Hello, I am 32 years old, diagnosed with Arthritis of the pubic joint and arthrosis of the hip joints, the disease appeared after childbirth, although I did not give birth myself, I had a planned cesarean section due to vision problems (child is 1.5 years old). After prolonged stress on the legs, the pain in the groin area intensifies, It’s hard to walk, and in general all the joints, hands, and feet hurt. I went to a rheumatologist, underwent an examination, made this diagnosis and prescribed treatment for 2 weeks. Teraflex Advance and then Teraflex for up to 6 months, after taking Advance nothing has changed, everything hurts, tell me, are there any non-drug methods of treating this disease, for example, does acupuncture make sense, or physical treatment? Thank you
Hello. Yes, physiotherapeutic treatment helps, but no treatment completely cures the problem once and for all, but only alleviates the symptoms and prolongs the life of the joints. But don’t be upset, except for the flu, almost no diseases can be completely cured)) All people have one or another chronic disease and yours is not the worst of them. It is best to be treated comprehensively. Unfortunately, I cannot describe the entire treatment complex without knowing all your details. Physical methods usually include magnetic therapy, hydrocortisone phonophoresis, etc. Sometimes intra-articular injections are needed. The treatment prescribed to you is correct, but apparently not sufficient. Complex treatment is necessary depending on the stage of the disease and its characteristics. By itself, no method can cure anything in this situation. As for acupuncture, I doubt it, but you can try it, it shouldn’t get worse, and it might help a little. + We must not forget about motor mode and lifestyle. I am sure you will find a complex of medication and physiotherapeutic treatment that will be effective for you.
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Since the time of Hippocrates, it has been known that during pregnancy there is a moderate softening of the joints of the pelvis and stretching of the pubic symphysis, which contributes to the favorable passage of the fetus through the bony pelvis.
In some cases, these changes exceed physiological boundaries, and then excessive relaxation of the pelvic joints occurs, accompanied by pain, leading to their excessive stretching and even rupture during childbirth, especially with mechanical impact or surgical interventions.
In the domestic literature, the following terms are used to characterize pathological changes in the joints of the pelvis during pregnancy and after childbirth - symphysiopathy and sacroileopathy, symphysitis, arthropathy of pregnant women, discrepancy and rupture of the symphysis pubis (1,2,6).
In foreign literature, many terms are used to characterize pathological conditions of the pelvic joints during pregnancy and after childbirth: relaxation of the pelvic ring (16); girdle pelvic pain (18); pelvic relaxation syndrome (25); antenatal pelvic pain (24); pubosacroiliac arthropathy (36); pelvic insufficiency (15); pelvic pain and instability of the pelvic joints, etc. These terms do not always reflect the essence of the pathological process, and therefore many authors (11,14,26) recommend using the term symphysis pubis dysfunction (SPD).
It seems to us that the proposed name also does not fully reflect the essence of the issue, since in addition to changes in the pubic symphysis, changes in the sacroiliac joints and in the structure of the pelvic bone tissue are often observed.
Dear doctors, I ask for opinions and recommendations!
At the moment, I am 35. About a year and a half ago, I began to notice periodic but mild pain in the groin on the inside of my thigh after a long walk. In April of this year I felt clicking. It seemed to me in the area of the hip joints. A couple of weeks ago the clicking got worse. I contacted a traumatologist. They took an x-ray.
Conclusion arthrosis of the symphysis pubis 2nd degree.
There were 2 births, the last in 2008. Afterwards there were no unpleasant sensations in the pubic area. I could walk easily.
From the recommendations of the traumatologist, swimming to strengthen the muscle corset. Nothing else. According to him, chondroprotectors are absolutely ineffective.
I'd like to hear more opinions. And a possible forecast.
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First, try to figure out (remember) the cause of the pain. What happened (changed) in your life a year and a half ago? I think that the impetus for the onset of pain was severe psychological stress (99%) or excessive physical activity (1%).
If the hassle still hasn’t gone away, drink motherwort tincture.
I advise you to limit salt in your food and drink more fluids.
Good luck and patience!
but slight pain in the groin on the inner side of the thigh after a long walk.
In April of this year I felt clicking. It seemed to me in the area of the hip joints. A couple of weeks ago the clicking got worse.
When do clicks occur, with what movement?
First, try to figure out (remember) the cause of the pain.
What happened (changed) in your life a year and a half ago?
Are you interested in what happened in April when the clicks appeared?
