Pelvic Bone Pain?

Submitted by metasequoia on April 24, 2006 - 8:42am
Body: 

I'm wondering if the pelvic bone pain I've been experiencing is related to any of the soft tissue changes that are going on "down there." I called to make my 6 wk pp appointment & can't get in till May 8th which will be 8 wks pp. So, I still am without a definite diagnosis for now.

This last pregnancy (my third) was very different than my first two. I had a lot of pubic bone pain during the second half, so much so that it was almost excruciating to roll over at night. Chiropractic made it tolerable, but now, at 6 wks pp, I am still having some intermittant pain. Yesterday I laid down on the couch with the baby asleep on my chest for a couple of hours & when I went to stand up, I could barely walk! It's hard to pinpoint exactly where the pain is coming from, but it doesn't feel like soft tissue pain, but more like something in the pelvis, down low. The possible prolapse of my front vaginal wall seems to have improved ever so slightly over the last week & I'm hoping it will continue to do so. I've been really good about the posture, the hardest part for me is not locking my knees - how does everyone do that??!!

Does anyone think that the pelvic bone pain could be related to the anterior wall "bulge" that I have? Does anyone else have pelvic bone pain/discomfort?

~Erin

UKmummy

April 24, 2006 - 9:32am

Hi Erin,
I know that I also had awful "joint" pain during the last few weeks of pregnancy, perticularly in my hips but it went after delivery. Some mornings I could only crawl around! I would think it is unusual to get such pain as you describe with a mild cystocele such as yours. All the joints relax during pregnancy, (due to the hormone relaxin being released), and I believe that this is why I was in so much discomfort. Perhaps this is the same for you and the hormone levels have not fallen yet? Are you still seeing your chirporactor?
Michelle

metasequoia

April 24, 2006 - 9:47am

Yep, I saw my chiro last week & plan to do so this week as well. I just wish my insurance covered her - LOL! As for the tissue issue, she said to just Kegel, so I guess I have to follow some of her advice & not all of it...the Kegel thing is very confusing. I'm not sure how to do it "right." I saw Christine mention doing them long & narrow or something & I don't understand.

The bone pain was bad, huh? It has a name, PSD, pubic-symphisis-dysfunction I think.

metasequoia

April 24, 2006 - 12:59pm

I just had an epiphany! I've been following the posture really closely & noticed that when I am at the computer, at the dining room table, keeping the curve in my lumbar spine, the part of me that is taking all of the pressure is the bottom part of my pubic bone (I think.)I spent a lot of time online yesterday! Right now, as I sit, I can feel all of the pressure on my urethra, which is right around my pubic bone!

How did I reach this epiphany?? My 6 yr old just recently had her training wheels taken off of her bicycle & has been so excited that she has been riding it all day, every day. The other evening she cried when she peed because she said it hurt so bad. My first thought was that she had a UTI, but once I thought about it for a while, I realized it was probably a bruise to her urethra or pubic bone from sitting on the seat for so long each day! Duh! I will try finding a new position for my online time....any suggestions? A friend of mine has her laptop on a shelf & she stands to type/read. Is that good?

Does this make sense? Maybe I have brusied this area??

Christine

April 24, 2006 - 2:56pm

The well-known PT, Diane Lee, believes pregnancy and postpartum pubic pain are due to relaxin-induced widening of the pelvic joints and thus a slight destabilization of the pelvis. She says:

“Consequently, the locking mechanism of the pelvic girdle is less effective, thus increasing the strain on the ligaments of both the sacroiliac joints and the pubic symphysis. The morphological changes within the pelvic girdle associated with pregnancy are universal and often occur without symptoms. Occasionally, women present between the 26th and 28th weeks with increasing tenderness over the sacroiliac joint and/or pubic symphysis secondary to loss of kinetic function. Normally, the pelvic girdle returns to its pre-pregnant state between the 3rd and 6th months postpartum and simply requires external stabilization during this period.”

You can seek the help of a PT for this, or see how constant use of the posture helps. Natural female posture creates the very stabilization Lee is talking about. Some sitting positions may be more comfortable than others - experiment! :-)

metasequoia

April 24, 2006 - 4:58pm

Thanks Christine! Is there a thread about recommended sitting positions here somewhere?

~Erin

Christine

April 24, 2006 - 5:12pm

In the FAQs.

