What pubic bone pain represents, is much more than just discomfort.

Symphysis pubis dysfunction (SPD), or pubic bone pain is a common cause of suffering during pregnancy. Your pubic bone is actually made up of 2 pelvic bones and a piece of cartilage. The two bones meet in the middle with the cartilage in-between, and this forms the “pubic bone” or symphysis pubis, in the front of your pelvis. The same pubic bones that meet to make the pubic bone, also meet at the sacrum in the back of your pelvis, where they form what is called the Sacro-iliac joints (SIJ).

The pubic symphysis is circled beneath, while the two sacroiliac joints are circled on the top. Abnormal position or movement of any of these, will lead to problems in the other joints.

The pubic symphysis is circled beneath, while the two sacroiliac joints are circled on the top. Abnormal position or movement of any of these, will lead to problems in the other joints.

So what causes SPD? 

One of the most common causes is misalignment (subluxation)and pubic bone pain is in the sacroiliac joints, or the pubic bone itself. Because of pelvic bone involvement, they are essentially inseparable. If you imagine subluxation of the sacroiliac joints (top two circles in the image above), would medication realign these joints? Would medication realign the pubic bone? The answer is NO to both. Would massage realign the joints? Unlikely. Pubic bone pain always has a cause. When the cause is subluxation, it must be corrected by a specialist in pregnancy (perinatal) chiropractic.

As the pregnancy progresses, hormones like relaxin do come in to play to relax the soft tissue structures in and around the pelvis in an effort to prepare mom’s pelvis for labor and delivery. As the structures loosen, there is more room for subluxation and inflammation of the pubic bone, which may lead to SPD.

SPD often starts to become painful gradually. If you feel pubic bone pain starting, that is the best time to seek help. If left alone, because of the nature of pregnancy and fairly rapid structural change and stress in the mother’s body, the pain and dysfunction will tend to get worse. Pelvic and symphysis pubis subluxation impacts your hips, pelvis, sacrum and low back. Dysfunction and subluxation in these areas lead to one of the leading causes of difficult and prolonged labor, also known as dystocia. To read Dr. Lou’s post on dystocia, click HERE. Remember, while your comfort and wellbeing related to pain are very important, the cause of the pain can also lead to dystocia, even c-section. If the baby is in distress or not progressing by the standards of your medical birthing team, they will suggest a c-section because the baby has become “at risk” of being a “damaged baby.”

I have pain in my pubic bone. What should my first step be?

Your first step after ruling out anything that could put you or your baby at risk of serious injury, you should contact a chiropractic office with a doctor who is board-certified in Perinatal chiropractic. For a list of doctors with the CACCP or FICPA designation, indicating board certification, CLICK HERE. Chiropractic care during pregnancy is extremely safe and effective. It is efficient and it is covered by insurance. For patients with no insurance, the out of pocket cost is well worth the price knowing that it may help with the pain, but it always helps with the function of the pelvis, pelvic position and it should set you up for a smoother labor and delivery by reducing the risk of dystocia.

I have pubic bone pain, hip pain, and sciatica. What should I do?

A collection of symptoms like this generally means greater underlying dysfunction and a much greater urgency for getting care. The more symptoms you feel, the more causes exist beneath the surface. These causes if left unaddressed, may create post-partum problems for mom too.

Dr. Lou Jacobs is board certified in perinatal and pediatric chiropractic by The Academy Council of Chiropractic Pediatrics and The International Chiropractic Pediatric Association (ICPA). Dr. Lou has been working as a Portland, Maine chiropractor for pregnant moms and children for over 17 years.