I think that the impetus for the onset of pain was severe psychological stress (99%) or excessive physical activity (1%).
Do you consider such possible causes of pain as autoimmune, steroid, idiopathic, or degenerative?
Well, if it doesn’t help, what should we do?
The urgency of the problem lies in the fact that few doctors not associated with manual medicine, traumatology and obstetrics are familiar with this pathology. In addition, there is often “ignoring” of symptoms both on the part of doctors (primarily obstetricians and gynecologists) and patients. And a painful symphysis pubis can initiate pain patterns (pain radiating to the lower abdomen, groin, perineum), similar to those in diseases of the pelvic organs.
During pregnancy, moderate softening of the pelvic joints and stretching of the symphysis pubis (CP) occurs, which contributes to the favorable passage of the fetus through the bony pelvis. However, these changes can cross physiological boundaries, leading to excessive relaxation of the pelvic joints, which is accompanied by the appearance of pain and leads to rupture of the pubic symphysis during childbirth, especially with mechanical influences and surgical interventions. The number of cases of symphysis pubis dysfunction (APD) varies from 0.1 to 55%. Such large fluctuations in the frequency of DLS can be explained by the lack of a unified definition of this pathological condition, unified diagnostic criteria, as well as insufficient attention to this problem by both patients and doctors.
Despite a fairly clear description of the symptoms of this disease, there is still no common point of view on the terminology of pathological changes in the joints of the pelvis during pregnancy. Thus, in the domestic literature (L.V. Vanina, 1954; L.S. Persianinov, 1964) terms such as “symphysitis”, “symphysiopathy”, “divergence” and “rupture of the symphysis pubis” are used, while foreign authors suggest use the term “symphysis pubis dysfunction” (DPD). In ICD-10 (2003), pathological changes in drugs during pregnancy are not identified as a separate nosological unit.
Painful sensations in the joints are not just unpleasant: they indicate existing disorders in the body, which can subsequently lead to limited mobility of the limbs and a decrease in the quality of life.
In the hip joints or pubic area, pain occurs due to inflammatory processes of an infectious nature or caused by malnutrition of the joints. In such cases, specialists diagnose various arthritis: acute bacterial, symphysis pubis, chronic monoarthritis, rheumatoid, chlamydia, osteoarthritis, polymyalgia rheumatica, ankylosing spondylitis and other types.
The development of arthritis is not associated with age-related changes; most often the causes of the disease are infections, including those caused by hypothermia, injuries, burns and cuts. People suffering from diabetes should pay special attention to the condition of their joints.
Recognized arthritis, treatment of which began on time, will help avoid many sad consequences - purulent melting of the joint, rheumatic heart disease, disability, death. You cannot do without the help of a doctor in treatment, but it will not be superfluous to familiarize yourself with additional information that will help determine the symptoms of the disease.
There are 3 joints in the pelvic area, inflammation of which can cause unbearable pain - the pubic symphysis, paired hip and sacroiliac joints.
The pubic bones are connected through a special semi-movable joint, which is a fibrocartilaginous disc with a fluid cavity. In the scientific literature one can find several synonymous definitions of this connection, in particular the concepts of pubic symphysis, pubic fusion, pubic fusion or pubic symphysis are used.
Arthrosis of the hip joint (coxarthrosis) is a collective concept that includes almost all pathological processes in the hip joint. They can arise for various reasons:
Such destruction is characterized by active progression, destruction of articular tissue, pain and dysfunction of the joint.
We can say about coxarthrosis that it is an acquired disease (not inherited), but its main causes are genetic in nature:
In view of this, the likelihood of developing the disease in close relatives is quite high.
Arthrosis of the hip joint can develop as a complication: Perthes disease (impaired blood supply to the hip joint), congenital dysplasia, trauma, necrosis of the femoral head.
Often, the disease can occur against the background of an inflammatory or infectious process in the body, for example, rheumatoid, purulent arthritis and tuberculosis of the hip joints.
Due to the sluggish development of the disease, it can be either bilateral or unilateral.
Factors that can provoke coxarthrosis can be:
Today, arthrosis of the hip joint can be diagnosed using radiography, magnetic resonance imaging (MRI) and computed tomography (CT). The most accurate picture of the disease and the condition of the soft tissues can be shown using an MRI of the hip joint, but a CT scan allows you to see the pathology of the bones.
It is important to use all diagnostic methods. They will help not only show the cause of the disease, but also the degree of its neglect.
