"Pelvic and Pubic Symphysis Pain in Pregnancy and Postpartum" - with Dr. Jaclyn Bonder

Yeah, I think a lot of people don't realize how common it is for pregnant women, and I'm including postpartum, to have pelvic pain.

I mean, certainly women who have been pregnant know this, but for anyone who's never been pregnant, what, men or women, I think they find it to be surprising how common it is.

And I mean, we're referring patients to you all the time.

I mean, you're like our go-to person, like our speed dial person.

[laughs]

Because it's just so common, and not a lot of people Know how to treat it, 'cause like you said, do you see a neurologist? Do you see an orthopedic surgeon? Do you see someone who says they're a sports medicine doctor? And they don't really touch on all the areas that need to be assessed, and you're like one of the people who really looks at it globally and can actually do a full assessment, and you're willing to see pregnant women.

They're...

It's, it's a difficult population for people 'cause they don't usually see pregnant people.

They don't know what to do about it.

I think the term pelvic pain is also really hard because the... there's no...

The definition is so vague.

Right.

Or really, what is the pelvis? What is pelvic? What is vaginal? What is rectal? You know, what is bony? You know, so I, I always try to differentiate between this idea of, like, pelvic girdle pain-

Right

... versus pelvic pain, um, and thinking, like, pelvic girdle pain is more of, like, a musculoskeletal origin of pain, and pelvic pain is more, um, gynecologic or lower abdomen or bladder or vaginal or rectal, which certainly could be musculoskeletal.

But yeah, it's hard 'cause I think the, the, the just u- the term pelvic pain is very, very vague.

It's not like shoulder pain.

Right.

It's pretty clear what your shoulder is, um, versus pelvic pain that can be really difficult to define, and pelvic pain in a pregnant woman is, can be very, very different than pelvic pain in a, you know, 75-year-old.

Let's talk about the, the pelvic girdle pain in pregnancy.

So first of all, why does it happen in pregnancy specifically, and what is exactly going on for women who have this pain? Like, what are the possible causes?

So pelvic girdle pain, i- if you look it up by definition, is really anything, any pain kind of from the, the waist or kind of w- what we medically call the iliac crest, but, like, it's kind of where most people think their waist start, to the gluteal fold, which is kind of that area where your kind of buttock, you know, meets your thigh, and it... anything kind of in between.

And so, so either whether it's in the front or the back, that is something that I, I will usually call pelvic girdle pain.

And so anything in between there can, can really cau- cause symptoms of, of musculoskeletal pain.

And so within that area, it's the, the pubic bone and the pubic joint.