has received special training in this area of ​​treatment;

Osteopath, chiropractor consultation. These doctors know how to cope with pain of this nature, so their consultation will be extremely useful;

Wearing a prenatal brace. This method of treatment applies to pregnant women suffering from pain in the pubic bone;

Percutaneous drainage. It is indicated for purulent symphysitis;

Local injections of glucocorticoids, NSAIDs - with osteoperiostitis;

Taking medications containing calcium.

Many pregnant women find relief after exercise such as the "lotus" or "butterfly". Pregnant women should avoid strong physical exertion, often go to rest, stretching their legs, but also do not forget about movement - despite the presence of pain, it is simply necessary for pregnant women to move.

If you find such symptoms, you should immediately contact specialist(traumatologist; surgeon; urologist; gynecologist), since pain in the pubic bone cannot appear without a reason.

Pregnancy brings many changes to a woman's life. Most of them have extremely positive aspects, because this is all for the sake of the birth of a long-awaited child. But still, only a few are given to avoid a certain discomfort. For example, such a phenomenon as the pubic bone hurts during pregnancy, not only causes inconvenience, but can also seriously scare the expectant mother. Let's figure out what it is and how dangerous it is.

Why It Happens and When Pubic Bone Pain Is Normal

In medicine, the pubis is usually called the pubic joint. It got its name due to its structure. At this point, the two halves of the pubic bone are connected to each other using cartilage tissue.

In a non-pregnant state, the pubic symphysis is fixed and immobile.

Starting from the middle of the second semester, the woman's body begins to prepare for childbirth. Cartilage becomes more elastic, bones are softer. As a result, the divergence of the pubic bones occurs. It should be understood that without this, the process of natural delivery is simply impossible.

The appearance of unpleasant sensations is associated with the divergence of the pubic symphysis. This also happens in connection with an increase in the pressure of the grown fetus. The gap between the bones of 0-5 mm is still considered the norm and characteristic of non-pregnant women. During gestation, this discrepancy may be slightly larger, but no more than 2-3 mm. Anything above these parameters will be considered as pathology.

What is symphysitis and how is it dangerous?

When the pubic bones separate and the distance between them becomes up to 1 cm, doctors can diagnose a condition called symphysitis.

Its main manifestations are:

• painful sensations in the pubic bone that can spread throughout the lower abdomen;
• the appearance of a duck gait;
• the presence of clicks or pops while walking;
• discomfort when pressing on the pubis.

The reasons for the development of symphysitis during pregnancy can be quite natural changes or pathological manifestations:

1. Hormonal changes. Starting from the second trimester, the hormone relaxin begins to be produced in the woman's body. Its purpose is to soften the ligaments and prepare the birth canal for the birth of a baby. If it is produced in excess by the body, the pubic bones diverge too quickly and too much, which causes pain.
2. Lack of calcium. Lack of the element can be caused by a deficiency of vitamin D, which has a direct role in the absorption of calcium by the body.
3. The fruit is too large.
4. Polyhydramnios.
5. The presence of chronic diseases of the bones, cartilage or joints, which are exacerbated during pregnancy.

There is no evidence that excessive divergence of the pubic articulation can negatively affect the growth and development of the fetus. But at the same time, it can seriously undermine the health of the mother.

There are 3 stages of the disease, depending on the magnitude of the discrepancy. The first is up to 1 cm, the second is within 1-2 cm, the third is over 2.

Diagnosis of stages 2 or 3 should be the reason for a caesarean section at the time of delivery. Since if the bones are too far apart, the woman will need long-term rehabilitation, which will take months, and maybe years.

How to detect and how to treat

According to experts, symphysitis during pregnancy in the 1st and 2nd degrees rarely has pronounced symptoms. But upon reaching grade 3, a woman may experience:

• pain while walking;
• the inability to take the leg straight to the side;
• swelling in the pubic area.

As diagnostic methods, specialists resort to the use of X-ray machines. They allow you to assess how advanced the disease is. It should be noted that this type of diagnosis is permissible only after 16 weeks, when the load on the fetus is lower.

Specialists do not carry out direct treatment of the disease. They only prescribe drugs to help relieve acute symptoms. This can be taking an anesthetic, for example, No-Shpy. Often, special ointments and rubbing are used, which also have an anti-inflammatory effect.

In any case, after delivery, the symptoms almost always go away. If this does not happen, a course of antibiotics and special physiotherapy aimed at recovery is prescribed.

How to relieve symptoms

If the pubic bone hurts for physiological reasons, then you should not be afraid of this. But there is no need to endure discomfort either. Comfort and excellent condition are especially important for the expectant mother. Therefore, experts recommend adhering to certain rules that will make it easier to transfer the ongoing changes:

1. Wearing a bandage. This uncomplicated device may well become an excellent assistant. The bandage will take some of the load on the pelvic bones and thereby significantly reduce pain. But even it should not be used without the advice of a specialist.
2. Minimizing physical activity. No matter how useful an active lifestyle is, in this case it is recommended to reduce it to a minimum. In especially severe cases, the doctor can recommend and significantly reduce the woman's physical activity. The transition to partial bed rest will relieve the body from overexertion and help to endure pain more easily.
3. Correction of nutrition. The diet should include foods rich in calcium. They will strengthen bones, ligaments and cartilage, and as a result, the woman will feel relief. In special cases, the doctor may prescribe an additional intake of drugs containing this element.
4. Re-equip a sleeping place. A pregnant woman is advised to choose a softer mattress, choose a comfortable bed.

Heeled shoes put a tremendous strain on the spine and pelvic bones. Wearing a soft and comfortable pair will significantly reduce the stress on the problem area.

In addition, you should pay attention to the correct posture and posture in which the woman is most often found. You cannot stay in the same position for a long time, this interferes with the correct distribution of the load.

Thus, if a pregnant woman has a pubic bone pain, then you should not immediately panic. First of all, you need to contact a specialist to exclude serious problems with the body, and then try to follow the proposed recommendations.