PUBIC BONE PAIN

THE PELVIS

(Keywords: PUBIC BONE PAIN, causes of osteoporosis, sacroiliac joint anatomy, pregnancy )

Pubic bone pain involves the pelvis, a ring of three bones: An ilium (A) on each side, with the sacrum (B) wedged between them. Between the three bones are three joints:

  • Two sacro-iliac joints , and
  • One pubic symphysis



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A. Ilium (pl. two ilia, adjective iliac, as in sacro-iliac joint)

B. Sacrum

C. Acetabulum where the ball of the thigh bone (femur) fits into the ilium.

D. Superior pubic ramus

F. Inferior pubic ramus

The pubic ramus bones as you can see are part of the ilium, and thus make up a portion of the pelvis. There are two pubic bones, one superior and one inferior. They are very important for the attachment of some of the great muscles of the thigh, and the deep muscles of the pelvis.

The pubic bones on the left articulate with those on the right via the pubic symphysis joint. Where is this joint?


The pelvis is a unique ring of bones in the body. It gives attachment for the legs to the body, forms the foundation of the spine and gives protection to many organs such as the bladder, colon, rectum, prostate. Read more about the PELVIS

For more information on the bones of the pelvis and, in particular the SACROILIAC JOINT ANATOMY ... click here.


Pregnancy




Because Pregnancy and Backache are words often mentioned in the same sentence, many Chiropractors' offices are full of pregnant women, and with good reason.


 They manage LOW BACK PAIN and PUBIC BONE PAIN very successfully.

Specialised courses for Chiropractors wanting to specialise in, or update on the treatment of the pregnant women and children are now commonly found on the Chiropractic Continuing Education websites.

Read more about CHIROPRACTIC PEDIATRICS by Dr Neil Davies DC …

Hormonal changes (to allow for the baby to exit via the pelvis) and postural changes (due to the increased curve in the back) mean that this can be a very difficult time for some women. Fitness and mobility of the joints is of the greatest importance in the management of PUBIC BONE PAIN.

UK practice IsisChiropractic is fairly typical, their website offering some good information on the subject of pregnancy and back pain, which I recommend that you read. Read more about CHIROPRACTIC PREGNANCY care…




The pubic bones can become extremely painful in differing syndromes, many associated with pregnancy. What is sometimes very distressing is that opening the legs during sex may be painful and, untreated, it may last for months and months after the birth. This is not vaginal pain, but the pain associated with this chiropractic syndrome, loosely called PUBIC BONE PAIN.


the close approximation of the bladder and uterus to the pubic bone shown here (in white) in the front. When your baby starts dancing on your bladder it can cause very awkward and embarrassing pubic bone pain.


In this picture you can see the two rami (one ramus, plural rami), one above, the other below. They are called the superior and inferior pubic rami.

As an aside: Osteoporosis , or brittle bone disease, is a condition that affects mainly women. This is an X-ray of an elderly woman who took a tumble, and fractured both rami. You can be sure she has extreme pubic bone pain, for some of the same reasons that we are considering - there are many large powerful muscles that attach to the inferior pubic ramus so, in her case, walking is also extremely painful. She's probably on crutches.

The causes of osteoporosis , are now fairly well researched and known. It's no longer necessary for any woman to suffer from this nasty disease, if she does something in time. Actually, in pubity it all begins.


Read more about the CAUSES OF OSTEOPOROSIS ... (PS. I think this is the most important of over 300 pages at Chiropractic Help - Even more so than PUBIC BONE PAIN !)


Note here the three very large muscles of the inner thigh that attach to the inferior pubic ramus. It is these muscles, together with the psoas muscle that usually cause the great pain of this syndrome. Opening the thighs stretches these muscles and, if their insertion into the pubic ramus is irritated, then sex will be very painful. Not vaginal pain, but thigh muscle and pubic bone pain.

Notice here how many of the nine pelvic muscles (in Dutch, the so-called 'bekkenbodem' spieren (bottom of the pelvis muscles) are attached to the pubic bones. Hence in pregnancy the pelvic bones often become very painful. This pain really lends itself to chiropractic treatment.



Three other condition in and around the pelvis that commonly cause groin and pubic pain with soft end feel in the hip are the

  • Piriformis Syndrome ...

  • Iliotibial band stretch syndrome ...

  • MERALGIA PARESTHETICA ... Pain in the groin and front or side of the thigh:


    • Treatment of PUBIC BONE PAIN

    Because these pubic pain syndromes are joint-muscle-nerve conditions, they responds very well to chiropractic management. The treatment is based on the findings during the examination, but the hallmarks are usually:

    • SacroIliac joint fixation.
      • Read more about the SACROILIAC JOINT …

    • Restricted hip range of motion, with soft 'end-feel'.
    • On palpation, marked pubic bone pain.
    • Extreme tenderness with active trigger points of the inner thigh. (and/or other muscles such as the piriformis or Ilio-Tibial Band.)
    • Occasionally neurological signs in the thigh, like numbness and even motor weakness. Usually in this case, a high lumbar subluxation will also be present.

