The topic of today's article is symphysitis after childbirth. What you need to know about this disease? After the birth of a child, young mothers dream of acquiring previous forms and getting rid of discomfort. This often happens, but it happens that in the postpartum period there are undesirable physical changes that lead to complications. Women begin to complain of pain and discomfort in the pubic area. These sensations can be amplified by a change in posture, getting out of bed, climbing stairs. The forehead in women swells, which prevents them from walking directly (the gait resembles duck movements). These signs indicate the progression of a disease such as pubic symphysitis.
The concept of pubic symphysis
Many people know about such a half-joint in women as the pubic joint. It is with him that the manifestation of symphysitis is associated. Two pelvic bones and a sacrum form a woman’s bony pelvis. These bones are connected together using a symphysis (pubic connection) and two sacral joints. The pubic bones of the pelvis are fused with the help of fibro-cartilaginous tissue and form a symphysis. The center of this compound (articular cavity) is filled with articular fluid. The pubic joint is strengthened by ligaments.
The pubic bones are 1 cm apart (this is the norm). The forehead in women is located in front of the symphysis. It has a fat lining and a ligament for attaching the clitoris. The pubic articulation is a half-joint with a slight circle of motion. Nerves and vessels are located under the symphysis. The bladder and urethra are located behind the fusion.
Description of symphysitis
The inflammatory process that occurs during pregnancy or after childbirth in the pubic joint is symphysitis. During gestation, the symphysis tends to soften, so that the baby’s head at birth can easily pass in the mother’s pelvic ring. As a result of increasing the stability of the symphysis, it can become inflamed. Most often, symphysitis occurs after childbirth, but sometimes this process begins to appear even during pregnancy.
Symphysitis is the collective name for negative transformations and disorders in the pubic joint. Doctors can still call symphysitis arthropathy, symphiosiopathy, sacroileopathy of pregnant women. Symphysitis after childbirth is recommended to be called dysfunction of the symphysis pubis.
Manifestation of the disease
The most common signs and symptoms of symphysitis:
- pain in the pubic joint, pubis, lower abdomen.
- aching pain in the lower back and hip joints.
- the manifestation of "clicks" while walking.
- a lame gait like a duck.
- difficulty lifting straight legs up from a prone position.
- difficulty moving up the stairs.
The degree of the disease
Symphysitis occurs after childbirth or in the first trimester of pregnancy. Sometimes this disease can be associated with pelvic injuries or prolonged exercise (in runners). If timely measures are not taken to prevent this inflammatory process, then this will lead to serious consequences. A woman's gait may change, urinary incontinence will appear, and sexual difficulties will arise.
The degree of softening of the symphysis and the increase in the distance between the pubic bones determine three levels of inflammation. For each level, a bone discrepancy is characteristic:
- From 0.5 to 0.9 cm.
- From 1 to 1.9 cm.
- More than 2 cm.
Development sources
It is impossible to say unequivocally what is the root cause of symphysitis. Symptoms often indicate two sources of such inflammation and discrepancies in the pubic symphysis. The first of these is a lack of calcium, so necessary for the body of a pregnant woman. The second source may be excessive secretion of relaxin, a kind of hormone secreted by the placenta and ovaries. He is able to relax the ligaments in the pubic joint.
The following factors may accompany the development of symphysitis:
- hereditary prerequisites for a disease of the musculoskeletal system of the woman in labor (lack of collagen);
- multiple births;
- injured pelvic bones;
- the formation of a large fetus (over 4 kg);
- inactive lifestyle;
- several times the recurring phenomenon of symphysitis in previous births.
Pain with symphysitis
The most striking manifestation of symphysitis is pain. Sometimes they are unbearable. For some pregnant women, even lying down becomes difficult. Shooting pain may appear in the pubic area. Any movement, abduction of the thigh can lead to pain. This greatly affects posture.
In some expectant mothers, pain can give down the abdomen or appear in the groin, back, crotch, leg. Leaning forward for such women is very difficult, standing on one leg is simply impossible. It is difficult for patients suffering from symphysitis to get out of a chair and turn in bed. The pains begin to subside only after a long rest. All pain can be accompanied by severe crunching. Pain can occur during bowel movements.
Diagnostic Measures
The study of symphysitis is carried out by special methods: X-ray, computer and magnetic resonance imaging, ultrasound analysis. First, the doctor finds out when the pain occurred in the symphysis, how much it affected the gait, at what stage of pregnancy they occurred. The specialist learns about the presence of pelvic injuries, whether operations were carried out, whether the musculoskeletal system suffered.
Next, an analysis of the transferred gynecological diseases, features and the course of pregnancy and childbirth is done. According to the results of ultrasound, the degree of divergence of the pubic bones is estimated. An x-ray after childbirth will help determine if the pubic bones have shifted sideways or upwards. A sick woman will not be prevented from consulting an orthopedic surgeon and physiotherapist.
