Pelvic and Pubic Bone Pain during/after Pregnancy

Parent Q&A

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  • Hi everyone,

    I gave birth almost four months ago and still have a lot of pubic bone/pelvic pain (gets especially bad at night). Icing helps a little bit but after this much time, I need to do something.

    Do you know of any Post-partum Physical therapists, Chiropractors, and/or Orthopedic surgeons who have a track record of success or have helped you heal, are in network with anthem blue cross, and lean more on non-invasive, safe for baby, root cause finding, long-term fixes?

     Thanks so much!

    I use Armene at Awaken Chiropractic on Grand - she was wonderful throughout both my pregnancies and I still see her regularly now.  I have sent many of my friends postpartum who also swear by her!

    Karen Hodges at Bayo Vista Physical Therapy helped me so much postpartum. Unfortunately they're not in-network with any insurance but if you have an FSA or HSA you can use those funds to cover it. https://bayovistapt.com/

    Had EXCRUCIATING pubis symphysis dysfunction from 5.5 months of pregnancy onward, through delivery. Most of it relieved itself after delivery, but still had sharp pain for a good 4-5 mos postpartum. Put together the best combo care team through research and referrals that helped me manage my pelvic pain in pregnancy and re-build strength after. Do not have much pain at all now. 

    I will rank these in order of importance based on my experience treating my pelvic pain:

    Physical therapy with whole-body approach: Karen Hodges at Bayo Vista Physical Therapy. She saved me. She is a private PT; I submitted super bills to my insurance directly. 

    Chiropractic: Awaken Oakland. Saw them during pregnancy and still see them today (have an appointment this afternoon). Love Dr. Armene Boatright. Cannot recommend enough. I was skeptical about how much this could help me, but after one visit Dr. Boatright was able to give me some relief, which kept me coming back. 

    Bodywork: Ereene at Bravebird Bodywork. Wonderful during and after pregnancy. Still see her now. She releases the following month's availability on the first of every month; online booking. Great for massage and relaxation; not a pelvic "fix" per se, but great in concert with physical therapy.

    Orthopedic surgeon: Cal Sports. Have found them to be great, but super hard to get into. I have been covered with them on both Aetna and Blue Shield PPO over the years. I have long-standing knee issues (20+ years with 3 surgeries) so I only saw them re: my pelvis because I was already there for hyaluronic acid injections in my knee. They did an x-ray of my pelvis in-office (everything was fine) and later an MRI of my pelvis, which revealed torn labrum in my hip. They do not push surgical intervention and have other ideas and options, which I like.

    Good luck. Wishing you healing and peace.

    Karen Hodges! She fixed my pelvis before and after kids :) 

    She's a PT and a Certified Functional Manual Therapist (CFMT)

    https://bayovistapt.com/

    I would highly recommend my acupuncturist! Jenny Nieters is a sports acupuncturist (works with the 49ers so you might not get her but her colleague Erin is also FABULOUS!). Ligaments and tendons response well. I had significant tail bone pain. I tried pelvic floor PT but that didn’t really help (not sure I believe the answer is “just do my kegels”….)

    i also started post partum pilates and noticed a huge difference in my core strength. I follow Kim Saha on YouTube. CanNOT recommend enough! (PS make sure you’ve been cleared for exercise by your OB…)

    I worked with a physical therapist at PHRC (Pelvic Health Resource Center) and she was very knowledgeable and helpful. I would imagine anyone there would be great. I think they did require authorization from PCP so you may need to talk to your OB/GYN to get a referral. But having to still ice at 4 months postpartum is not normal so you should definitely get some support!!

    Hi! I wanted to respond to you because I was in the same boat and the thing that finally helped me was 1-on-1 megaformer pilates sessions. After just a few sessions, I was pain free. I learned that I needed to strengthen surrounding muscles that had weakened during pregnancy to support my pelvis. I hope you find relief!

    If you are open to a more self-guided approach (or as an addition to personalized care), I am currently doing this program and finding it really valuable: https://every-mother.com

    Went to Origin Women's Physical Therapy in SF. Not in Berkeley, but they take insurance and will breakdown costs before the first appointment. Staff is friendly and welcoming. Lots of different techniques available to try and ease pain. 

    https://www.theoriginway.com

    Hi There,

    Im not sure if they accept Anthem Blue Cross but I’d like to recommend Awaken Chiropractic in Grand Ave in Oakland. Awaken is woman-owned / operated and they specialize in everything you mentioned. I went there all through out my pregnancy. 

    https://www.awakenoakland.com

    Best of Luck! 

