Pubic Symphysis Pain During Pregnancy

Pubic symphysis pain, also known as Symphysis Pubis Dysfunction (SPD) or pregnancy-related pelvic girdle pain, is a common condition that causes pain in the front of the pelvis during pregnancy. It may make walking, rolling over in bed, climbing stairs, getting dressed, or standing on one leg uncomfortable. Pelvic floor physical therapy can help reduce pain, improve stability, and keep you active throughout your pregnancy.

What Is Pubic Symphysis Pain?

The pubic symphysis is a small joint located at the front of your pelvis where the left and right pelvic bones meet. During pregnancy, hormones such as relaxin and progesterone help loosen the ligaments surrounding this joint to prepare your body for childbirth.

While this increased mobility is normal, some women develop excessive movement or irritation of the joint, leading to pain and difficulty with everyday activities. This condition is commonly called Symphysis Pubis Dysfunction (SPD) or pregnancy-related pelvic girdle pain (PGP).

Although common, pubic symphysis pain should not be considered something you simply have to "push through." Many women experience significant improvement with the right treatment.

Common Symptoms

Symptoms vary from person to person but often include:

• Pain directly over the pubic bone
• Sharp pain when walking
• Pain getting in or out of a car
• Difficulty climbing stairs
• Pain rolling over in bed
• Pain standing on one leg to put on pants or shoes
• Clicking or grinding sensations in the pelvis
• Pain that radiates into the groin or inner thighs
• Difficulty walking long distances
• A feeling that the pelvis is unstable
• Pain after prolonged standing
• Waddling or altered walking pattern

Many women notice their symptoms worsen later in the day or after increased activity.

What Causes Pubic Symphysis Pain?

Several factors work together to contribute to pubic symphysis pain during pregnancy.

Hormonal Changes

Pregnancy hormones naturally loosen the ligaments supporting your pelvis. In some women, this increased flexibility allows more movement than the joint can comfortably tolerate.

Growing Baby

As your baby grows, the weight placed on your pelvis steadily increases. This added load can stress the pubic symphysis.

Changes in Posture

Pregnancy shifts your center of gravity forward, requiring your muscles to work differently to support your body.

Muscle Weakness or Poor Coordination

The deep abdominal muscles, gluteal muscles, hips, and pelvic floor all help stabilize the pelvis. If these muscles are not working efficiently together, additional stress may be placed on the pubic joint.

Asymmetrical Movements

Activities such as standing on one leg, climbing stairs, getting dressed, or carrying a toddler on one hip often increase stress across the pubic symphysis.

Who Is More Likely to Develop Pubic Symphysis Pain?

Some women are at greater risk, including those who:

• Have experienced pelvic girdle pain during a previous pregnancy
• Carry multiples (twins or more)
• Have a history of low back or pelvic pain
• Perform physically demanding jobs
• Have generalized joint hypermobility
• Experience significant changes in activity level during pregnancy

Even women without these risk factors can develop SPD.

When Should You Contact Your OB or Healthcare Provider?

While pubic symphysis pain is usually not dangerous, certain symptoms require prompt medical evaluation.

Contact your healthcare provider if you experience:

• Vaginal bleeding
• Leaking amniotic fluid
• Fever or chills
• Regular contractions before term
• Severe abdominal pain
• Sudden inability to bear weight
• Pain following a fall or trauma
• Decreased fetal movement appropriate for your stage of pregnancy

If you are ever unsure whether your symptoms are normal, it is always appropriate to contact your obstetric provider.

Can Pelvic Floor Physical Therapy Help?

Yes. Pelvic floor physical therapy is considered one of the most effective conservative treatments for pregnancy-related pelvic girdle pain.

Rather than focusing only on the painful joint, your physical therapist evaluates how your entire body moves. Improving strength, coordination, and movement patterns often decreases the stress placed on the pubic symphysis.

Many women are able to return to walking, exercising, sleeping, and daily activities with much less discomfort.

How Physical Therapy Helps

Your treatment plan is individualized based on your pregnancy, symptoms, and goals.

Treatment may include:

Pelvic Stability Training

Specific exercises improve the muscles that support your pelvis without placing unnecessary strain on the joint.

Glute Strengthening

Strong hip muscles help control pelvic movement during walking and standing.

Core Coordination

Rather than traditional abdominal exercises, we teach your deep core muscles to work together with your breathing and pelvic floor.

Pelvic Floor Assessment

The pelvic floor plays an important role in supporting your pelvis during pregnancy. Improving coordination—not simply strengthening—may reduce discomfort.