Clinical detection of the disease includes:
Often, bone tuberculosis can be hidden under the guise of this disease. As a rule, the onset of the disease is erased and manifests itself like any other problem of the musculoskeletal system. This process can continue for a very long time, and it will only be visible on X-rays in advanced cases (photo).
To confirm the diagnosis and understand its cause, a puncture of synovial fluid may be required.
For tuberculosis of bone tissue, it is strictly forbidden to use physiotherapeutic methods. You should also not use warming ointments, perform warming procedures, massage or exercise therapy.
If these methods of treating arthrosis do not give the expected result and cause a deterioration in health, then the diagnosis should be reconsidered in favor of tuberculosis. It is characterized by leukocytosis and increased blood ESR.
Symptoms of the disease will vary depending on its severity. However, we can name the main signs for all stages:
At this stage, the symptoms of hip arthrosis will be vague. The patient may feel pain only during active physical activity (fast walking, running) or immediately after it.
In addition, discomfort is felt in the joint itself, and rarely radiates to the hip or knee. The patient's gait is preserved, muscles are toned, and lameness is not observed.
During medical diagnosis, x-rays will show bone growths located along the outer and inner edges of the acetabulum. No other pathological processes will be detected in the neck and head of the femur.
Osteoarthritis of the hip joint of the 2nd degree is characterized by a significant increase in symptoms. It hurts constantly and intensely. When the joint is loaded, the person begins to limp slightly, and pain radiates to the groin and thigh (and this happens both in movement and at rest). It often becomes difficult to move the hip.
At this stage, you can see an increase in the number of bone growths (osteophytes).
If the disease is not treated, it gradually moves into the third stage. At this time the pain is constant and excruciating. Even at night, the patient does not leave the feeling of discomfort. It becomes increasingly difficult for him to move without assistance, a cane or crutches.
The volume of the joints is quite limited, the muscles of the buttocks, thighs and lower legs atrophy. The affected leg shortens and the patient has to bend the body while walking.
Due to the constant shift in the center of gravity, the joint affected by arthrosis is even more loaded. The x-ray clearly shows numerous bone growths, an enlarged femoral head and a maximum narrowing of the joint space.
If you start treatment for arthrosis of the hip joint as early as possible, then it is quite possible to avoid surgical intervention. It is equally important to establish an adequate diagnosis in a timely manner, differentiating arthrosis from other problems with the musculoskeletal system and tuberculosis of bone tissue.
In case of illness of the first and second stages (photo), the patient can be cured with a competent integrated approach using:
Each of the methods must occur under the strict supervision of the attending orthopedic surgeon. This approach will help solve several problems at once.
To relieve pain, modern pharmacology can offer an impressive selection of various nonsteroidal anti-inflammatory drugs (NSAIDs). However, you should know that they only affect the symptoms and are not able to in any way affect the development of the disease.
If the patient systematically uses only these painkillers for joint pain, then the disease and destruction of cartilage tissue will still progress.
Every patient should understand that NSAIDs have a number of dangerous side effects. Therefore, their prolonged use is unacceptable. Such drugs have a detrimental effect on the production of proteoglycans, dehydrate an already weakened body, and aggravate problems with cartilage tissue.
Painkillers should be used under the supervision of a doctor and only during an exacerbation.
Non-steroidal anti-inflammatory drugs include the following drugs: Nise, Ketanov, Nurofen, Voltaren, Nimulide, Celebrex, Texamen, Nimica, Meloxicam, Ketarol, Flexen, Ibuprofen, Faspik, Ketorolac, Nalgesin, Movalis, Diclofenac, Ortofen, Artrosilene, Ketonal, Diclak. Artrosan, Bystrumkaps, Burana.
There are local drugs for the treatment of deforming arthrosis of the symphysis pubis. They work as warming ointments, but at the same time they can reduce pain and relieve spasms from muscle tissue:
If we are talking about the early stages of destruction of the symphysis pubis, then the condition of the cartilage can be significantly improved with the help of chondroprotectors:
These may be tablets, creams or injections.
You can qualitatively improve blood circulation and relieve spasms thanks to drugs that constrict blood vessels: Trenal, Vazonide Retard Stugeron, Agapurin, Cinnarizine, Xanthinol nicotinate Pentoxifylline. All of them are in the middle price range and are accessible to many.
