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.

Sciatica: A Real Pain In The Backside!

Sciatica is another constant companion of many a pregnant woman. Like indigestion, edema, and constant urination, sciatica tends to show up in the 2nd trimester. And like its companions it tends to stick around until the baby is born. The good news is that sciatica can be sent on its way rather quickly and leave you alone to deal with the indigestion, edema, and constant urination.

What is sciatica?

Sciatica is an often misused term. Many people say they have sciatica if they have any lower back pain. However, sciatica occurs when the sciatic nerve (the largest nerve in the body and the one that innervates the majority of the lower body) becomes pinched or irritated.

Sciatic pain follows a particular path from the lower back or hips and runs down the leg generally ending near the knee. Sciatic pain is often described as a burning pain or a pins and needles sensation. Numbness and tingling can occur as well. Sciatic pain makes it incredibly painful for a person to sit, stand, bend, or really do anything other than lay on their back.


Why is sciatica so often associated with pregnancy?

Sciatica in pregnancy is common for 2 reasons.

Hormones: Our good friend relaxin is just doing his job and is allowing the pelvis to become hyper-mobile. (Read previous post on relaxin.) Unfortunately the sciatic nerve is attached in the pelvis and becomes irritated with all the unaccustomed movement.

Structure: As the baby grows, the uterus grows and puts pressure on the sciatic nerves and its surroundings. This weight is pulled forward, which increases the arch of the back and can lead to pressure on the sciatic nerve.

What can be done to ease the pain?

Sciatica can cause even the toughest to break into tears. It can be debilitating and miserable, but it doesn't have to last. Although it is tempting to stay in bed, not moving a muscle and praying to feel better, recent studies have shown that this is ineffective and can actually prolong the agony.
Getting up and moving while painful, will ultimately help the sciatic nerve.

Home remedies:

• An ice pack applied for 10 minutes to the low back can help and is safe for pregnancy.
• Sleep or lie down on your side with a pillow between your legs and one in the small of your back.
• Try to stand as straight as possible and sit up straight.
• Avoid standing or sitting for extended periods of time.
• No heavy lifting.
  

Outside help:

• Chiropractic is one of the best and safest treatments for sciatica. Using a gentle, low-force adjustment a chiropractor can free the sciatic nerve and allow normal impulses to return. A majority of women feel relief after the first treatment, and all but the rarest case are feeling fine by the 2nd or 3rd visit.

• Some women find that acupuncture can really relieve the pain. It is believed to be safe for the baby and effective. Although it is great for pain relief, it does not correct the underlying structural problems causing sciatica, and it will return.

So, all you sciatica sufferers, get moving. Help your amazing body do its job without hurting you!

For more information about chiropractic visit www.abetterbrain.com

84% of Pregnant Women Get Back Pain Relief From Chiropractic

Here is a little gem of a study for those of you contemplating chiropractic treatment for your back pain or sciatica.

In a recent study 84% of patients receiving chiropractic manipulation reported relief of back pain during pregnancy. There was significantly less likelihood of back labor when spinal manipulative therapy was administered during pregnancy. ("Back pain during pregnancy and labor". Diakow PR, et al. Journal of Manipulative and Physiologic Therapeutics, 1991: 14(2): 116-118.)

Not only does chiropractic treatment bring relief of symptoms it also reduces the chance of "back labor" which as many of you know can be rather painful. Chiropractic is safe and effective and can help you feel better now and keep you from pain later.