Manual Therapy

Gentle hands-on treatment may improve muscle tension and movement around the pelvis, hips, lower back, and surrounding soft tissues.

Movement Education

Small changes in daily movement often make a significant difference.

We'll teach strategies for:

• Rolling over in bed
• Getting out of bed
• Getting in and out of the car
• Climbing stairs
• Lifting safely
• Standing from a chair
• Walking with less discomfort

What to Expect During Your Evaluation

Your first visit is a private, one-on-one evaluation with a Doctor of Physical Therapy.

We'll discuss:

• Your pregnancy history
• Your symptoms
• Activities that increase your pain
• Exercise routine
• Previous pregnancies
• Your goals for the remainder of pregnancy

Your therapist will assess:

• Walking mechanics
• Pelvic alignment and stability
• Hip strength
• Core coordination
• Breathing mechanics
• Functional movements
• Balance and movement strategies

Based on your findings, you'll receive an individualized treatment plan and home exercise program designed specifically for your pregnancy.

Self-Management Tips

Many women find relief by making small changes throughout the day.

Helpful strategies may include:

• Keep your knees together when getting out of bed or the car.
• Sit down to put on pants or shoes.
• Avoid standing on one leg whenever possible.
• Take smaller steps while walking.
• Pace activities and avoid long periods of standing.
• Sleep with a pillow between your knees.
• Consider using a pregnancy support belt if recommended by your provider or physical therapist.
• Continue appropriate exercise instead of complete rest, unless instructed otherwise by your healthcare provider.

Every pregnancy is different, so individualized guidance is often more effective than generalized advice.

Frequently Asked Questions

Is pubic symphysis pain normal during pregnancy?

Yes. It is a common condition, but that does not mean you have to simply tolerate it. Treatment can often make daily activities much more comfortable.

Can pubic symphysis pain hurt my baby?

No. The pain comes from the joints and supporting structures of your pelvis and does not harm your baby.

Will exercise make it worse?

Not necessarily. The right exercises often improve symptoms by increasing pelvic stability. Certain movements may need to be modified temporarily.

Should I stop walking?

Most women benefit from remaining active. However, if walking significantly increases your pain, a physical therapist can help determine appropriate modifications.

Does wearing a belly band help?

Some women experience symptom relief with a pregnancy support belt. It is typically most effective when combined with physical therapy rather than used alone.

Will pubic symphysis pain go away after delivery?

For many women, symptoms improve significantly after childbirth. However, some women continue to experience pelvic pain postpartum and may benefit from continued physical therapy.

Can I have another pregnancy if I had SPD?

Yes. Many women go on to have healthy pregnancies. Beginning physical therapy early in pregnancy may help manage symptoms more effectively.

Is this the same as pelvic floor dysfunction?

Not exactly. While they are different conditions, the pelvic floor muscles play an important role in supporting the pelvis and may contribute to or be affected by pubic symphysis pain.

Related Conditions

If you're experiencing pubic symphysis pain, you may also find these resources helpful:

• Round Ligament Pain During Pregnancy
• Pelvic Girdle Pain
• SI Joint Pain During Pregnancy
• Low Back Pain During Pregnancy
• Hip Pain During Pregnancy
• Sciatica During Pregnancy
• Tailbone Pain During Pregnancy
• Birth Preparation Physical Therapy
• Pelvic Floor Physical Therapy During Pregnancy
• Postpartum Recovery

Why Choose Evolve Physical Therapy?

At Evolve Physical Therapy, pregnancy care is one of our specialties. Every appointment is a private, 60-minute, one-on-one session with a Doctor of Physical Therapy who understands the physical changes that occur during pregnancy.

Our treatment plans are personalized to your symptoms, activity level, and goals. Whether you're hoping to continue working out, care for your family more comfortably, prepare for labor, or simply walk without pain, we'll work with you to help you feel your best throughout pregnancy.

We proudly care for patients from Holly Springs, Apex, Fuquay-Varina, Cary, Raleigh, and communities throughout Wake County.

Schedule Your Pregnancy Physical Therapy Evaluation

You don't have to accept pelvic pain as a normal part of pregnancy.

If pubic symphysis pain is affecting your sleep, exercise routine, work, or daily activities, our team is here to help. Contact Evolve Physical Therapy today to schedule a one-on-one pregnancy physical therapy evaluation and receive a personalized treatment plan designed to keep you moving with confidence throughout your pregnancy.