Wendy06

April 24, 2006 - 5:22pm

Hi Erin,
I found during my last pregnancy and afterwards that switching my computer chair for one of those big pilates balls (sometimes called a Swiss ball) was really helpful. I've been using it again recently and it does seem to me to be compatible with what Christine says about good posture when sitting.
Just a thought!
Wendy

UKmummy

April 24, 2006 - 6:33pm

This is totally what I did too................

louiseds

April 25, 2006 - 4:10am

Oh yes, I remember that pain and tenderness after one of my pregnancies. Not nice at all. I will pass. I wish I had known all of this posture stuff 20 years ago.

Cheers

Louise

louiseds

April 25, 2006 - 4:11am

Oh yes, I remember that pain and tenderness after one of my pregnancies. Not nice at all. I will pass. I wish I had known all of this posture stuff 20 years ago.

Cheers

Louise

metasequoia

April 25, 2006 - 4:11pm

Like an exercise ball? The big bouncy ones?

~Erin

UKmummy

April 25, 2006 - 10:54pm

Yes, that is what I am sitting on right now..................:)

Wendy06

April 26, 2006 - 3:43am

Me too! Now I've gone back to sitting on it at my desk I remember why I found it so helpful. It's forgiving on the bones, but encourages you to sit up tall, strengthening the back, and it's nice to roll it a bit while you're working, giving your pelvis and back a bit of exercise. Certainly stops me getting that "seized up at the desk" feeling.
If you're thinking of buying one, just check you get the right size in diameter. I'm about 5'6" tall and I've got a 65cm diameter Gymnastikball, which is right for my leg length.
The recommended sizes are:
53cm ball for heights up to 5' 2".
65cm ball for heights 5' 3" to 5' 10".
75cm ball for heights 5'11 and over.
Wendy

metasequoia

April 26, 2006 - 8:06am

Thanks Wendy - that is SOOO helpful!! I never would have known that there were sizes. I'm 5'9, so I guess you & I would use the same size ball. That's it, I'm buying one!!

Erin

mummy76

April 27, 2006 - 3:27pm

Had the very same 'pubic-symphisis-dysfunction' you're describing latish on in my pregnancy and have also developed a cystocele and have been wondering if they had been linked. I'm also doing kegels and having a go at the posture. Have felt a little more stable the last few days. I'm hoping if the pelvis takes a while to reform that the prolapse may improve a little with it. I start physio in a few weeks so I'll ask about it.

HT

April 28, 2006 - 5:41am

I also had this during the latter stages of pregnancy - and was hospitalised at 35 weeks for bedrest because of the severity of the pelvic instability. My baby (toddler) is now 2 1/2 and I still have recurring problems with this. The pain has reduced to almost nothing now but if I move the wrong way or stand on one leg, say, when shaving the other, (bad, I know) it still hurts afterwards. Dont know if it will ever go away? Does the posture help with this as well?

Thanks in advance,

HT

Christine

April 28, 2006 - 1:05pm

Hi HT and thanks for writing,

What destabilizes the pregnant pelvis is a widening of the joints (the pelvis is made up of three bones and six moveable joints.) The pain comes from a stretching of the nerve-rich ligaments in between the joints.

What stabilizes the pelvis is a process called “nutation.” This is accomplished every time we are on our feet and in several seated positions as well. Nutation moves the tops of the great, wide hipbones, or ilia, together while raising the very bottom of the spine, or tailbone. This movement wedges the top of the sacrum (the triangular bone at the base of our spine) down between the hipbones that are clamping it tightly together on either side.

In turn, the sit bones widen. What happens with the pubic bone is interesting. Its joint, or symphysis, widens at the back because it is connected directly to the sit bones, yet clamps together at the front, because it is closely connected to the ilia! Our pelvis is extremely dynamic, not a stationary bone that just sits there.

In the latter stages of pregnancy, the pubis cannot clamp tightly together because hormones have relaxed its ability to do so. Its ligaments are stretched and that is the source of the pain.

Natural female posture, in the absence of relaxing hormones, creates the scenario described above wedging and clamping the pelvis together so that it forms a very stable horizontal platform from which the rest of the spine balances vertically. It is a completely amazing process!

I say, YES! the posture will help your pubic bone pain and prevent other conditions so many of the women here are dealing with.

Christine