    Dr.Melissa at life chiropractic is excellent. 
     

    not in network but she has affordable family plans and is worth it! Excellent hours too 

    The only pelvic physical therapist I found that takes insurance was at the Women's Health Center in Lafayette, and they were great. https://www.sutterhealth.org/find-location/facility/womens-health-cente… I looked really really hard in 2018, so there might be other options now, but the general issue is that there are great practitioners around, but they don't take insurance, and give you superbills to submit on your own. I also went to Reclaim in Lafayette, and she was amazing. But we could not get Blue Shield to process my superbill claims, all of them were denied, which we have unfortunately found is common with superbills from various practitioners with various insurance providers over the years (we've had issues with Aetna and Cigna with another provider my husband sees). I would also add that it's totally worth seeing someone, even if you have to pay out of pocket, and can't really afford it, it's that important to go. 

    This isn’t the type of service you mentioned, but a very dear friend in the Santa Cruz area has dealt with pelvic floor issues and significant pain for over a decade & your situation has similarities to hers. She recently found fantastic benefits from myofascial release work. The provider really “gets up in there” (her words), so something to be aware of. She’s also found that crying often occurs during the sessions as the pain she has experienced is the result of her body physically holding on to past traumas. So maybe something to check out? Wishing you luck and the end of pain. 

    I’ve been going to Origin PT in SF for my pelvic floor issues, seeing Madeline Mannion.  I am very impressed with her and the clinic. And they take insurance! It’s a bit of a journey to Cow Hollow from the East Bay but they do have video visits for some problems.  

    I love Kendra and and Armene at Awaken for chiro. They literally helped me walk during my pregnancy and moved things around later. I also saw a pelvic physical therapist.  The team at Pelvic Health and Rehabilitation Center is amazing.  My insurance didn’t cover it but it really helped. 

    The chiros at Awaken Chiropractic are both incredible. Highly recommend.

Archived Q&A and Reviews


During Pregnancy Post-Partum Related Pages

Pubic and pelvic pain in pregnancy

March 2010

Does anybody out there have experience with pubic symphisis and pelvic pain during pregnancy? If you had this problem, did it magically disappear when you gave birth? I've recently been told a horror story about a woman who can hardly walk post-birth because her pubic symphisis ligament is so messed up (she had an epidural, and thinks that maybe she pushed too hard at the wrong time and couldn't tell because of the drugs). I'm trying to decide how much this needs to be addressed, beyond basic pain management. If it really just goes away after labor then I will worry about this less, but I'd like to get some more anecdotal reports (the BPN posts I've been able to find are at least 5 years old).

Here's my situation: My pains began at about 18-20 weeks and were mostly centered on an ability to abduct my right leg. Well, I had SI joint pain starting at about 12 weeks, but only when I lay on my back. The burning pain in my pubic area started at about 23-24 weeks, and at 28 weeks I'm finding it absolute torture to turn in bed or walk to the bathroom at night. I have historically (prior to pregnancy) had SI joint pain and hip issues, so it's hard to tell what's pregnancy and what's not, or if it even matters at this point.

So, what do you think? Should I be seeing a chiropractor who specializes in pregnancy issues? (And does this necessarily mean someone trained in Webster technique or not?) Should I seek out an OB who considers SPD to be a real problem and who can monitor this for me? Are there doulas out there with knowledge of this syndrome? Should this be something I put onto my list of things to worry about at labor? I suppose the bottom line is, should I worry about this or just get through it? I look forward to your replies. Niki


I had terrible SPD from about 24 weeks until birth. Like you, turning in bed was agony and I could hardly walk. I saw an osteopath, which kept things a little more bearable, and cycled instead of walking since that was much easier for me (though getting on and off the bike was a little tricky). But really, it was just terrible for the second half of my pregnancy. The good news: it magically disappeared at birth. I had a scheduled c-section (for placenta previa) and by the time I recovered from that there was no trace at all of the terrible pubic and pelvic pain. it can just disappear


I'm almost 32 weeks pregnant and I've been seeing Esther Dolowich for physical therapy at Alta Bates Summit - originally for sciatica, but now more pelvic and abdominal pain and soreness. There's a lovely Women's Health Center in Lafayette and also a more traditional PT clinic in Oakland. Esther specializes in pelvic floor issues and has been helpful to me, though my problems don't sound as severe as yours. Since I haven't given birth yet, I can't tell you whether it will go away immediately, but since you have a while to go, I think it's worth trying to do something about your pain now. I hope Esther can help you! 510-204-1788 - Oakland 925-962-9129 - Lafayette AKD


I saw Ethan Feldman at Back in Action when I was pregnant, and it made a huge difference. I went from doubling over to mobile in 3 visits. So much changes when the bones separate... also, I would definitely find a provider who takes it seriously or make clear to you current OB how important this is to you. Good luck. molly


I had really bad Symphysis Pubis Dysfunction (SPD) with both pregnancies. It was incredibly painful to roll over in bed or even walk up stairs. By the end of my pregnancies, I had to sort of slide and roll out of bed because the pain was too much to separate my legs and put weight on just one leg to get out of bed. And while the pain MOSTLY went away after childbirth, it did not go away immediately and it has never gone away 100%. But it has gone away about 95%. It was very gradual and probably took about 6 months each time to be back to almost normal for me. The discomfort that still remains (after 2.5 yrs from 2nd birth) is very minor and doesn't affect my day-to- day life. It is just something I am mindful of when making certain movements.