If there are strict indications, then muscle relaxants (drugs for muscle relaxation) may be prescribed:
Such treatment can have both positive and negative effects on the body.
The drugs significantly reduce pain, but at the same time spasm and tension are protective reactions, removing which only increases the rate of destruction of joint tissue.
The procedure should be carried out in a hospital setting and with extreme caution, especially when using hormonal drugs:
Such drugs relieve pain and inflammation, but at the same time have a pronounced immunosuppressive effect. Hormones provide short courses with gradual withdrawal. Doctors note that the use of these drugs is not always justified.
It is better to treat with injections of chondroprotectors into the thigh, for example, injecting Alflutop or Chondrolon. It will take from 5 to 15 procedures twice or thrice during the year. Injections into the joints with hyaluronic acid are indicated.
Any physiotherapeutic procedures for arthrosis of the symphysis pubis have both their supporters and opponents. In some situations, treatment with a laser or magnet may not have the desired effect. The same applies to other procedures for this disease, because the affected joint is located deep enough and they simply cannot achieve the goal. Many doctors consider physical therapy a waste of the patient's time and money.
Other treatment measures may often be used:
Such treatment can eliminate the causes of symphysis pubis disease, strengthen the periarticular muscles, and increase joint mobility. With adequate combination with drug therapy, the distance from the socket to the head can be increased and the pressure on the femur, and in particular on its head, can be reduced.
Coxarthrosis responds well to treatment using a complex of physical therapy.
Without a competent selection of exercise therapy exercises and their systematic implementation during the period of remission, it is impossible to obtain a significant improvement in the patient’s condition.
If a patient is overweight, the doctor will definitely recommend that he switch to a diet. This will also help relieve stress from the affected joint and eliminate the causes of arthrosis, however, the diet will not have an independent therapeutic effect.
Also, coxarthrosis can be alleviated through the use of crutches or a cane. These devices are necessary depending on the degree of destruction.
Coxarthrosis of the third degree always requires surgical treatment. This is important, because the nature of the destruction is so severe that the joint should be replaced with an endoprosthesis. According to indications, a prosthesis can be used:
This operation can be performed after a thorough medical examination. During its implementation, general anesthesia is used.
As a result of the manipulation, the signs of arthrosis of the symphysis pubis recede, and the hip begins to fully function. After the intervention, a number of postoperative measures are also necessary:
The duration of treatment is 6 months. Installed dentures last about 20 years, and after this time they require an equivalent replacement.
Carrying a child involves enormous challenges that a woman's body must endure. Most obvious changes require no explanation, but sometimes some changes in the body of the expectant mother cause concern. One of these exciting factors that needs special attention is the pubic symphysis. Every pregnant woman should know where the pubic symphysis is located, what are the causes of possible pain in its area and how to cope with it.
The pubic symphysis, which also has a second name - the pubic symphysis, is two pubic bones of the hip joint, connected by fibrocartilaginous tissue along the midline. It is located in front of the bladder above the external genitalia and is attached to the pelvic bones by elastic ligaments.
During the prenatal period, a woman’s body is subject to dramatic changes that affect her hormonal balance. The result of the influence of hormones such as progesterone and relaxin is the softening of all ligaments. The pubic symphysis, where the cartilage tissue is located, also becomes less static. This often leads to unnatural, painful mobility of the pubic symphysis.
During pregnancy, the purpose of the action of these hormones is to increase the flexibility of joints and bone structure, which contributes to an easier course of labor. Meanwhile, dysfunction of the pubic symphysis is quite rare in patients and requires immediate action.
The appearance of space between the pubic bones is called discrepancy. This diagnosis must be made on the basis of the complaints described by the pregnant woman. Symptoms often include:
- pain in the pubic area, which can result in unpleasant aching sensations below, “pulling” the leg and groin;
- sudden pain during loading movements (turning from side to side, climbing stairs, etc.);
— a kind of cracking of the joints is possible when the hip moves;
To obtain more accurate diagnostic data, you should undergo an ultrasound of the symphysis pubis and MRI. The latter will help determine the degree and width of the discrepancy, which can reach one of three levels:
The symphysis pubis is threatened during pregnancy due to impaired metabolism and lack of vitamin D. For example, hormones produced by the parathyroid gland are involved in the regulation of phosphorus-calcium metabolism in the body. If there is a lack of calcium supply, required for the full development and growth of the fetus, the body begins to draw the necessary substance from the mother’s reserves. The main source of calcium for the future baby will be the mother’s teeth and bones. Also, gastrointestinal diseases and diabetes mellitus can cause calcium deficiency. In turn, vitamin D significantly affects the body's absorption of incoming calcium.
