After childbirth, my bones hurt very badly. Why does the pubic bone hurt and swell after childbirth?

There are many reasons for a woman to experience leg pain in the hip joint after childbirth. But they are all associated with changes that allow the body to adapt to pregnancy and ensure the safe birth of the baby. Knowledge about the nature of the occurrence of discomfort allows you to navigate in time and take steps to prevent any pathological changes.

The main causes of pelvic pain after childbirth and characteristic symptoms

The described condition is detected in 50% of all women who give birth. The lower back may also hurt, pubic part, hip joint, tailbone, knee. Any discomfort interferes with living and fully caring for your baby. Some recover quickly, others take time. Explain painful conditions not difficult. Among the many possible factors Doctors identify the following provocateurs:

Features of the body. In the third trimester hormonal background expectant mother changes, internal systems in this way they prepare for the upcoming process. Relaxin is produced in large quantities along with sex hormones. Its action leads to softening of the bones and joints of the pelvis. Becoming loose and mobile, the bones participate in the formation of the birth canal. With severe divergence of the symphysis pubis, severe pain occurs. It can bother women for another three months after the successful birth of the baby. Over time, the discomfort goes away on its own.
Violation of vitamin and mineral metabolism. To the developing fetus you need a lot of phosphorus and calcium. He receives them from his mother, “removing” them from the bones. As a result of this, the skeletal frame gradually softens. Since during childbirth the greatest load falls on the pelvis, its elements suffer the most. This condition can cause persistent pain and the development of dangerous injuries.
Increased load on musculoskeletal system. As the fetus grows, the uterus and fundus muscles stretch. Lower section the spine bends back. The pubic and sacroiliac joints diverge. The situation is changing hip bones. When all this returns to normal, severe painful sensations arise.
Birth injury. Considered potentially dangerous appearance into the light large child in a woman with a narrow pelvis. If the process is fleeting, the internal space does not have time to transform and adapt to the growing load. In such situations, rupture of the symphysis pubis often occurs, which causes severe sharp pain. You can get rid of them after long-term treatment or surgical intervention.
Possible diseases. Many women develop symphysitis during pregnancy. With this pathology, under the influence of hormones, the cartilage disc connecting the pubic bones to each other is stretched. The development of pathology is accompanied by an inflammatory process. A woman experiences severe pain while walking, when performing any, even the slightest, load, or when changing body position. Discomfort increases with defecation and urination. Cartilage rupture during childbirth is rare. It requires surgical intervention, after which a long recovery period and strict bed rest begins.

Fight with pain syndrome begins with eliminating the causes of its occurrence.

When to see a doctor

If you are constantly bothered by nagging or sharp pain in the pelvic area, lumbago occurs, which is accompanied by nausea and vomiting, increased sweating, you must make an appointment with a traumatologist or orthopedist and undergo a full examination.

There should be cause for concern severe dizziness and loss of consciousness (even short-term), vaginal bleeding, fever and chills. Considered dangerous sharp drop blood pressure. The following warning signs are: serious reason to call an ambulance.

Establishing diagnosis

If the specialist sees that the woman does not require emergency surgery, he begins to question the patient in detail about the symptoms and medical history. He is interested in how the pain arises - suddenly or constantly, what its character is - acute or drawing, how severe discomfort on a ten-point scale. The doctor must understand what causes the formation of the syndrome, whether there are other factors that increase or alleviate the symptoms.

After a physical examination is performed, based on its results, the specialist is able to draw preliminary conclusions and determine the circle necessary examinations. As a rule, patients are given a referral for the following diagnostic procedures:

General analysis of urine and blood:
Ultrasound of the pelvic organs;
CT or MRI.

Vaginal swabs must be taken to detect sexually transmitted infections. If the interpretation of the tests does not reveal the cause of the pain, laparoscopy may be performed.