I didn't do anything as far as treatment goes. Many people recommend some kind of support belt. There is also anecdotal evidence that a chiropractor may help, but I can't speak to that. From my personal experience and understanding, there is nothing to really ''worry'' about - it is more of a pain management issue and it is indeed temporary. I had an epidural for both labors and the SPD wasn't an issue during labor for me. But I have read that you should minimize spreading your legs widely during labor. I've also read that it's true that an epidural might not allow you to feel if you are over-straining the pubic symphysis. I would definitely try to find an OB that recognizes SPD as a real condition and doesn't just chalk it up to general pregnancy aches and pains like mine did. In the long run, it didn't matter, but it would have been nice to have someone that was sympathetic. Good Luck!


I had terrible hip pain during my second pregnancy and it was awful. (hip joints and pubic symphasis.) Nights were the worst. My midwife recommended a chiropractor, Elon Bartlett, who specializes in pregnancy. Wow! He was great. That afternoon after seeing him, I was pain-free for the first time in a long time! I think I saw him about every two weeks for the rest of the pregnancy and that helped me make it through: http://www.bartlettchiropractic.com/ A body pillow helped too so I could put my legs around it during the night. Good news: the pain mostly goes away after the birth when all that weight is magically off your pelvis. My pelvis would still be sore from time to time, but nothing like during the pregnancy. I had a little pain off and on for six months or so, but it was totally bearable. You will make it through this! Andi


Because of the functional weakness in your right leg, this implies that you may have a pinched nerve or similar low back problem. A chiropractor who specializes in pre and post natal might help.

Pubic Symphasis Dysfunction is certainly real, and if your OBGYN is blowing you off, then maybe you should be seeing someone who can help you deal with the pain and disability.

Both PSD and sacroiliac instability are caused by pregnancy hormones that soften ligaments. This allows for movement in joints that normally have little to no movement. The effects of ligament laxity can last up to 20 weeks postpartum, so I would not expect your problems to magically disappear with childbirth. Some women only experience these issues after childbirth.

You might get some relief by wearing a support belt that would help support the weight of your belly. At this point your goal should be to get out of the acute phase, where you have a lot of pain and swelling.

Avoid all movements that place shear and/or tensile forces on those joints. NO twisting and bending at the same time. Avoid lifting heavy objects. Don't vacuum, change the sheets, or dig in the garden. No yoga, Pilates, and most traditional ab work. No straddle stretches, groin stretches, deep side bends, or any lower back openers, like seated tailor stretch. Don't cross your legs when seated.

Always log roll when getting out of bed or off the floor. With you head, chest and pelvis moving as one, roll to one side, then use your arms to push your torso upright, then come to standing. BeFit-Mom, www.befitmom.com


Hi, I had TERRIBLE pubic symphisis/pelvic pain in my pregnancy. Like you, it started in about my 5th month. It got to the point where it hurt to push the clutch in my car and excruciating to move in bed.

During labor, the baby was really low in my pelvis for a lot of transition, and it was extremely painful, but I did it without drugs. My doula and midwife were both aware of the issue, but it really didn't seem to affect my labor, so they didn't need to address it. My recovery was great and I felt back to normal completely after delivery.

The only recurrence of this pain at three months later is doing a really specific move during pilates (bridging while lifting one leg at a time). I heard all the horror stories of the pain lasting long after delivery, and I'm so happy to say it went away immediately after my daughter came out. Good luck to you!


Post Partum Symphisis pubic disfunction

Aug 2009

Hi, Does anybody have suffered of post partum symphisis disfunction? Any tips or recommandation? Do you know anybody who treats this conditions? thanks


I highly recommend seeing Ada Wells at ProBalance in Alameda. I have worked with Ada and she has treated this diagnosis very successfully. www.probalancept.com Good Luck. A Believer in Therapy & Pilates


I have no recommendations for professional help (I wish I did), but my doctor told me that there was not much I could do as long as I had that pain. After my first birth, I kept aggravating the injury by trying to run; after the second, I didn't run until the pain was entirely gone. It took longer the first time, but I still had to wait almost a year after the second baby before I could run again. Good luck. Take care of yourself. Been There


I recommend John King at Sports and Orthopedic Specialists, 6300 Telegraph Ave (at 63rd), Oakland 547-8293. It can take a little while to get in to see him, but he is worth it! He was my 3rd PT for problems after my daughter was born, and he diagnosed my pubic symphisis issue as having not healed. Congrats on your baby!


