Is it Pubic Symphysis Disorder or round ligament pain?

Pubic Symphysis Disorder (PSD or SPD) is a painful condition felt in the pubic area and is often mistaken for round ligament pain.  Unfortunately not a lot of OBs will give much heed to PSD (or even round ligament pain) because they cannot do much about it.  However, being able to distinguish the two will allow you to choose a more effective remedy in reducing your pain.

1. Where is the pain?

PSD: Almost always the pain is felt at the pubic symphysis joint—the bony part at the top of the pubic area—and will be very sore to the touch.  The pain usually radiates down into the groin and will often also radiate out into the hip joints.

Round Ligament: The pain is usually felt in the lower abdomen and slightly off to one (or both) sides.  It often radiates into the groin and/or around the sides to the flanks or hips.

2. What is the quality of the pain?

PSD:  Sharp and intense.  For some the pain feels like they are breaking open from the inside or their hip bones are grinding together.  Oftentimes a clicking sound is heard when walking or moving.

Round Ligament:  Also sharp and can be intense.  Many times the pain happens suddenly.

3. When is the pain felt?

PSD:  When standing, walking, shifting while sitting, and intensely when rolling over in bed.  The pain continues even after stopping the movement.

Round Ligament:  When performing sudden movements and usually diminishes if not goes away after a few seconds.

If you still aren't sure which it is here is a simple test: stand on one leg (please use your arms to support yourself when doing this).

PSD: You will experience increased pain or even an inability to stand on one leg (the other leg may give out).  You will find it difficult with activities like walking up stairs, raising one leg to put on pants, or getting in/out of a car.

Round Ligament: You will experience minimal, if any, change in pain and should find it easy to stand on one leg.

Here is a side note: Sciatica and sacroiliac joint dysfunction (SIJD) are sometimes co-conditions of PSD.  The presence of sciatica or SIJD does not rule out PSD, but it doesn’t guarantee it either.

Pelvic Pain in Pregnancy

Pelvic pain during pregnancy is something that is often misunderstood by the medical community at large. The degree of pain is something that is often not addressed at all.
I became aware of the severity of pelvic pain when my wife was pregnant with our second child.

During the 2nd month of my wife’s pregnancy she began to complain about pain in her hips and pelvis when she rolled over in bed at night. She said it felt as if her bones were grinding together. I was a young, inexperienced student at that time and I told her I didn’t know how to help her.

She went to her OB multiple times over the next 3 months as the pain became debilitating. She walked as if she were an old woman, and used a wheelchair for situations that required a lot of movement. Her OB could only recommend Tylenol and told her she might want to try massage. Other than those suggestions she would just have to wait it out.

Now, my wife is not one to sit around and wait for anything, so she began her own research. She found a small blurb about something called  Symphysis Pubic Disorder or SPD in a medical journal online; she then was able to find a support group for SPD in Great Britain. She emailed them and found out that this disorder is something that is just recently gaining attention in Great Britain and they sent her some literature. She was relieved when one of the first treatments mentioned was chiropractic care. (Did I mention I was a student and was somewhat MIA?)

My wife began chiropractic care and within a week was making great progress. Her pain levels went from a 10 to a 3 and she was able to tolerate the remainder of her pregnancy without too much discomfort. She moved like a different woman in a matter of weeks.

So now, thanks to my wife, I look like the hero when I tell pregnant women I know what is wrong with them and how to help them. She is the real hero.

Check back next week for details about SPD and its treatment, or email me directly at drrichards@abetterbrain.com.