Therapy methods

The therapeutic regimen is aimed at eliminating the provoking factor. Apply in parallel therapeutic measures, helping to relieve the main symptoms of illness. For this purpose, non-steroidal anti-inflammatory drugs (Ibuprofen) are prescribed. If there is no effect, analgesics are used.

When the pain spreads to the muscles, complete rest will help relieve the condition. dry heat and physiotherapy procedures. It is imperative to replenish calcium and vitamin D reserves, for this purpose it is used special diet or dietary supplements. Sore joints can be influenced through the skin, using painkillers and anti-inflammatory ointments, massage.

Treatment of pain in the pelvic bones after childbirth is necessarily complemented by physiotherapy procedures. Experienced stress and unstable hormonal levels depress the central nervous system and changes the perception of pain. Some women may also be prescribed mild sedatives: Glycine, Valerian, Motherwort tablets.

On initial stage therapy, each patient must make one important decision for herself: whether she will continue breast-feeding or switch the child to formula. The selection of medications will depend on this.

Preventive measures

In order to prevent any discomfort, it is important to learn how to properly recover after childbirth. To do this you need:

Immediately after the birth of the baby, observe bed rest, reduce physical activity as much as possible, and, if possible, entrust the care of the newborn to relatives.
Wearing bandages, the design of which was specially designed for women who have just given birth: they limit mobility hip joint, take part of the load upon themselves.
Visit an osteopath.

During an uncomplicated pregnancy, it is useful to walk a lot, take walks fresh air, take vitamin-mineral complexes, eat right: eat more foods that contain phosphorus, calcium, magnesium, iron. A full night's sleep is very beneficial.

Sometimes after childbirth there are complaints of pain or discomfort“crunching” in the symphysis pubis, which intensifies when changing position or walking up the stairs. A diagnosis is made: symphysitis. As a rule, a woman associates the resulting pathology with the birth. Is this fair?