During pregnancy, I visited a chiropractor, Elon Bartlett, in Berkeley and he made a big difference for my symphyseal separation. Now 1.5 years, postpartum, I still feel pain when running but overall it is much better. I'm not sure how postpartum you are but time really does make a lot of difference. Elon showed me a bunch of stretches that helped along with some yoga. Unfortunately, they say that with a subsequent pregnancy, the separation shows up much earlier. still recovering


Painful pubic bone postpartum

Sept 2007

I gave birth to an 11+lb. baby naturally about 2 months ago. My pubic bone (front of my pelvis) has'nt been the same since. When I lie on my back and turn over in either direction the pain is almost unbearable. It is difficult to get out of bed and slightly painful to raise one foot at a time while standing. My midwife suggested that the pain would get better over time. That has not happened. My pelvic floor muscles were very sore and painful toward the end of my pregnancy, much worse than now, but I am concerned that I have an ''unstable pelvis'' and I am not sure what to do about it. Anyone know of a chiropractor or physical therapist that has dealt with this issue before? No diagnosis or x-rays as I do not have a gynecologist and have yet to make an appointment to see my GP (I hate Drs. : ). Any recommendations? Thanks.


After giving birth, my pubic bone/sacrum was actually out of alignment and was very painful, like what you're describing. I had a physcial therapist work on it as well as a Rolpher. Both were quite uncomfortable but well worth it in the end. I also did Pilates with a trainer and I highly recommend it, it will strengthen your pelvic floor, abdominals, back and create stability in your pelvis. In the beginning I seriously recommend working with a trainer on the machines, not the mat classes because of your specific need. I do hope you begin to feel better soon. cassidy


Linda Avery is a physical therapist who specializes in pelvic floor issues. She's located in Berkeley, near Alta Bates (although I believe the practice is moving to Oakland near Summit). She and her associates are all fabulous. I'm sure that they would provide you with useful information, and symptom relief! Sara


You have the classic symptoms of pubic bone instability. Since you are only 2 months post-pregnancy, your connective tissues, including the ligament between the right and left pubic bone, are still soft and pliable. This will get a lot better in the next four months.

In the mean time, you need to be careful not to stress the area. When rolling over in bed, do a ''log roll'' to keep your body in one piece. To do this, roll your entire spine and legs to one side, taking care not to twist your body in any way. Then simultaneously use your arms to help push your torso to vertical as you lower your legs off the side of the bed. If you do these moves together your torso will not bend or twist.

You can do a similar move to get up from the floor. But this time log roll all the way onto all-fours, then holding on to a piece of furnitiure or a wall with one hand for balance, step one foot then the other to standing.

Don't try to stretch your grion as this can make the situation worse. Don't do any exercises that open the legs or twist the spine. No impact exercise.

Do lots and lots of Kegels, or pelvic floor contactions. For a complete discription of how to do effective Kegel contractions visit my web site at: www.befitmom.com, select Prenatal and Postpartum Fitness and Exercise, then select Pelvic Floor. Helene Byrne, BeFit-Mom


I had similar pain during my pregnancy. This didn't happen to me postpartum, so forgive me if this advice seems unrelated. If you don't find help elsewhere, try chiropractic. Your pubic symphysis might be out of alignment.

Chiropractors are scary for some people. However, there are good doctors out there, who are gentle and don't wrench your body about, and who won't try to rope you in for endless follow up appointments. (I know I have had a negative experience of my own with a doctor in NY who needed to see me twice a week indefinitely!) I highly recommend Claudia Kindler at Valley Chiropractic in Noe Valley, SF. 415-550-1200. Hannah


Pregnancy hormones soften the pubic bones to make labour easier and this combined with the trauma of a baby going through tends to scar the bone. You can see this on a woman's skeleton as a telltale sign that they have given birth. The larger your pubic bone needs to ''stretch'' to accomodate the baby during birth, the more trauma to the bone and to the cartilage that connects the two ends of your pubic symphisis (the bones in front are not connected, they meet). I am trained in osteology and anatomy, but am not a doctor. If the pain is this bad, it may just be, as your midwife said, that it will go away in time as the bone heals (this can take awhile and will probably happen naturally without any intervention, it will just be painful for a very long time). If it is something more serious, the only way you will be able to find out is with an x- ray. No matter how much you hate doctors (and I sympathize with that), if you think it is something more serious the only thing a chiropracter will do is make it worse. This is not something that involves your spine. As far as a physical therapist goes, I would be very wary of one who will treat you without knowing exactly what damage might have been done to your pubic bone. My advice is either let it heal and put up with the pain (sorry) or see a real doctor. Otherwise, you will probably make it worse in the long run. Even if a chiropractor can make you feel better for a couple weeks, inappropriate treatment could result in long-term damage. Lisa


I FEEL your pain TRULY!! I had this pain (pubis symphisis dysfunction) from my 3rd month of pregnancy with twins. No one ''got'' how excruciatingly painful it was & Dr.s (good ones)shrugged their shoulders.