    Sacroiliac joint treatment ... is not usually particularly painful, but the treatment of the muscles of the thigh and groin may be extremely painful. In my experience, one light stroke along the muscle (painful), one deep stroke (very painful), and one or two stretches (not particularly painful) are about all that most people can tolerate. Follow up with ice at home. Some bruising may occur.

    As you can see from the picture above, the stripping of the muscles will be very close to sensitive areas. Take your husband along for the first few visits, just to put everybody at ease. Your chiropractor may be even more anxious than you are, whilst working in this area.


    A regular walk will help. Take granny along for company, good for you both. If you want to know just how fit granny is, click here for a simple three minute fitness test. KASCH PULSE RECOVERY TEST ...


    FROM THE COAL FACE.

    Mrs S. is a young woman in her late twenties who consulted me for severe headaches, which responded well to the usual chiropractic care. She also had had some mild sacro-iliac pain since the birth of her second child, some fifteen months earlier. At what I thought was going to be our last visit before she went onto her two monthly maintenance care, she posed the following question, her confidence in me having been established. 'Doctor, do you think you can do something for the pain here in my groins. It is so painful ... when I open my legs ... stumbling on awkwardly ... you know,' she finished lamely. Because this condition involves examination of the more private areas close to the vagina, it is more than likely your chiropractor will omit it, unless you draw his attention to the fact that you have pain in the thighs and groin. This is particularly true should you be expecting. Leg pain during pregnancy is very common and readily and safely treated with Chiropractic. Leg pain during pregnancy ...

    Deep Pelvic Pain & Pubic Bone pain

    Undoubtedly one of the causes of pubic bone pain is referred pain from the deep internal pelvic organs. Some reports that one in seven women suffer from one degree or another from deep, chronic, incapacitating pelvic pain. This could be endometriosis, birth trauma to the uterus or vagina, bladder conditions and other. When all else fails, medicine has been using a procedure called LUNA, cutting the nerves to the pelvic organs, but a new study done on 500 women reveals that it has no benefit at all. Type LUNA into WebMD. Research suggests it doesn't help pubic pain ...



    PERTHES DISEASE and DEVELOPMENTAL HIP DYSPLASIA

    Another condition with a soft end-feel is Perthes Disease , a condition of the hip and groin in the growing child. Please, if your child is limping, and complaining of pain in the groin, hip, or knee take him or her to your chiropractor without delay. Perthes is such a serious condition that it must be caught early, and is very definitely not one of those 'wait and see' conditions. Don't let anyone kid you with talk about growing pains. They don't exist. Hip dysplasia is a condition that should have been picked up at birth. However mild cases slip through under the radar. Groin pain, a short leg and very mobile hip are the signs. Both, if missed, lead to premature severe hip arthritis. You don't mess with pain in the groin, it can be very serious.



    HIP ARTHRITIS and LEG LENGTH INEQUALITY

    The hip, where the ball of the femur fits into its socket in the ilium is a weight bearing joint and is particularly prone to wear and tear osteo-arthritis. Hip arthritis is more prevalent should you have a short leg which causes an uneven gait and extra stress on the hyaline cartilage in your joints. Hip arthritis starts much earlier in neglected childhood syndromes such as Perthe's Disease, sports trauma, and a Slipped Femoral Capitus Epiphysis, a condition found primarily in the obese child. Another only recently understood condition called Femero Acetabular Impingement Syndrome causes stiffness in the hip but little pain in the young adult. Caught early it's very treatable. Ignored, it inevitably causes premature hip osteo arthritis. Likewise with hip dystrophy. The key sign: pain in the groin.

    Both arthritis in the hip (generally in the older person) and the impingement syndrome (younger people, who of course become older, so in all age groups) are characterised by a hard end feel when ranges of motion of the hip are tested.

    For more information about hip arthritis which is usually characterised by groin and pubic bone pain, click here. HIP ARTHRITIS ...


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    COCCYX PILLOW

    Last, but definitely not least, we will briefly consider the coccyx. Direct trauma to the coccyx can fracture or subluxate the coccyx and sprain the ligaments, causing months of pain, mostly when sitting. This is a very treatable syndrome that chiropractic excels in. A coccyx pillow has much virtue and the coccyx can usually be adjusted externally.

    As a fall on the buttocks, injuring the coccyx often shakes the whole pelvis up, sacro-iliac and pubic bone pain may accompany this condition.

    It is also commonly associated with Child-birth.

    For more information about the bruised coccyx and coccyx pain relief with Chiropractic, click here: COCCYX PILLOW ...



    IMPORTANT CONSIDERATIONS @ PUBIC BONE PAIN


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