A little anatomy to find out Why do my pelvic bones hurt after childbirth??
During childbirth, the fetus passes through the woman’s bony pelvis, which is formed laterally by two pelvic bones (fused pubis, ischium and ilium), and behind - the sacrum. Both pelvic bones are connected in front by the pubic joint - the symphysis, and in the back - by two sacroiliac joints.
The pubic symphysis is the pubic fusion of both pubic bones of the pelvis through a fibrocartilaginous disc, in the center of which there is an articular cavity in the form of a slit filled with articular fluid. In front and behind, above and below, the symphysis is strengthened by ligaments that give strength to this joint. The pubic symphysis is a semi-joint, i.e. has an extremely limited range of movement. Normally, the width of the symphysis (the distance between the pubic bones) can be up to 1 cm.
In front of the pubic symphysis is the pubis with its fatty lining and the ligament that elevates the clitoris. Nerves and blood vessels pass below the symphysis. Behind the pubic symphysis are urethra And bladder.Symphysitis- This common name changes and damage to the symphysis pubis, under which up to 16 components are hidden: loosening, softening, edematous impregnation, stretching, expansion, divergence, rupture, inflammatory process, special shape hypovitaminosis, symphysiopathy, symphysitis itself, etc. Most often, these changes arise and manifest themselves during pregnancy, childbirth and postpartum period. This article will discuss the consequences that they can lead to. Divergence of the symphysis pubis.
It arises as a result of events physiological changes as an adaptive process to facilitate childbirth; those. these are normal changes.
At physiological pregnancy the ovaries and placenta secrete the substance relaxin, which has a specific relaxing (relaxing) effect. Under the combined action of relaxin and female sex hormones articular cartilage and the ligaments swell, loosen, additional gaps filled with fluid appear in the joints, resulting in an increase in mobility in the pelvic joints and an increase in the distance between the bones that form each joint.
These changes are especially pronounced in the symphysis pubis, there is an increase in blood supply, swelling and loosening of everything ligamentous apparatus. The width of the pubic articulation increases by 5-6 mm, small movements (up to 10 mm) of the articular ends of the pubic bones up and down are possible, like the keys of a piano. The width of the pubic joint reaches 1.5 cm; the divergence of the sacroiliac joint increases to a lesser extent.
In the postpartum period, all these changes are gradually eliminated - the cartilage in the joints becomes denser, the ligaments acquire their former elasticity and density, and the width of the joint space decreases. Symphysiopathy. This is the name for excessive relaxation of the symphysis pubis as a manifestation of toxicosis in pregnant women with a predominant lesion osteoarticular system woman's body. For some women these changes in the structure of the joints go beyond physiological processes, acquire pathological character and lead to excessive divergence of the pelvic joints. Symphysiopathy is characterized by the appearance of complaints and symptoms in the presence of discrepancies in the symphysis pubis. There are three degrees of divergence of the symphysis (above the physiological discrepancy of 5-6 mm):
I degree - discrepancy by 5-9 mm;
II degree - by 10-20 mm;
III degree - more than 20 mm.
The leading role in the development of symphysiopathy is played by disturbances in phosphorus-calcium metabolism and lack of vitamin D. Calcium is the main structural component skeletal bones and teeth. The metabolism of calcium and phosphorus is regulated mainly by the hormone pair thyroid gland, calcitonin - a thyroid hormone - and vitamin D, depends on quality composition food, the ratio of calcium, phosphorus and magnesium in it. When the phosphorus-calcium balance is disturbed in the direction of decreasing calcium, these elements come to the fetus from the “reserves” of the mother’s body - bones and teeth.
With a lack of vitamin D, bone mineralization is impaired due to impaired absorption of calcium and phosphorus from the intestine, as well as their mobilization from bone tissue. A decrease in calcium levels in the blood can also be observed with concomitant pathologies: diseases gastrointestinal tract, chronic enteritis, dysfunction of the parathyroid gland, renal failure, diabetes mellitus, as well as with a diet insufficient in calcium, vomiting during pregnancy and other conditions. Against such a painful background, pregnancy and breastfeeding can aggravate calcium deficiency.
As a rule, symphysiopathy manifests itself long before childbirth. Against the background of calcium starvation, tooth decay, brittle nails, general fatigue, paresthesia (the appearance of a tingling sensation and changes in skin sensitivity), twitching and contraction of individual muscles are characteristic, night cramps in the calf muscles. With minor discrepancies in the symphysis, the appearance of “flying” pain in the pelvic bones and lower back is regarded as radiculitis, osteochondrosis, or threat of miscarriage. In the second and third trimester of pregnancy, symphysiopathy is characterized by pain and discomfort in the pelvic bones when walking and standing.
The disease is not uncommon. Symphysiopathy may not make itself felt before childbirth and may be hidden. In the second half of pregnancy, the pubic bone ratio is constrained by the tension of the abdominal muscles due to the enlargement of the uterus. Immediately after childbirth, flabbiness of the abdominal muscles occurs and the discrepancy of the pubic bones can increase to 20 mm or more. For divergence of the symphysis pubis II and especially III degree during pregnancy and childbirth, diagnosis is not difficult: a change in the nature of pain in the symphysis occurs, which intensifies when turning in bed, when active movement legs, often a woman cannot walk. In bed, the patient takes a certain position - the “frog pose”: she lies on her back with her hips turned outward and her hips turned outward and her knees slightly bent.
