Patient's question:
I've been pregnant for more than two months. Starting from the eighth week, when I need to sleep or turn over, it feels uncomfortable and a bit painful in the area between my thighs and pelvis, like the pain after a joint sprain. Now, as I'm approaching two and a half months, the condition is becoming more noticeable. Sleeping and turning over requires slow, careful movements. After sitting for a while or getting up from sleep, I feel like my left leg can't support me when I stand up—it feels painful and weak. Once, I even had to kneel down because I couldn't stand. However, it only affects my left side, not the right. I searched on Baidu, and many people said it's likely symphysis pubis diastasis.Doctor's answer:
General symphysis pubis diastasis is also classified as pelvic rotation syndrome. It is usually caused by twists and contusions of the pelvic joints, leading to aseptic inflammation and a series of pathological changes. The incidence rate is higher in women than in men. In addition to trauma and overuse, it is most commonly seen during menopause, pregnancy, and postpartum. In the early stages, the main symptoms are pelvic and lower back pain. In later stages, it can lead to spinal curvature, overextension, and easily cause imbalance in the multi-joint alignment of the entire spine.Clinical manifestations may include: ( does not need translation), two-leg length discrepancy, and some may exhibit sacral nodding or tilting. Pressure points can usually be found outside the sacroiliac and lumbosacral joints. Generally, if the pelvic alignment is corrected, and the sacroiliac and lumbosacral joints are realigned, the symphysis pubis diastasis can return to normal on its own.
For checking leg length discrepancy (), the patient lies supine with both legs extended and straight. The midpoint between the ankles should align with the midpoint between the navel and the nose. If the feet are flexed in pain, unequal length of the heels indicates leg length discrepancy (). For checking ( does not need translation), the patient lies supine with both legs extended and slightly apart, with relaxed feet. If one foot appears externally rotated (), it is primarily due to posterior rotation of the ilium, causing the hip joint to move backward. The other foot appears internally rotated (), mainly due to anterior rotation of the ilium, causing the hip joint to move forward.
The examination for leg length discrepancy and ( does not need translation) typically involves checking the lumbar and sacral triangles. The sitting flexion test can also be performed to differentiate between lumbar-sacral joint misalignment and sacroiliac joint misalignment. Additionally, X-ray examinations can help identify the issue. The primary treatment methods are bone-setting and massage therapy.