I saw a chiropractor at the time, but relief was nominal. The best thing I could do was spend 4 hours a day in our big bathtub and float... seriously. I know you are dealing with a newborn so you may not have that same kind of time, but maybe an hour a day?

The pain persisted after they were born. I believe nursing will also make it last longer as your hormones are still producing relaxin. Give it time -- hard to do when you can't take a decent stride or roll over in bed--it will pass.

I had moments up to 1yr where I would sort of pull something if I lunged, but the hardcore pain left when my nursing decreased (6 months solids) (again, I had twins so I was doing DOUBLE nursing with that much more hormonal activity -- it may not take as long for you to feel better).

Try Dr. Audrey Egan in SF (chiropractor)- I know she's dealt with this before and she really takes extra special time with people. Very caring chiropractor! It may offer some relief. Good luck. I wish you the best quickly! Nancy


Wow - you have exactly explained my symptoms since having my daughter by VBAC 10 months ago. I, too, have not made it to the doctor, mostly because I am tired of the ''well, nothing obvious is presenting itself to me in the 7 minutes I've allotted to this appointment....'' attitude.

I don't have any answers for you, but wanted you to know there was someone else out there is very glad you asked the question. THANK YOU! catherine


You may need to give your midwife's advice a little more time....My son was posterior (face up rather than face down); the improper positioning did quite a bit of damage to my pubic bone, and I had pain similar to what you describe. It did get better, and eventually stopped hurting entirely, but it was maybe 6 months after giving birth. Best of Luck


Two months isn't long, but since you are worried I would highly recommend Dr. Jerome Weiss and the Pacific Center for Pelvic Pain and Dysfunction. He is expensive and doesn't accept insurance (you can submit to your insurance company anyway and probably get some money back, I did) and his missed appointment policy is prohibitive (I think they require a two day notice for missed appointments and they WILL charge you if you really can't make it, even for emergencies). BUT I think he saved my vagina. 16 months postpartum and I still have some pain, but I can have sex now, and pick up my son, and sit in my car comfortably, etc. Dr. Weiss used both western and eastern therapies and is just a lovely, comforting man. anon


i am a PT, and this is very common, and having a big baby makes it more likely (bones having to separate more).

i work inpatient, but even i know a few exercises. try lying on your back, knees bent, and squeeze a basketball between your knees, or something else that size or a few inches smaller, that is firm but slightly yielding. you can pad it a bit with a folded washcloth if it feels too bruising on your knees. squeeze as hard as you can for 5-10 seconds. at the same time, try to do a slight kegel (tightening your pelvic floor muscles, you may have learned this prenatally?), focusing on the forward muscles, ie the ''pee'' area, but not the anus, or not as much towards the back. repeat 5 or so reps.

if you are lucky, you will feel a shift, as the sacroiliac joint and pubic symphysis realign into a better fit.

then get up and try some of the things that bother you (gently, just to the onset of pain), to see if there's an improvement. if so, you know you're on the right track. repeat the exercise as necessary while waiting for a PT appt.

and definitely see a PT, since one can evaluate you specifically to see what direction the misalignment is (upslip, rotation, etc.), and do manual resistance to help you pull things into proper alignment. anon


I have the *identical* symptoms, except for my babe wasn't quite as large (congratulations on pushing yours out)! It is appalling that allopathic medicine barely recognizes our condition, which is called Symphysis Pubis Dysfunction (SPD), and is when the two sides of the pelvis are misaligned at the pubis symphysis joint. A more severe version is called Diastasis Symphysis Pubis (DSP) and is when the pubis symphysis joint is separated as well as being misaligned. Your midwife absolutely should have been able to diagnose your condition -- I would find a new practice at once. The following website has very useful information, with a description of SPD/DSP and first hand accounts of women who have successfully dealt with the problem: http://www.plus-size-pregnancy.org/pubicpain.htm

SPD/DSP are essentially bone injuries and so take a long time to heal, especially with the relaxin pregnancy hormone still lingering in your body. Avoid as much as possible any movements that hurt, which may include all motion that involves separating your legs and/or that is weight-bearing. For me this has included standing for prolonged periods and just plain walking. It may seem impossible to limit yourself that much, but with a supportive husband I have managed to feed and soothe my newborn and verbally entertain my toddler all from the confines of a Lazy-boy chair. Try to keep your hips in the same plane at all times (i.e. don't cross your legs, sit on the floor sideways, etc.). I found it extremely helpful to sleep with a pillow between my legs at night. You may need to experiment with pillow number and/or thickness (don't overextend your legs).