When pressing on the pubic symphysis, both from the front and from the vagina, severe pain is determined. In addition, you can determine the discrepancy itself - the fingertip is placed in it. A significant discrepancy of the symphysis pubis (more than 2 cm) is also indicated by the appearance of a waddling, duck-like gait.
The diagnosis is clarified by x-ray and ultrasound diagnostics. During pregnancy, preference is given to ultrasound diagnostics, considering bad influence x-rays for the fruit Typically, an X-ray of the pelvis reveals discrepancy of the symphysis pubis of varying degrees, but there are no pathological changes in the bones.
When determining the concentration of calcium and magnesium in the blood and urine, their amount in the blood decreases by almost half, and their content in the urine is slightly increased. Only by determining the content of calcium and magnesium in the blood and urine of a pregnant woman in the absence of complaints can one predict the divergence of the symphysis pubis.
The course of symphysiopathy is usually favorable. This disease in itself during pregnancy is not an indication for delivery through surgery. caesarean section- neither as planned nor in urgently. For determining obstetric tactics In choosing a method of delivery, the size of the divergence of the symphysis pubis is important.
In case of pronounced divergence of the symphysis during pregnancy and the risk of injury bony pelvis In labor, delivery is carried out by cesarean section. With a narrowing of the pelvis and a relatively large size of the fetus with a voluminous dense head, the critical distance of divergence should be considered 10 mm.
Rupture of the symphysis. This severe form of symphysis injury is rare. It is characterized by a violation of the integrity of the joint, is most often associated with childbirth and occurs when the divergence of the symphysis pubis of the third degree is more than 2 cm. Rupture of the symphysis pubis with damage to the ligaments is often combined with damage to one or both sacroiliac joints and usually occurs during childbirth with operative delivery ( obstetric forceps) or when a narrowed pelvis is combined with violent labor.
Mechanical trauma itself does not have a dominant significance: the tensile strength of the pubic symphysis is on average 200 kg. Of primary importance are changes associated with symphysiopathy, as well as previous inflammatory changes in the pubic bones and pubic symphysis, and even minor mechanical impact is an impetus for breaking the weak adhesion of the ligamentous apparatus.
In most cases, during childbirth there is a slow spreading of the tissues of the symphysis pubis, so complaints of pain in the pubic area, aggravated by moving the legs, appear a few hours or on the 2nd -3rd day after birth. Only in in rare cases the woman in labor feels sharp pain in the pubic area, sometimes audible characteristic sound ruptured ligaments, after which even a large fetal head quickly descends through the expanded bone ring.
Rupture of the pubic symphysis is sometimes accompanied by injury to the bladder and urethra, the formation of hematomas in the pubic area and labia, and the addition of an inflammatory process - symphysitis.
The postpartum woman cannot raise her legs (symptom of “stuck heel”) and turn on her side; in bed she takes a forced position (“frog pose”). On palpation both from the front and from the side of the vagina, severe pain is determined and, in addition, mobility of the pubic bones and retraction due to their wide distance from each other.
The nature of the damage is clarified when X-ray examination. A rupture of the symphysis pubis is indicated by: divergence of the pubic bones up to 7-8 cm,
the presence of a vertical displacement of the horizontal branch of the bone by 4 mm or more.
Without special treatment symphyseal ligaments do not fuse or are connected by scar tissue, forming false joint, therefore, when walking, both halves of the pelvis subsequently make rocking movements, a “duck walk” appears, and constant complaints of lumbosacral pain are regarded as radiculitis.
In severe cases of damage to the symphysis pubis (rupture, severe sprain), as well as in the absence of effect from conservative treatment, as a rule, are used surgical treatment using metal structures, applying lavsan and wire sutures. Working capacity is restored 3-4 months after surgery.
Symphysitis. This term means changes in the pubic symphysis caused by the inflammatory process. Symphysitis is characterized by the fact that in the presence or absence of a pronounced divergence of the pubic bones, the disease is accompanied by a characteristic inflammatory reaction: pain, impaired movement in the limbs, swelling and redness in the pubic area, and a feverish state. The x-ray shows the discrepancy of the symphysis pubis with the phenomena of osteoporosis (rarefaction) in the bone tissue.
Chronic inflammatory processes in the bladder (cystitis) and urethra (urethritis) may be accompanied by focal changes in the pubic symphysis. The disease develops when there is chronic infection in the genitourinary tract (ureaplasma, mycoplasma, herpetic infection, staphylococcus carriage) in pregnant and postpartum women against the background of calcium and magnesium deficiency, with hypovitaminosis D. The use of antibacterial therapy in combination with calcium and magnesium preparations, UV irradiation gives excellent and rapid therapeutic effect even with severe course symphysitis with pronounced divergence of the symphysis pubis.
For the prevention of symphysiopathy and other injuries of the symphysis pubis, the following are important:

A diet rich in minerals and trace elements involved in the formation of the skeleton (calcium, phosphorus, magnesium, zinc, manganese), as well as rich in vitamin D: milk, lactic acid products, yoghurts, low-fat cheeses, eggs (yolk), meat and liver of mammals and birds, fatty fish meat, fish liver, caviar, seafood, as well as legumes, mushrooms, herbs, nuts.
Sufficient physical activity during pregnancy, visiting schools for expectant mothers where it is used physiotherapy to strengthen the muscles of the back, abdomen, buttocks and stretch the pelvic floor ligaments.
Prolonged stay in the fresh air. Under influence ultraviolet rays sunlight Vitamin D is produced in the skin.
Taking multivitamins for pregnant women, biologically active additives with trace elements and antioxidants.
For poor calcium absorption associated with gastrointestinal disease, take digestive enzymes, fight against dysbiosis.

Treatment of symphysiopathy
If the pubic symphysis diverges during pregnancy and childbirth, as a rule, surgery can be avoided.
In case of development of symphysiopathy with slight divergence of the symphysis pubis during pregnancy or after childbirth, restriction is recommended physical activity, wearing a bandage, sleeping on an orthopedic mattress, taking calcium supplements in a well-absorbable form (CALCIUM CARBONATE, CALCIUM L ACT), CaDs NYCOMED, FISH OIL (preferably in capsules), MAGNE Be, B vitamins, UV irradiation. In the presence of a urogenital infection, it is prescribed antibacterial therapy taking into account sensitivity to antibiotics. It is also recommended to use painkillers in the form of gels, ointments or suppositories and tablets.
At II and III degrees divergence of the pubic bones in the postpartum period, the main thing is to bring the ends of the pubic bones closer together and hold the pelvic bones in a certain position. This is achieved by bed rest (you cannot get up or walk for 2 to 6 weeks after birth), as well as by using a bandage or tight bandage. On the first day after birth, cold is used, and subsequently physiotherapeutic procedures are used on the area of the symphysis pubis. Calcium supplements and painkillers are used; if inflammation occurs (symphysitis), antibacterial therapy and a diet with increased content calcium.
After the expiration of the period, X-ray control is carried out, after which the woman begins to wear a bandage.
Currently, special corsets are used that help hold the pelvic bones in a certain position, which allows for extended bed rest. Usually, after 3-5 days of bed rest in a corset, a woman can already get up and care for her child. The corset is worn from 3 to 6 months.
In order to facilitate childbirth, eliminate the existing obstacle to the passage of the fetus, especially the head through the bone ring in the presence of pelvic narrowing, from ancient times to the present in some countries of Africa and Latin America They use a pelvic dilatation operation - symphysiotomy (dissection of the symphysis).

During pregnancy and childbirth, a woman’s musculoskeletal system undergoes significant transformations. To make it easier for a newborn baby to walk through birth canal on latest dates The pelvic bones begin to separate and soften cartilage tissue. After childbirth, reverse changes occur, which may be accompanied by significant painful sensations. Most often, the pain is localized in the pubic bone area. Why does this happen and how to reduce pain?

What causes pain?

The pelvic bones are connected in front by the pubic symphysis. The symphysis is the pubic symphysis pelvic bones, surrounded on all sides by ligaments. Its width does not exceed 1 cm and it has very limited motor capabilities. During pregnancy, the pubic joint gains some mobility and stretches. This occurs under the influence of the hormone relaxin secreted by the placenta and ovaries, which helps soften the cartilage and ligaments at the junction of the pubic bones to facilitate the passage of the child through the birth canal.