The divergence of the symphysis pubis begins to develop long before the birth of the child. However, the effects of hormones and fetal weight contribute to the manifestation of the above symptoms only in the second or third trimester. Often, the signs of pathology that appear are not given due attention and are attributed to osteochondrosis, radiculitis, or the threat of miscarriage.
Timely diagnosis is extremely important. It will help you take the necessary treatment measures in time, prevent negative consequences through natural delivery or resort to caesarean section.
Typically, pubic bone dehiscence does not require any intervention. After a successful birth, the flexibility, elasticity and integrity of the pubic symphysis can be restored naturally.
Recommendations from obstetricians and gynecologists to reduce unnecessary stress on joints and ligaments include:
- performing gymnastic exercises;
- prescribing the necessary medications (magnesium, calcium, vitamins, especially group B).
The woman in labor should inform the obstetricians about the presence of this pathology before the start of labor.
A discrepancy that progresses to a more severe degree is fraught with rupture of the symphysis pubis. To avoid further expansion of the pubic bones, doctors also strongly recommend limiting physical activity, giving preference to bed rest.
If the discrepancy of the pubic bones is observed mainly during gestation, then a rupture is possible during the birth process. Among the types of breaks, violent and spontaneous are distinguished. The latter occur during spontaneous labor. The reason for the appearance of violent ruptures is often cited as the use of additional efforts when removing the fetus or manually separating the placenta. In addition, insertion of the hand into the uterine cavity in most cases is a decisive factor in the probable rupture of the symphysis pubis.
If a rupture occurs, the patient needs strict bed rest. The hip joint area is subject to tight bandaging. It is optimal to use a wide linen bandage for this purpose. Legs should be placed on the headboard and blocks should be attached to them at the level of the pelvis. The ends of the bandage must be tied on wooden strips, which are tied with cords. These cords pass through the blocks, and a load must be suspended from their ends, starting with a couple of kilograms and gradually increasing to 10 kg.
Thanks to early recognition of the rupture, restoration of the symphysis pubis occurs within 2-3 weeks. In case of delayed treatment, the bandage is applied for at least 1 month. Bandages made of fabric resembling a hammock are often used for this purpose. Its edges are attached to the longitudinal straps. The pelvic bones begin to converge due to the patient’s own weight. The recovery time when staying in a hammock is the same.
The musculoskeletal functions of the pelvis are completely restored when the treatment approach is carried out without delay. With a more delayed definition of the rupture, the inflammatory process of cartilage tissue contributes to difficult healing and protracted rehabilitation.
The changes that occur in a woman's body during pregnancy can affect her health. One of the complaints that worries expectant mothers in late gestation is pain in the symphysis pubis. This sign does not always indicate the development of some kind of disease. In most cases, discomfort observed when walking and sudden movements is considered normal. After all, the body weight of the fetus in the later stages is already quite large. Therefore, the child puts his weight on the pelvic bones and ligaments. Infringement of the nerve structures in this area causes pain.
In some cases, divergence of the symphysis pubis occurs during pregnancy. This is not considered normal. The discrepancy can have serious consequences for the mother's health. Therefore, if you experience pain in the pelvic bones, it is recommended to consult a doctor. The doctor will determine whether there is a pathological condition in this case, or whether the woman is experiencing temporary discomfort that does not pose a danger. Self-treatment without consulting a doctor can be harmful.
The structure of the female pelvis is designed in a special way. Its size is larger than that of men, due to which childbearing occurs. The pelvis is a closed ring consisting of several bones. The unpaired structures include the sacrum and coccyx. The pelvic, ischial and pubic bones are located in front, side and bottom. The latter are held together by dense connective tissue. This forms the pubic joint, or symphysis. In late pregnancy, the connective tissue between the pubic bones begins to soften. This is considered a natural process necessary for the passage of the baby through the birth canal.
Pathological conditions develop in cases where excessive softening of the symphysis occurs. This leads to severe bone mobility, which should not normally exist. As a result of such changes, a disease such as symphysitis can occur - inflammation of the symphysis pubis. The main criterion for this pathology is pain in the pubic area, which a pregnant woman experiences not only when moving, but also when at rest.