Keep in mind that DSP sometimes cannot be detected by X-ray since pregnancy already scars the joint, so don't get dejected if you go to an MD of some sort and s/he can't help. However, it is downright ridiculous (someone needs to chide you) for you to be in severe pain for two months and have not gone to a doctor! Get off your butt and get over your fear/reluctance -- the best case scenario is that they refer you to a helpful health care practitioner that is covered by your insurance and you might feel better in days.

Although time is a factor, there are other anecdotal things you can do to actively manage the pain and heal more quickly. Many women have been helped by chiropractors and physical therapists, as well as by osteopaths and postpartum-specialized exercise instructors (e.g. Pilates). When searching for a practitioner, it is important to find one who has experience treating SPD/DSP. Below are some resources to find practitioners (I have found that it's most useful to play dumb when you are calling to determine their experience level): 1) Chiropractors -- go to the International Chiropractic Pediatric Foundation website at www.icpa4kids.org and search for providers with experience in the Webster technique (used to turn breech babies) 2) Physical therapists -- go to the American Physical Therapy Association website at www.apta.org and search for providers specializing in women's health and orthopedics 3) OB/GYNs -- ask the physical therapists for doctors who refer their clients 4) Various practitioners - check the provider list for your area on the International Pelvic Pain Society website at www.pelvicpain.org.

I am naturally suspicious of chiropractors, but I am seeing one for the first time and it is helping with the pain. The osteopathic poster whose said that SPD/DSP does not involve your spine is incorrect -- your symphysis pubis is the front joint of your pelvis and your sacrum (the bottom of your spine) is the back of your pelvis. Thus if something is wrong with your sacrum (spine), it will also affect your SP joint and vice versa. A chiropractor may not help long term, but if they adjust your sacrum and shift your pelvic alignment, this allows your muscles and ligaments a chance to heal with the pelvis in better alignment. My PT sister explained (to convince me not to chase after my toddler too much) that there should not be much movement in a functioning SP joint, so while you are healing, minimal activity and proper pelvic alignment (i.e. with PT or chiropractic adjustments) are helpful to ensure that the muscles and ligaments surrounding the joint heal tightly.

You don't have to just wait for your relaxin hormone to dissipate, like allopathic medicine recommends. At the minimum do pelvic floor exercises. If you are not sure you are doing pelvic floor exercises effectively, get a consultation from a Pilates/yoga/PT/etc. person so they can guide you through various exercises -- the personal feedback is much better than watching a video or looking at a website. In addition, I have gotten the same isometric exercise that the PT poster recommended (squeezing a ball between your legs) from multiple health care practitioners so it is probably safe and possibly helpful. I have been doing it in conjunction with chiropractic adjustments and pelvic floor exercises with slow but sure success. It is probably true that SPD/DSP will eventually heal on its own with no active management, but anything that makes the healing process go faster is essential for maintaining sanity and for being able to care for your new baby. Good luck! jp


Near-constant pelvic pain on the public bone

March 2006

I'm about 20 weeks into my second pregnancy and have been experiencing near-constant pelvic pain, especially on the pubic bone. It's not so intense that I can't go about most of my usual routine but it's still bothersome. I talked to my doctor about it, who kind of shrugged it off as ''one of those pregnancy things'' (absent other symptoms). I also experienced this with my first pregnancy but it wasn't as intense or long-lasting. Any advice on how to relieve the pain or specific activities to avoid so as not to make it worse? (is walking good or bad? I'm not clear.) I'm trying to rest more and avoid squatting and picking up my 2-yr-old, but would appreciate other remedies and suggestions. thanks!


I experienced some serious discomfort in my pelvic area during the last month or two of my pregnancy. It would generally happen while I was walking and felt like a deep shooting pain. My midwife and chiropractor both said it was from cartilage softening in that area due to increased levels of the ''relaxin'' (sp?) hormone that kicks in during pregnancy. I found that limiting my walking and wearing a pregnancy support belt both helped. I swam for exercise instead. anon


From your brief description, I'm guessing you may have symphysis pubis dysfunction, or separation at the joint in the middle of the pubic bone. If the pain is focused in the center of the pubic bone and it hurts when you straddle your legs, this is probably what you have. I had this problem with my pregnancy and I got a lot of relief by altering my activities. I stopped standing on one leg (e.g., while putting on pants I sat down), tried to eliminate all lateral and straddle movements with my legs, and tried to keep my legs together (e.g., when getting in the car I sat on the seat first then moved both of my legs together into the car). I was also careful to keep my legs together when rolling over in bed and avoided any exercise that hurt my pelvis or involved separating my legs (e.g., sideways shuffling and breaststroke). Some women feel chiropractic care helps them and I did see a chiropractor who specializes in treating pregnant women, but it was unclear if it helped.