In the last stages of pregnancy, relaxin is produced more and more intensely, causing the appearance of gaps in the joints, swelling of cartilage tissue, increasing the mobility of the pelvic joints and the distances between the pelvic bones. The pubic symphysis also increases, usually by 5–6 mm. Very often such changes in musculoskeletal system accompanied by unpleasant sensations. Almost all women experience a little pain before giving birth pubic bone and this is considered the norm.

However, in some cases, the softening of the pubic joint occurs too much, which leads to hypermobility of the bones and swelling of the pubis. This condition is called symphysiopathy, is accompanied by severe pain and requires consultation with a doctor.

Women with this pathology develop a characteristic “duck” gait. If the pelvic bones hurt very much when walking or turning from side to side during sleep, the doctor prescribes an ultrasound examination of the woman, as well as a consultation with a gynecologist and surgeon to determine the cause of the pain. Carrying and giving birth to a child puts a serious strain on a woman’s body, physical level . Under the influence of hormones, cartilage tissue softens, bones separate, ligaments and muscles stretch. This is necessary so that the baby’s passage through the birth canal is painless. Reversal changes and restoration of the body can be delayed and occur with complications. Complaints from mothers that the pubic bone hurts after childbirth are common. Besides severe pain

, pathological divergence of the symphysis pubis is accompanied by changes in gait and generally spoils a woman’s quality of life. The pubic symphysis is a type of semi-movable skeletal joint located in one of the three pelvic bones - the pubis. In medicine it is called the pubic or pubic symphysis. Unlike joints, symphyses do not calcify over time, do not lose their cartilage layer, and have a cavity inside. For example, intervertebral discs

are also symphyses.

During pregnancy and childbirth, transformation of the symphysis pubis occurs, often accompanied by moderate pain in the pubis. The gap between the branches of the pubic bone increases, on average, by 5-6, sometimes by 10 mm from the initial values. This is a physiological phenomenon.

Normally, in the postpartum period, the discrepancy of the pelvic bones is eliminated, the width of the cavity becomes denser and decreases. But, with favorable factors, changes in the structure of the joint sometimes go beyond the normal. In such cases, they talk about symphysiopathy, which means pathology of the pubic symphysis, in which the pubic bone hurts greatly. Sometimes the term symphysiolysis or symphysiolysis is used synonymously with symphysiopathy. In obstetrics it is known as a syndrome that includes three stages. The first is pain in the pubis, the second is divergence of the symphysis pubis to varying degrees

In practice, the word symphysitis is used to denote a collective diagnosis of excessive and painful divergence of the pubic bone. But in essence, symphysitis is translated as inflammation of the bone tissue of the joint, manifested similar symptoms, but with differences in diagnosis.

Causes

There is no consensus on why pathology occurs. The trigger for a situation where the pubis hurts after childbirth is a number of factors. This is also anatomical narrow pelvis, And large fruit, And multiple pregnancy. In combination with rapid, violent labor or use obstetric forceps. This leads to the fact that the pelvic bones do not return to their previous state in a timely manner, and sometimes become even more damaged.

These factors and mechanical injuries do not always cause complications in the form of symphysiopathy or rupture of the articulation. Bosom in healthy body Can withstand loads up to 200 kg. But the positioning factors lead to the fact that during the birth process it is overstretched and damaged.

Why does the pubic bone hurt after childbirth:

acute deficiency of vitamins and minerals leads to pathological “weakness” of the skeleton;
Excessive production of the hormone relaxin contributes to excessive relaxation of the tissues of the pubic joint.

The main role in the development of symphysiopathy belongs to vitamin D deficiency and failure of calcium-phosphorus metabolism. This happens in the background concomitant diseases. For example, with diabetes, kidney failure, problems in the gastrointestinal tract, and often with an unbalanced diet in pregnant women.