To suspect a disease, you need to know what the symphysis pubis is, where the symphysis is located and how the inflammatory process manifests itself. Specially trained medical personnel will help answer such questions. Classes on preparation for childbirth are organized in almost every clinic.
It should be noted that symphysitis can develop not only during pregnancy. However, it is more often observed in expectant mothers. Due to the softening of the dense connective tissue that closes the bones, a divergence of the symphysis pubis occurs. If it is not very pronounced, there should be no cause for concern. In this case, only observation and limitation of loads is indicated. If there is severe divergence of the symphysis pubis, hospitalization is necessary.
There are several reasons why there is a distance between the pelvic bones. Among them:
Disjunction of the symphysis pubis during pregnancy is more often diagnosed in women with a history of multiple births. In this case, the body does not have time to restore strength. There is a long-term lack of estrogen, leading to “washing out” of calcium from the bones. Due to frequent childbirth, the weakness of the symphysis gradually increases. As a result, divergence of the pubic bones occurs.
Risk factors include pelvic injuries and physical inactivity. If the pubic bones have been damaged previously, then the likelihood of their divergence during pregnancy increases several times. Symphysitis is more often observed in women who lead a sedentary lifestyle. In this case, the ligaments and muscles of the pelvis do not stretch properly. Therefore, the load can lead to sudden damage. The symphysis pubis tends to diverge during pregnancy if the baby's weight is above average (more than 4 kg). A narrow pelvis is also a risk factor.
Bone separation and inflammation of the pubic symphysis in non-pregnant women can occur due to injury and physical stress. Risk factors include strenuous sports.
The severity of the disease depends on the distance between the bones of the symphysis pubis. It is determined using instrumental diagnostic methods. Pregnant women most often undergo ultrasound examination. Depending on the distance between the pubic bones, the following stages are distinguished:
The severity of symptoms of symphysitis depends on the severity of the disease. The more the pubic bones are separated, the more difficult it is for a woman to move.
As already mentioned, the symphysis pubis during pregnancy can hurt not only with pathology, but also normally. It all depends on the intensity of the discomfort and gestational age. It is believed that if pain does not prevent a pregnant woman from sleeping, then there is no reason to worry. Mild discomfort in the pubic area when walking is a normal reaction of the body. As the inflammatory process develops, the pain becomes stronger. They not only make it difficult to walk, but are also observed in a lying position.
Symptoms of pubic bone dehiscence and symphysitis include:
Most often, discomfort appears in the third trimester, but sometimes it occurs earlier. Women who have calcium deficiency may feel discomfort as early as 4 months of pregnancy. The larger the fetus becomes, the more it puts pressure on the pubic symphysis. Where is the pain most often felt? Unpleasant sensations arise suddenly. They first appear in the area of the inguinal folds, and then move to the pubic tubercle. When the pubic symphysis is inflamed, swelling of the tissue is observed and the pain intensifies.
Discomfort while walking increases when there is a load. Climbing stairs leads to severe pain. With symphysitis, other ligaments and muscles of the pelvis can also become inflamed. Some patients indicate pain in the sacrum, coccyx, and lower back. When the pubic bones diverge, heaviness in the lower abdomen may be noted.
Compression of the nerves leads to the development of a “lumbago” sensation and tingling sensation on the inner thigh. A clear sign of the inflammatory process is swelling of the pubis. As the disease progresses, it intensifies.
To diagnose pathology, the doctor must palpate the symphysis pubis. Where is the symphysis located? The discrepancy is noted in the pubic area. If the distance between the pubic bones is large, it can be diagnosed without special research methods.
In late pregnancy, women often complain of pain in the pubic area. The doctor must find out how severe the discomfort is. The doctor pays attention not only to the pregnant woman’s complaints, but also to the results of the examination. Swelling and tenderness of the pubis indicate symphysitis. The divergence of the bones is indicated by a “duck gait.” The doctor also measures the size of the pelvis. You should find out whether there were similar pains during previous pregnancies.
The main research method is ultrasound of the symphysis pubis. Where to do this diagnostic procedure? Ultrasound examinations are performed in almost all clinics and hospitals. A referral for an ultrasound of the pubic symphysis can be obtained from a gynecologist or therapist. In addition to the obstetric history, it is worth finding out whether the woman has had pelvic injuries.
If symphysitis is suspected in a non-pregnant patient, radiography is performed. This method allows you to evaluate the location of the pubic bones and the distance between them. A biochemical blood test is important for diagnosis. It can be used to determine whether there is a calcium deficiency in the body.
