Pelvic instability (pelvic pain, symphysiolysis)

1. Pelvic instability: pain in the pelvis, lower back and hips. Pelvic instability is also referred to as pelvic pain, symphysiolysis, or chronic pelvic pain syndrome. The bands and muscles that hold the bones of the pelvis together are loosened, damaged or weakened. This creates pain. Are you pregnant or have you just given birth? Then pay extra attention to the symptoms of pelvic instability.

What is pelvic instability?

1. The pelvis consists of the sacrum (os sacrum) on the dorsal side, the pubic bones (os pubis) on the front and an ilium (os ilium) on both sides. These bones are joined together by bands and muscles. In pelvic instability, one or more of those ligaments or muscles is damaged or weakened. The pelvis is important in transferring power between your legs and the rest of your body. When the muscles and ligaments in the pelvis are weaker, the joints in your pelvis become over-movable. The result: the joints shift and the muscles can no longer keep the pelvis in the right place. This causes pain in your pelvis, hips, lower back or around your tailbone and you have trouble moving. Pelvic instability mainly occurs after pregnancy or childbirth, but men can also get it. Then a sports injury or accident is often the cause.

Causes of pelvic instability

1. There are different forms of pelvic instability. These also have different causes. For starters, pregnancy hormones can cause pelvic instability. When a woman is about 20 weeks pregnant, her body produces the hormone relaxin. This hormone causes the bands that hold the bones in the pelvis in place to become weaker and more elastic. The less tight straps allow the bones to move loosely apart. This creates more space for babies to come out during delivery. But it is precisely because of this that you can get complaints. The uterus also gets bigger and bigger and the mother's posture changes. As a result, the pressure on the pelvis increases even more and the pelvic ligaments are subject to additional stress. This also leads to complaints in some women. Overuse or incorrect posture can make it worse. The balance between load and resilience is often disturbed. Pelvic instability can also develop during labor, especially if it is very rapid. Or if the baby is in the wrong position. A woman will have stretched or torn pelvic ligaments or damaged cartilage. This shape is called mechanical pelvic instability. Sometimes the ligaments and cartilage of the pelvis are already weakened during pregnancy. These can then stretch or tear more easily during labor. The cause of pelvic instability is then a combination of hormones and the delivery itself. Finally, an accident or sports injury can stretch or tear the pelvic ligaments. This occurs in both men and women. With this form of pelvic instability you have the same complaints as pregnant women or women who have just given birth.

Symptoms of Pelvic Instability

1. There are a number of symptoms associated with pelvic instability. The most common are: Pain in the front and / or back of the pelvis (around the pubic bone). This pain can radiate down the inside of the thigh, to the groin or the vagina. Pain in the lower back, often at the level of the two dimples. This pain can radiate over the entire buttock, to the groin and the back of the thigh. Pain around tailbone (the lowest point in the lower middle of the back). Pain while walking (stairs). The pain often increases with fatigue. Many people with pelvic instability tire more quickly and recover from fatigue and pain more slowly. The pain also gets worse with certain movements such as cycling on an uneven surface, running, bending over, turning over in bed, turning in the back or other jerky movements. Furthermore, â € start painâ € ™ is one of the hallmarks of pelvic instability. Starting pain means that the pain comes on suddenly when you start moving out of nowhere, for example when you get up from the couch. It is also true that the more unstable the pelvis is due to pelvic instability, the more it bother you.

Diagnosis

1. Sometimes the symptoms only start a few days or a few weeks after the delivery. However, based on the symptoms, the doctor, midwife or a specialized physiotherapist can make a good diagnosis. They also advise on measures that can relieve pain and restore the balance between resilience and load. This means that you are looking for the balance between what your body can do and what it requires.

Risk factors and â € “groups

1. Pelvic instability occurs mainly in pregnant women. 50 to 60 percent of them experience it during pregnancy. Men can also suffer from pelvic instability. But the condition hardly occurs in them and non-pregnant women. One woman with pelvic instability has little or no pain, while the other experiences a lot of pain. It is not known why this is so. Some women naturally have smoother bands around the pelvis. As a result, they may be more likely to experience pelvic instability pain.

Treatment of pelvic instability

1. If you suffer from pelvic instability, you need to find a balance between activity and rest. Exercise is necessary to keep the muscles strong and prevent muscle weakness. Rest is important to protect the ligaments and haircuts of the pelvis. Otherwise, the complaints can get worse. Learning to deal with pain, fatigue and muscle strength is also part of recovery. It is better to leave out activities that require a lot of energy and provide little pleasure and muscle strength. If the pain does not go away, a physiotherapist who specializes in manual therapy or pelvic physiotherapy can treat the complaints. A non-elastic band that supports the pelvic joints can also help. In case of serious complaints, a rehabilitation doctor can advise on, for example, necessary adjustments at home.

Forecast

1. Pelvic instability usually involves normal pelvic or low back pain that eventually resolves on its own in the vast majority of women. That often takes a few months. Some women, especially those with serious complaints, still suffer from pelvic instability more than six months after giving birth. But those are exceptions. Permanent disability almost never occurs. Very few women end up in a wheelchair due to pelvic instability. Sources)

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