As a result, weak mineralization of the woman’s bone tissue occurs. During pregnancy, in order to meet the fetal needs for calcium, it is “redistributed” to the detriment of the mother’s body. In this case, the pathology manifests itself earlier, pain in the pubis occurs even before childbirth.

Second version - hormonal imbalance. Relaxin is responsible for the relaxation of bone tissue and the physiological divergence of the symphysis pubis. Excessive hormone production leads to pathological increase symphysis fissures and the appearance of discomfort in pubic area.

Symptoms and complications

Typically, signs of pathology appear during pregnancy. At the end of the second and third trimester of pregnancy, the pubic bone begins to ache before childbirth, and the sensations intensify. Articulation divergence can be suspected if there are related problems with teeth, hair loss, the appearance of convulsive twitching of the calf muscle.

It is not uncommon for the first symptoms of pubic bone dehiscence to occur only after the birth of the child. Due to constant tone Abdominal muscles holding the growing uterus, a kind of fastening of the symphysis occurs. After childbirth, the flabby abdominal muscles no longer hold back the joint, and the gap appears, accompanied by pain.

The severity of symptoms depends on how much the bones have separated. In addition to pain in the pubic bones, the woman complains of pain in the groin, lower abdomen, lower back and pelvis that occurs at night or after physical activity. Discomfort increases when walking, changing position, moving your leg to the side, turning in bed or rising from a chair.

In addition to pain, the pathology provokes poor posture. A pronounced divergence of the articulation contributes to the appearance of a waddling gait, called a “duckling”, up to a complete loss of the ability to move. Sometimes upon palpation you can hear a cracking or clicking sound coming from the pubis, while the pubic bone is painful.

A dangerous type of injury is rupture of the symphysis during childbirth. The condition is rare and is characterized by a violation of the integrity of tissues and ligaments. Occurs when pathological expansion pubic fissure of more than 20 mm and lack of adequate labor management tactics.

A rupture of the joint damages the bladder and urethra. Often the pubis after childbirth turns blue and swells, a hematoma appears in its area and an inflammatory process occurs - symphysitis.

Diagnostics

Discrepancies of the pubic bone during childbirth are determined based on the woman’s complaints of characteristic pain. At gynecological examination the doctor can literally feel the gap in the womb and feel its asymmetry.

The diagnosis is confirmed after X-ray, ultrasound or MRI of the symphysis, where the discrepancy of the symphysis pubis is clearly determined by more than 0.8-1.0 cm. In this case destructive changes are not found in the pelvic bones. A rupture of the symphysis is indicated when an X-ray shows a gap in the pubis 7-8 cm wide and there is a horizontal displacement of the bones.

Pathological discrepancy of the symphysis pubis is divided into three stages:

I – increase in the symphysis gap by 5-9 mm exceeding the physiological expansion during pregnancy;
II – by 10-20 mm;
III – more than 20 mm.

Regardless of the results additional examinations, the fundamental factor for the medical conclusion is the well-being of the woman in labor. Thus, a discrepancy of 1 cm in one woman indicates symphysiopathy and becomes a reason for a caesarean section, while in another it does not cause any discomfort.

When visualizing the destruction of bone tissue, that is, with porosity, friability, the question arises about the addition of inflammation and then the diagnosis of symphysitis is made. In this case, usually simultaneously with the appearance of pain, the woman notes that her pubis has become larger after childbirth and has turned red. This occurs due to swelling of the soft tissues. During the inflammatory process in the womb, an increase in body temperature is observed.

Clinical blood tests show a decrease in the level of calcium and magnesium, urine, on the contrary, - slight increase. With symphysitis, unlike symphysiopathy, leukocytes are also found in the urine. Differential diagnosis carried out with radiculitis, inflammation sciatic nerve, hernias, pelvic vein thrombosis.

