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J Can Chiropr Assoc. 2012 Jun;56(2):102-11.

Pregnancy-related symphysis pubis dysfunction management and postpartum rehabilitation: two case reports.

Author information

1
Ashbridge's Health Centre, 1522 Queen St. East, Toronto, ON M4L 1E3. E-mail: dremilyhowell@hotmail.com.

Abstract

OBJECTIVE:

Two case reports review the chiropractic treatment and rehabilitation management of Symphysis Pubis Dysfunction (SPD).

CLINICAL FEATURES:

Patient 1: a 35-year-old female presented at 30 weeks pregnant with severe left sided Symphysis Pubis Dysfunction and low back pain. Patient 2: a 33-year-old female also 30 weeks pregnant, presented with right sided Symphysis Pubis Dysfunction and sacroiliac pain.

INTERVENTION AND OUTCOME:

Treatment included soft tissue therapy, pregnancy support belt, side-lying mobilizations, pelvic blocks and instrument-assisted pubic symphysis adjustments. Home advice included: ice, staying active, moving as a unit, stretching, use of a pillow between the knees while sleeping, regular breaks from sitting and pelvic floor (Kegel) exercises. Both patients reported some relief with treatment and home care. Post-partum, rehabilitation exercises were prescribed to restore muscular endurance, control and pelvic stability. On long-term follow-up patient 1 reported no pubic symphysis pain, but some low back pain secondary to a subsequent knee injury. Patient 2 reported being mostly pain free with a rare re-exacerbation of pubic symphysis pain.

SUMMARY:

Conservative chiropractic management appears to reduce pain and improve mobility and function for SPD. Post partum rehabilitation of the associated lumbo-pelvic musculature with specific stabilization exercises is recommended to reduce pain, improve long term outcomes and prevent chronicity.

KEYWORDS:

chiropractic; exercise; pelvic pain; pregnancy; pubic symphysis; rehabilitation

PMID:
22675223
PMCID:
PMC3364059
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