Therapy
To relieve pain in women, you need to immediately begin treatment. A quick therapeutic effect is given by taking antibiotics, as well as calcium and magnesium preparations. Along with medicines physiotherapy is prescribed. Modern methods of treatment allow the treatment of symphysitis after childbirth in an non-surgical way. As anesthesia, pregnant women are recommended to take Paracetamol, and after giving birth they are allowed to take non-steroidal anti-inflammatory drugs and opiates.
If symphiosiopathy is accompanied by a small discrepancy of the pubic bones, then the course of the disease can be alleviated using the following procedures:
- immediate restriction of physical activity;
- sleep applications for orthopedic mattress;
- intake of calcium, magnesium and B vitamins;
- daily physiotherapy;
- antibacterial treatment in cases of urogenital infection.
Disease duration
Very many people are interested in the question, how long does symphysitis last after childbirth? Most often, this phenomenon disappears 2-3 months after the appearance of the baby. In cases of injuries to the sacrum, diseases of the osteoarticular system, severe toxicosis, hormonal imbalance, vitamin deficiency, the disease can occur for a long time. For some, it takes several months or more than a year.
The birth process is very complicated, sometimes the ligaments of the symphysis can be damaged. This is due to the large fruit. Very often, symphysitis appears after the rapid appearance of the baby in women in labor with a narrow pelvis. This can lead to injury to the bladder and canal. Such complications prolong the recovery period of joints and complicate the treatment of symphysitis after childbirth.
Preventative measures
There are some recommendations to help relieve pain or stop the development of symphysitis:
- it is not necessary in a sitting position to throw one leg on the other;
- in a standing position it is necessary to evenly distribute the weight on two legs;
- hard surfaces are not suitable for pregnant women to sit and lie down;
- prolonged walking or standing upright is not recommended;
- descents from inclined surfaces and stairs should be avoided;
- Before turning in bed on the other side, you must first turn the shoulders and upper body, and then the pelvis;
- it is necessary to carefully monitor the increase in body weight;
- food should be rich in calcium (recommended use of nuts, fish, dairy products, dried apricots, sesame seeds);
- taking short walks will contribute to normal calcium metabolism;
- an orthopedic mattress will allow you to take a comfortable posture for sleeping.
Pregnancy should be planned, it will help to prepare for it correctly: to identify and cure chronic and gynecological diseases. Having become pregnant, a woman should contact a antenatal clinic as soon as possible and be registered (up to 3 months). A visit to an obstetrician-gynecologist should be systematic.
A very important point in the prevention of symphysitis is dietary nutrition. Food should contain moderate amounts of fats and carbohydrates. It is better to exclude flour, sweet, fatty and fried foods from the diet. It is advisable to increase the use of foods high in protein (lean meat, legumes, lactic acid products).
Pregnant women need to avoid mental stress. If necessary, the doctor may prescribe mild sedatives. All these measures lead to the rational management of childbirth and the prevention of complications.
Bandage for symphysitis and physiotherapy exercises
Many pregnant women are saved from pain by wearing a bandage. It can be bought at the pharmacy. Many types of bandages have been developed. Instead, you can use a tight bandage, which also prevents excessive divergence and displacement of the bones of the symphysis.
On sale there are models of bandages in the form of a corset, it is more suitable at the stage of bearing a child. In the postpartum period, you can use the model in the form of thongs. Such hip retainers are very effective for symphysitis. They solve the problem of the safety of the pelvic area and the restoration of damaged joints. There are hard and semi-rigid bandages, the second ones are more suitable for pregnant women.
It is no secret that one of the measures to prevent symphysitis is physiotherapy exercises. Walking, stretching, breathing exercises will be only beneficial for pregnant women. The 1st and 2nd degree of the disease involves the implementation of a set of special exercises that strengthen the pelvic and lumbar muscles and joints. Here is a sample workout:
- Starting position - lying on your back. A woman pulls her feet closer to the buttocks, then spreads her knees to the side. After that, slowly returns them to their initial position. Such movements need to be repeated 6-10 times.
- The next exercise is performed like the first, only a woman slightly puts the feet off the buttocks. She slowly lifts the pelvis up, and then carefully returns it to its place. Such movements are performed 10 times.
- Starting position - kneeling. Woman rests her hands on the floor, relaxes her back. She tries to keep her head, neck, back and pelvis level. Then the expectant mother arches her back up, and lowers her head and neck down. The muscles of the hips and abdomen tighten. You do not need to repeat the movement more than three times.
It is worth noting that at the last stage of symphysitis, such exercises are contraindicated.