Treatment

The symphysis discrepancy can be corrected without surgical intervention. Severe ruptures of the symphysis pubis do not go away on their own; surgery is required using lavsan, wire sutures, knitting needles, and titanium structures. Recovery period takes 3-4 months after surgical treatment.

The existing inflammatory process (symphysitis) is stopped by taking antibiotics to eliminate the source of infection. At the same time, therapy is carried out aimed at eliminating the causes that caused the discrepancy of the pubic bones. Prescribed calcium and magnesium supplements, vitamins D, group B, fish fat. Held ultraviolet irradiation womb area.

What to do if your pubic bone hurts after childbirth:

consult a doctor and do not self-medicate;
take medications and perform physical procedures and exercises for the pelvic muscles prescribed by a doctor;
enrich the diet with foods containing calcium, magnesium and other elements;
limit or eliminate physical activity;
provide support for the pelvic bones with a bandage or corset;
For pain relief, use special gels, ointments, creams or tablets.

Self-medication for pubic pain is extremely contraindicated. Only a doctor can accurately determine the width of the divergence of the joint and, therefore, select effective therapy. If at the first stage of symphysiopathy it is enough to limit activity and take vitamins, then for the second and third stages more serious measures are necessary. Bed rest lasts at least 3-6 weeks, often using tight or postpartum swaddling. The goal of the measures is to achieve maximum approximation of the edges of the symphysis.

The lack of adequate help leads to the fact that pubic pain does not go away for longer than 6 months, sometimes even several years. This occurs as a result of improper fusion of damaged tissues, their replacement with scars and development chronic pathology. Prevention postpartum complications symphysis consists of obligatory healthy diet, taking special vitamin-mineral complexes and providing physical activity even at the stage of pregnancy.

According to statistics, almost 50% of women experience pain in the pubic bone after childbirth. Below we will describe the main reasons for this problem and also explain how it can be solved.

IN last weeks During pregnancy, a woman’s body changes greatly, reacting to the imminent onset of labor. In expectant mothers, the pelvic bones diverge and the cartilage tissue softens. Well, after the birth of the child, reverse processes begin that return the body to normal. Which explains why the pubic bone hurts after childbirth.

What do we have to do?

Many mothers ask the question: What to do if the pubic part hurts after childbirth, how to react to the discrepancy of the bones? For starters, don't panic. As already mentioned, this process is absolutely normal. Indeed, during pregnancy, a woman’s body releases the hormone relaxin, which softens cartilage and ligaments. Under its influence, the pubic part in the pubic area is stretched, which provokes pain.

Especially strong impact relaxin is observed in the last weeks of pregnancy. During this period, cartilage tissue swells, the distance between bones increases, and their mobility increases. These changes often cause discomfort. They also cause inconvenience at the postpartum stage, causing pain symptoms in the pubic bone area.

In 90% of cases, pain goes away within 1-2 weeks after birth. To eliminate them, you need to spare your body, follow all the doctor’s recommendations, and eat right. And also remain calm and good location spirit. After all, stress and anxiety create additional load on the body, slowing down its recovery.

Is there a health risk?

In some cases, the pubic part is displaced too much, which provokes inflammation of the symphosis (the pubic joint of the pelvic bones). However, this disease can be easily cured after childbirth by adhering to the following rules:

wearing a bandage belt that fixes the pelvis and hips in the desired position;
regular intake of vitamins and minerals recommended by your doctor (especially calcium and magnesium);
reception sunbathing(for the absorption of vitamin D);
limitation of physical activity, frequent changes of position (you cannot sit, stand or walk for more than an hour);
consumption of food containing a large number of calcium (nuts, dairy products, fish, etc.).

Treatment may also be accompanied by taking painkillers and anti-inflammatory drugs under the supervision of a doctor. As for surgery, there are very few reasons to perform surgery on the pubic bone. Less than 1% of mothers require this procedure.