Pubic bone pain at twenty weeks gestation is unusal. At his point in pregnancy, your ligaments (which connect bone to bone, and are responsible for joint stability) have not softened or stretched that much. So instability at the pubis, which is most often associated with late pregnancy and postpartum, though possible, is unlikely.

From my experience, many people mistake groin pain for pubic pain. If your pubic bone is unstable, you will feel pain directly on the center of the joint, right in the middle, where the two bones connect. Groin pain is more commonly felt just off to one side. And groin pulls/injuries are notoriously slow to heal.

I'd suggest that you see a specialist, either a PT or chiropractor who specializes in pregnancy, to sort out what is actually going on in your body. You shouldn't have to suffer with this level of discomfort at only 20 weeks. Dr. Elon Bartlett in Berkeley is a good choice.

As for what to do and not to do...

Avoid picking up all heavy objects. When your toddler needs to cuddle up, sit down in a chair, and then have her climb up onto your lap.

Always sit in a neutral spine position, with lower back support, thighs parallel to the floor, knees bent at a right angle, both feet flat on the floor.

Avoid all sitting positions that bend or twist your pelvis and spine. Do no try to stretch the area to relieve pain. Unstable joints should never be stretched.

To relieve flare-ups, use an ice pack for 10 - 15 minutes, to reduce inflammation. When using ice, always wrap the ice pack in a thin towel or other material. Never place an ice pack directly in contact with skin.

For more in depth advice on pelvic pain during pregnancy, consult my web site: www.befitmom.com. Click on Prenatal and Postpartum Fitness and Exercise, select Common Pregnancy Discomforts, and then click on Pelvis. Helene Byrne, BeFit-Mom


I am at exactly the same stage of pregnancy as you (due mid July) and it's also my second pregnancy... and I had pelvic pain starting at 13 weeks this time. Same spot as last time (in the back, just to the left of the tailbone) but much, much earlier. Like you, my doctor was dismissive of it as ''just part of being pregnant'' and wouldn't refer me to anyone else who could have helped.

You don't say where your pelvic pain is (in the front? in the back?) but chances are it is loosening ligaments, which is definitely a pregnancy thing. Mine is in the sacro-iliac joint. I don't know about what you can do if it's in the front (symphesis pubis - maybe try googling it?) but for me a couple of things helped for the SI joint pain. I sleep with a much thicker pillow between my knees or under my knee... I think that did the most good. There is also an exercise my yoga teacher showed me involving lying on your side with the painful side up, top leg a little forward, and having your partner gently pull on your leg on your exhale, and release on your inhale. I think this also helped a bit. Between those two things my pelvic pain is really manageable now.

Aside from that, a hot pad kind of worked when it was really painful. People recommended massage but I didn't pursue that. anon


I would like to suggest that you see a chiropractor and/or a massage therapist. You very possibly have weakness/tightness in your pelvic floor muscles which can cause the kind of pain you describe. I can recommend a chiropractor who works with pregnant women and newborns. His name is Elon Bartlett.His office number is 510 843- 1234. I'm a massage therapist (I work with Elon) and I understand the muscles and mechanisms of the pelvic floor muscles. In truth,I've never had a pregnant client with your complaint (though I''ve had many pregnant clients) but i''ve had non- pregnant people with similar complaints. I have experience in exercising the pelvic floor muscles and can show you how to strengthen them (a must during pregnancy and esp. after delivery. My office number is same as Dr. Bartletts. I would also suggest, if not me, that you see a massage therapist who is experienced with pregnancy massage. It may be ''one of those pregnancy pains'' but is definately not something you have to live with. Good luck. June


Terrible pelvic and groin pain in week 24

Jan 2005

I am now 36 weeks pregnant.Starting in about week 24 I have had terrible pelvic and groin pain.I am not able to walk half a block w/o feeling a ripping sensation in my pelvis and groin. The pain became more intense as my belly grew. Now I'm a total mess. Together with this I have been having braxton hicks contractions, fairly strong and painful also starting around week 24. I've been told by my OB that what I've been experiencing is round ligament pain along with early and apparently nonproductive contractions.By the way,(kienahora) everythings is fine with the baby. I was just wondering if anyone out their went through something comparable? Lynne