Ultrasound of the symphysis pubis is performed on all pregnant women if there is a suspicion of bone discrepancy and an inflammatory process. This method is considered safe for the fetus and mother. Using ultrasound, the degree of divergence of the pubic bones is determined.
In most cases, inflammation and separation of the pubic symphysis does not affect the baby’s condition. However, it can harm the mother's health. In severe cases, pathological complications occur. These include:
Such consequences are unlikely, but they cannot be excluded. Inflammation of the symphysis that develops during pregnancy can spread to nearby tissues. In particular - on the pelvic joints. Arthrosis of the symphysis pubis is characterized not only by inflammatory, but also by destructive changes. As a result of this disease, gait disturbance becomes permanent. In some cases, lameness persists after childbirth. To avoid arthrosis, preventive measures should be taken as early as possible.
Rupture of the symphysis pubis during childbirth occurs if there is a divergence of the bones of 2 or 3 degrees. Connective tissue softened during pregnancy becomes very fragile. As the baby passes through the birth canal, the pressure on the symphysis increases, as a result of which it can rupture. Such a complication will not harm the child. However, to prevent rupture, delivery by caesarean section is recommended.
A fracture of the symphysis pubis is considered the most severe complication. Most often it occurs due to injury. There are isolated fractures of the pubic bones and combined injuries to the pelvis. The risk of developing this complication increases with insufficient calcium in the bones. If the joint is fractured and the continuity of the pelvic ring is disrupted, damage to internal organs may occur. This condition is life-threatening and requires immediate surgical attention.
In most cases, doctors only observe how the pubic symphysis has changed. Treatment is performed only for severe disease. A similar tactic is used for pregnant patients. The main goals of treatment measures:
Most often, the pubic bones come together on their own some time after childbirth. To prevent the discrepancy from increasing, it is worth preventing risk factors. For this purpose, it is necessary to exclude physical activity.
For moderate to severe disease, bed rest is indicated. In some cases, the pregnant woman may need to be hospitalized in a maternity hospital. To eliminate unpleasant sensations, a course of massage is carried out, and special exercises are performed. Gymnastics is indicated if the discrepancy of the pubic bones is not very pronounced. A traditional exercise for pregnant women is the “cat”. The woman gets on all fours and arches her back as far as possible. It is also recommended to carefully spread your legs while lying on your back. This will help strengthen the pelvic muscles and relieve pain. Wearing a bandage is recommended.
To prevent the progression of symphysitis, calcium supplements and a special diet are prescribed. Pregnant women are recommended to include dairy products in their diet: cottage cheese, cheese, kefir. To ensure calcium is well absorbed, preventive doses of vitamin D are prescribed.
If symphysitis develops in a non-pregnant patient, physiotherapeutic procedures and painkillers and anti-inflammatory drugs are prescribed. These include medications “Ketorol”, “Diclofenac”, “Baralgin”.
A fracture of the pubic bones with rupture of the pelvic ring is a dangerous disease. Due to severe bleeding, it can be fatal. During pregnancy, women are more susceptible to fracture due to softening of the pubic symphysis and lack of calcium. Bones can be damaged as a result of falls, impacts, or work-related injuries. In rare cases, a pubic fracture occurs in athletes under excessive stress. If you suspect such a complication, you should immediately call an ambulance. Moving during a pelvic fracture is prohibited, as this can cause damage to internal organs.
In case of injury, x-rays are performed. If a fracture is suspected in a pregnant woman, an ultrasound of the symphysis pubis is performed. Emergency physicians must place the patient in the correct position to immobilize the pelvis. Treatment is performed by traumatologists. For delivery, an emergency cesarean section is performed. Obstetric tactics depend on the condition of the fetus and mother.
Recovery of the pubic symphysis occurs gradually. The speed of bone fusion depends on the characteristics of the body and the degree of discrepancy. After childbirth, the pubic symphysis usually returns to normal on its own. This occurs provided that a sufficient amount of calcium enters the body and the woman refrains from physical activity. The condition of the pubic symphysis can be judged by the patient’s sensations. In most cases, discomfort when walking and sudden movements can persist for up to 6 months. If there is a calcium deficiency, the regeneration process is delayed.
