Laxity of the Pubic Symphysis Joint – Symphysis Pubis Dysfunction

The loosening of the pubic symphysis joint, also known as symphysiolysis or symphyseolysis, is a condition that most commonly occurs in women, particularly in middle-aged individuals. This phenomenon becomes particularly pronounced during pregnancy and childbirth, as the body prepares for motherhood. The anatomical structure of the female pelvis and hormonal changes contribute to the loosening of the joint between the pubic bones, facilitating the easier passage of the baby during delivery.

Complaints related to symphysis dysfunction, such as pain and restricted movement, often increase during these periods and can have a significant impact on daily life. It is important to understand that this condition not only causes physical discomfort but can also impose a psychological burden on the woman. Appropriate treatment and rehabilitation are crucial in the healing process.

The aim of this article is to detail the causes, symptoms, and treatment options for symphysiolysis, as well as past medical practices that have reduced risks associated with childbirth.

What Causes the Loosening of the Pubic Symphysis Joint?

The loosening of the pubic symphysis joint, or symphysiolysis, can develop due to various factors. The exact causes are often unknown; however, several physical factors can contribute to its development. Particularly, pelvic traumas, such as injuries sustained in accidents or during childbirth, play a significant role in this process. Congenital or acquired pelvic deformities, as well as certain diseases, such as rheumatoid arthritis, can also increase the risk.

During pregnancy, hormonal changes, especially the rise in progesterone and relaxin levels, promote the loosening of the pelvic joints. These hormones are essential in preparing for childbirth, but if produced too early or in excessive amounts, the pubic joint may become overly loose. This situation can cause pain and restricted movement, which are common complaints among pregnant women.

Childbirth complications, such as a narrow pelvis, obstructed labor, or the birth of a large fetus, can also contribute to the loosening of the pubic symphysis joint. In such cases, injuries to the pelvic ligaments and joints, as well as asymmetric loading, can be particularly burdensome and may result in increased pain.

The Dysfunction of the Pubic Symphysis Joint and Its Symptoms

Symphysis dysfunction, also known as pubic symphysis joint dysfunction, can present with a variety of symptoms that significantly affect daily life. The most common complaints include dull pain in the lower abdomen, which is often pulling in nature, and occurs around the front of the hips and the pubic area. The pain generally intensifies during walking or any asymmetric load on the pelvis, such as turning in bed.

As a result of the dysfunction, movement becomes more difficult, and the pain can sometimes be so intense that walking becomes nearly impossible. Additionally, swelling and tenderness in the area may occur, further exacerbating the situation. The stability of the pelvis, provided by the joint structures, is vital for normal walking, so dysfunction can have a serious impact on mobility.

At the end of pregnancy, hormonal changes naturally cause the pubic symphysis joints to loosen to facilitate the birth of the baby. However, if this process occurs excessively, movement within the joint can result, leading to severe pain. These pains may arise not only during load-bearing activities but also with any asymmetric movements, significantly affecting the quality of life for the expectant mother.

Treatment of Pubic Symphysis Joint Dysfunction

In many cases, the dysfunction of the pubic symphysis joint resolves on its own, typically within 2-3 weeks. However, pain may persist for months, especially if symptoms are severe. The first step in treatment is rest and pain relief, which should be conducted under medical supervision. During pregnancy, it is particularly important to avoid taking pain relief medications during the first trimester.

In the second and third trimesters, if the pain becomes unbearable, certain non-steroidal pain relievers or steroid injections may be used under medical advice. Treatment should always be conducted under a doctor’s supervision to avoid potential complications.

Medical aids, such as pelvic support belts, can also assist in managing the dysfunction. These belts support the pelvis and are recommended to be placed at the height of the pubic symphysis. Properly guided physical therapy can also be beneficial, especially in the early stages of pregnancy.

In severe cases, when conservative treatment methods are ineffective, surgical intervention may be necessary. In this situation, an orthopedic surgeon may stabilize the bones to eliminate movement in the joint, thereby reducing pain levels and improving the patient’s quality of life.

Childbirth Practices in the Middle Ages

It is interesting to note that in the Middle Ages, before the development of safe cesarean sections, the artificial separation of the pubic symphysis joint was also practiced. This method was used in cases of narrow maternal pelvis to facilitate the birth of the baby. Cutting the pubic bone was essential to avoid uterine rupture, which posed a serious risk to both the mother and the child during childbirth.

Although this practice was extremely risky, it was intended to prevent life-threatening situations that could arise during labor. Medical practices in the Middle Ages and the management of childbirth-related risks have evolved significantly since then, but the functioning of the pubic symphysis joints remains an important topic in obstetric and gynecological care. Modern medicine offers much safer and more effective methods that improve both the childbirth experience and women’s health.