I can so relate! Go buy a belly support belt today. It has saved me. If you can, go to Fashion after Passion on Webster St. in alameda - the belts are about $10 and come in all different sizes. They will make sure you get the right size. I am about 36 weeks and bought the belt about 2 months ago. I wish I had bought it sooner. It does not make the pain go away totally, but I don't (can't) go on walks without it. Good luck


I had severe pelvic pain, starting at 6-1/2 months. I got disabled plates from my GYN, and used a wheelchair when I had to walk more than half a block. It lasted until the day before the birth, when the baby moved. Feldenkrais helped, as did removing prescribed shoe arch supports. Today I'd try chiropractic or energy healing, in the same situation. Good luck. anon


I have a 6-week-old baby and experienced the same sort of pelvic pain. It was really awful, particularly rolling over/getting out of bed. I also could not walk comfortably by the last month or so. The only thing that helped while I was pregnant was not being too active, which is not the best solution, but the only thing that worked for me. On the plus side, most of the pain went away as soon as I gave birth. I have noticed pain as I have begun to exercise again, but nothing like before. I am planning to go to a physical therapist who specializes in women for a post-partum appointment. Ask your OB for a referral. As an aside, most people including my OB did not seem to understand the level of pain this can cause. It is not the same as the round ligament pain I felt at other times in my pregnancy and it was ! so bad it brought me to tears at times. Hang in there and good luck! Miranda


I had very similar experiences with both of my pregnancies. I had tons of groin and pelvic pain. It was especially painful when changing positions (sitting up from lying down, standing up from sitting, etc). It did get progressively worse as my pregnancy went along. It also got so bad that when I moved, you could actually hear popping and grinding noises from my pelvic bone. My doctor assured me that this was normal round ligament pain and that my pelvis was just ''loosening up'' in preparation for birth. She said that it was a similar feeling to someone who has broken their pelvis. Anyhow, the pain was gone as soon as I delivered both times. In my situation, I had VERY large babies - 9.13 and 10lbs. Both delivered vaginally and naturally. I assume this is why there was so much pressure and pain! on my pelvis. Hopefully that doesn't scare you if this is your first child :o) But, if it helps, they were both easy deliveries. Sympathetic


Hello, I had similar groin pain while I walked. I felt it the worst when I tried to turn while I slept. The pain was so sharp I would wake up in tears. A physical therapist recommended that i wear a special belt around my hip when it hurt. I only wore it at nighttime. After a few weeks, the pain went away. It only recurs when I exercise and do a lot of squats or other hip flexing exercises. I highly recommend Dawn Loretz, a physical therapist. She provides pre-natal exercises once a week. Good luck, -Almost done with my pregnancy!


I feel (er, felt?) your pain! I too had terrible ligament pain during both my pregnancies: toward the end of the first, and then starting just 12 weeks into my second. At night, I was waking my husband up crying out with the pain in my sleep when I tried to roll over--it felt like my pelvic bones were coming apart at the seams; during the day I could barely walk. By my 4th month my OBGYN suggested I wear a maternity belt to take some of the weight off my pelvis and this helped tremendously. I couldn't go an hour without it, once up out of bed for the day, without feeling the strain. You can get one at Cotton and Company on College Ave., where they were very helpful in fitting me with one. There are a couple different kinds, but I settled on the least expensive, a simple band of cotton and elastic that wraps around under your belly with velcro straps. I also found sleeping with a pregnancy body pillow very helpful at night. Unfortunately the only cure for this is giving birth--your hormones are prepping your body to be more limber to facilitate delivery. It does go away afterwards, so chin up: it's a temporary inconvenience. Good luck! anon


I had terrible pelvic pain in all three of my pregnancies. It was just my pattern of pregnancy. In my case it was separation of the symphysys pubis joint (where the pelvis joins in the front.) I also had problems with the back of the pelvis separating (sacro iliac joint) earlier in pregnancy, but it was the p.s. pain that I remember the most. (I'm writing these names because unless you are really specific about where it hurts, your issue will get brushed off as round ligament pain, which it probably is not.) Turning over in bed was out of the question & those many, many trips to the bathroom were torture. I remember crying and gripping the wall as I walked the 10 feet to the bathroom. Physical Therapy was the only thing that helped and that was just so-so. I coped with an occasional Tylenol PM, but never found complete relief. Childbirth was the magical cure in all three cases, and I mean magical. The pain was instantly gone.

The suggestion about getting a disabled licence placard for your car is an excellent one and I wish I'd thought of that for myself! Another friend with the same issue says now that she wishes she had just worn Depends to bed. I think she's kidding but I'm sure you can relate to that sounding like a good option at this point. Good luck. been there