Pubic bone pain, formally known as Pelvic Girdle Pain (PGP) or Symphysis Pubis Dysfunction (SPD), is a common condition experienced during pregnancy. The discomfort is localized to the front of the pelvis at the pubic symphysis joint, but it can radiate to the lower back, groin, or inner thighs. This pain can severely limit mobility, making simple daily activities like walking or turning in bed feel nearly impossible.
Understanding the Source of Pelvic Girdle Pain
The pain arises from biomechanical and hormonal factors unique to pregnancy. The pelvis is a ring of bones with three joints: the pubic symphysis at the front and two sacroiliac joints at the back. These joints are normally held stable by strong ligaments and surrounding muscles. During pregnancy, hormones like relaxin cause the ligaments to soften and stretch in preparation for childbirth. This increased flexibility leads to excessive or uneven movement within the pelvic joints, causing instability. The growing uterus also shifts the body’s center of gravity forward, increasing the load and stress on the pelvic girdle. This combination of lax ligaments, postural changes, and muscular imbalances strains the pubic symphysis, resulting in pain.
Modifying Daily Movement for Immediate Relief
Immediate relief comes from changing how you perform everyday movements to minimize strain on the pubic joint. The goal is to keep the pelvis working as a single, stable unit and avoid asymmetrical movements that spread the legs apart. This means consciously keeping your knees and ankles together whenever you change position.
When getting in or out of a car, sit sideways on the seat first, then swivel your entire body as one unit, keeping your knees pressed tightly together. To get out of bed, roll onto your side first, keeping your knees together and bent. Then, use your arms to push your torso up while swinging your legs over the side of the bed.
To roll over while sleeping, use a pillow placed between your knees and ankles to maintain alignment and move your hips and shoulders simultaneously. Asymmetrical actions like standing on one leg to put on pants or shaving in the shower should be avoided by sitting down instead.
When climbing stairs, take one step at a time, leading with the less painful leg or going up sideways to minimize the single-leg stance phase. Limiting long periods of sitting and taking short, comfortable walks can also help maintain circulation and reduce stiffness.
Targeted Therapies and Specialized Support Gear
When movement modifications alone are insufficient, targeted interventions can provide structured relief. Prenatal physical therapy is a primary treatment approach for PGP, focusing on correcting muscle imbalances and improving pelvic function. A physical therapist with expertise in pelvic health will prescribe exercises tailored to strengthen the deep core muscles, including the transverse abdominis and the pelvic floor.
These stabilization exercises create a dynamic compressive force that supports the pelvic joints from the inside. A therapist may also use manual therapy techniques, such as gentle joint mobilization or myofascial release, to alleviate muscle tension and restore proper joint mechanics. Consulting a specialist ensures that exercises are performed correctly and that painful movements, like deep lunges, are modified or avoided.
External support can be provided through specialized gear, such as a sacroiliac or maternity support belt. These belts are worn low around the hips to gently compress the pelvis, stabilizing the pubic symphysis and reducing movement during activities like walking. A healthcare professional should determine the correct type and fit of a support belt for maximum benefit.
Aquatic exercise, such as gentle swimming or water walking, offers another therapeutic option. The buoyancy of the water reduces the gravitational load on the pelvis, allowing for pain-free movement and strengthening.
Medical Management and Postpartum Recovery
For managing acute pain, safe over-the-counter medication may be used after consultation with an obstetrician or midwife. Acetaminophen (paracetamol) is a first-line option for pain relief during pregnancy, though stronger pain relief must be discussed directly with a doctor. Applying cold therapy, such as an ice pack wrapped in a cloth, to the pubic area for 10 to 20 minutes following painful activity helps reduce localized inflammation and discomfort.
The prognosis for PGP is positive, with the pain resolving shortly after delivery. Once the baby is born, relaxin levels drop significantly, allowing ligaments to gradually regain their pre-pregnancy firmness. Most individuals see their symptoms improve or disappear within a few weeks to a few months postpartum.
Roughly one in ten individuals may experience persistent pain after birth. For these cases, continued physical therapy is necessary to restore muscular endurance and stability to the lumbopelvic region. Postpartum recovery should prioritize rest in the initial weeks, along with a gradual return to activity, ensuring that any ongoing symptoms are addressed by a healthcare provider.