To help the bones come together faster, bed rest is prescribed after childbirth. The woman should not walk or make sudden movements for 2-6 weeks. Wearing a bandage or bandaging the pelvis is also indicated. If a rupture of the pubic symphysis occurs at the time of birth, cold is applied to the damaged area on the first day. Then physiotherapeutic procedures are performed to accelerate healing. In the postpartum period, it is allowed to use painkillers that were contraindicated during pregnancy. For severe swelling and pain in the pubic area, antibacterial and anti-inflammatory drugs are prescribed.
Disjunction of the pubic symphysis and its inflammation develops in 20% of pregnant women. In most cases, a mild degree of pathology is observed. Despite the fact that bone separation and symphysitis do not lead to serious consequences, the woman experiences discomfort. Painful sensations affect the emotional state of the pregnant woman. To avoid the development of symphysitis and divergence of the pubic bones, it is necessary to follow preventive measures. These include:
The appearance of pain in the area of the pubic symphysis is a reason to consult a doctor. To make sure that there is no discrepancy of the bones, it is enough to perform an ultrasound examination. This diagnostic method is safe for pregnant women.
Arthrosis of the sacrococcygeal joint is a pathological process characterized by inflammation and ultimately leading to limited functionality of the joint. Typically, this condition is diagnosed in older people; the disease is considered a rare pathology.
The coccyx is the bone of the lower spine . It consists of small fused vertebrae that have processes. They are connected to each other and at the same time form five scallops on the back, which are reunited using joints:
Arthrosis of this area is a condition in which the abnormal position of the coccygeal bones is formed and damage to the nerve endings occurs.
The main symptom of this disease is pain. It can be dull or regular, intense and spontaneous. A relapse of the disease can be caused by improper lifting of loads, as well as hypothermia. Patients experience limited activity extending to the lower spine.
Manifestations of the disease make themselves felt in different ways. They directly depend on the reasons that provoked the pathological process.
Unpleasant sensations may occur in the lumbar region, which will make themselves felt during movement. If there is a dislocation, in addition to pain in the tailbone area, swelling will occur. Sometimes patients complain of discomfort occurring in the sacrum area. In addition, redness and an increase in temperature are observed in this area . The nature of the pain can be regular or temporary. There is an increase in pain or a decrease when changing different positions.
For a long time, the disease can be in a quiescent stage, and exacerbations can occur only during freezing and physical exertion.
The main manifestation of this disease is pain. Therefore, as soon as this symptom makes itself felt, you need to immediately contact a doctor and undergo a thorough examination. First of all, the specialist performs palpation; some tests are also carried out in the vertical position of the body, sitting and horizontal.
In the case of a unilateral form of the disease:
When, when bending to both sides and forward from a sitting or standing position, restriction of movements occurs to the same extent, this indicates an inflammatory process in the lumbar region. In this case, when the knee joints work, resistance occurs in a horizontal position.
Arthrosis of the coccyx makes itself felt by increasing pain from a sitting position. The sensations increase, if you put pressure on the muscle areas and ligaments of the coccyx, vague pain occurs in the perineal area.
Arthrosis of the sacroiliac joints is checked using the following methods:
Then the patient is necessarily sent for x-rays, computed tomography, and laboratory tests.
For a disease such as arthrosis, it is necessary to treat exclusively with conservative methods:
more about what uncoarthrosis is and how it is treated here.
A variety of procedures can be prescribed as additional and effective treatments:
Symptoms and treatment of arthrosis of the coccyx is a very serious issue, so it should be entrusted exclusively to a professional.
Loads on the lumbar region should be minimized; do not run, jump, or otherwise load the sore joint. It will be useful to walk, but take your time. It is contraindicated to stay in one position for a long time or sit for a long time. Patients are also recommended to wear bandages and corsets. To minimize the load, it is necessary to do special exercises to strengthen the back muscles.
Considering that these types of arthrosis are practically not treated, increased attention must be paid to prevention methods. The patient must lead a healthy lifestyle, monitor his weight, exercise systematically, and not lift heavy loads. Special gymnastics for strengthening muscles is very effective and useful.
From this material you learned about such a condition as arthrosis of the sacrococcygeal joint: what it is. The pathology is rare, accompanied by a moderate clinical picture. Due to the fact that this area is characterized by insufficient functionality, stiffness in movement is not clearly expressed.
The pain is usually tolerable and patients often tolerate it. But you shouldn’t delay going to the doctor, as this can lead to irreparable consequences in the form of coxarthrosis and other serious diseases. To establish the correct diagnosis, it is necessary to undergo a detailed examination.