Index to Chiropractic Literature
Index to Chiropractic Literature
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ID 22374
  Title Pregnancy-related symphysis pubis dysfunction management and postpartum rehabilitation: Two case reports [case report]
Journal J Can Chiropr Assoc. 2012 Jun;56(2):Online access only p1-2-111
Peer Review Yes
Publication Type Case Report

Objective: Two case reports review the chiropractic treatment and rehabilitation management of Symphysis Pubis Dysfunction (SPD).

Clinical Features: Patient 1: a 35-year-old female presented at 30 weeks pregnant with severe left sided Symphysis Pubis Dysfunction and low back pain. Patient 2: a 33-year-old female also 30 weeks pregnant, presented with right sided Symphysis Pubis Dysfunction and sacroiliac pain.

Intervention and Outcome: Treatment included soft tissue therapy, pregnancy support belt, side-lying mobilizations, pelvic blocks and instrument-assisted pubic symphysis adjustments. Home advice included: ice, staying active, moving as a unit, stretching, use of a pillow between the knees while sleeping, regular breaks from sitting and pelvic floor (Kegel) exercises. Both patients reported some relief with treatment and home care. Post-partum, rehabilitation exercises were prescribed to restore muscular endurance, control and pelvic stability. On long-term follow-up patient 1 reported no pubic symphysis pain, but some low back pain secondary to a subsequent knee injury. Patient 2 reported being mostly pain free with a rare re-exacerbation of pubic symphysis pain.

Summary: Conservative chiropractic management appears to reduce pain and improve mobility and function for SPD. Post partum rehabilitation of the associated lumbo-pelvic musculature with specific stabilization exercises is recommended to reduce pain, improve long term outcomes and prevent chronicity.

This abstract is reproduced with the permission of the publisher. Click on the above link for free full text.


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