How to diagnose and treat
pubic symphysis dysfunction

How do clinicians diagnose pubic symphysis dysfunction?

Most of the time, diagnosis starts with your story, not a scan. A clinician will usually ask when the pain started, what movements set it off, and how it is affecting daily life, like walking, climbing stairs, turning in bed, getting dressed, or caring for a baby.^1,2

They will often ask where you feel pain and whether it is mainly:

• Front of the pelvis (at the pubic bone), which fits pubic symphysis (joint that connects the two pubic bones) pain, or
• Back of the pelvis (near the sacroiliac joints), which can happen in pelvic girdle pain too^1,4

What clinicians typically assess

A clinician may:

• Map your pain and triggers, especially tasks that load one leg at a time (stairs, stepping into a car, rolling in bed).^1,4
• Check how your pelvis and hips handle load, often using simple movement tests that are designed for pregnancy-related pelvic girdle (bony ring connecting the lower limbs to the trunk) pain.^1,4
• Look for other causes if your symptoms do not fit the usual pattern, like hip problems, low back nerve irritation, or infection.^1,4

Tests you might see (when they are relevant)

Some clinicians use specific tests to improve confidence in the diagnosis, such as the Active Straight Leg Raise, which checks how your pelvis manages load during a leg lift.They may also use other pelvic pain provocation tests as part of a small “cluster” rather than relying on just one test.^1,3,4

When imaging is used

Imaging is not routinely needed for typical pregnancy-related pelvic girdle pain. It may be considered when symptoms are severe, unusual, or after trauma, or when a clinician needs to rule out another condition. If imaging is needed during pregnancy, ultrasound or magnetic resonance imaging without contrast are commonly considered options, and decisions weigh medical benefit and safety.^1,4,7,8

Clinical insight

Guidelines emphasize that pelvic girdle pain is usually a clinical diagnosis, and most people do best when care focuses on education and active rehab rather than early imaging or long periods of rest.^1,4

What are the treatment options for pubic symphysis dysfunction?

Treatment is usually stepwise, starting with the lowest-risk options that help you move more comfortably and rebuild support around the pelvis. Many people improve with conservative care, especially after delivery, but timelines vary depending on symptoms, demands, and recovery factors.^1,4,6

1. Education and activity choices
   Education helps you reduce strain on the pubic symphysis while staying active. This can include practical strategies like pacing, changing how you get out of bed, avoiding painful wide steps, and keeping movements symmetrical when possible.^1,4
2. Exercise-based rehabilitation
   Exercise-based rehab is a core treatment in postpartum pelvic girdle pain guidance.⁴ Programs commonly focus on:
   1. Building coordinated support from the hips, trunk, and pelvic floor
   2. Gradually returning to tasks that currently hurt, like stairs, walking, and rolling in bed Evidence reviews support exercise and related interventions for pregnancy-related low back and pelvic pain, though study quality varies.^4,5
3. Support belts or support shorts
   Non-rigid pelvic support belts or supportive garments can reduce pain for some people, especially when combined with education and exercise. The “best” schedule is individualized, and comfort and function are usually the guide.⁵
4. Medications
   Medication choices during pregnancy and postpartum should be guided by your clinician. Acetaminophen is commonly used in pregnancy when needed, while certain anti-inflammatory medicines are avoided later in pregnancy.⁹
5. Manual therapy and symptom tools
   Some people get short-term relief from hands-on care or symptom tools like heat or a transcutaneous electrical nerve stimulation unit, often as an add-on rather than a stand-alone fix.^1,5
6. Injections
   Injections are not common for pregnancy-related pelvic girdle pain, and evidence is limited. They are more likely to be considered postpartum in specific cases after other causes (like infection) are ruled out.¹
7. Surgery
   Surgery is rare for pregnancy-related pubic symphysis pain. It may be considered in uncommon cases of true pubic symphysis separation with major instability that does not improve with conservative care.¹

Sword's approach

Sword Health helps people manage pain and movement issues with expert-guided AI care you can use from home. Our model combines clinical support with modern technology, designed to work around your life.

Sword makes recovery easier and more accessible. You get high-quality care at home, guided by clinicians and supported by smart technology.

• Care that adapts to your progress in real time
• Licensed experts guiding every step
• Simple, non-invasive, evidence-based programs
• Proven results for pain relief, movement, and satisfaction

How can I find pain relief for pelvic symphysis dysfunction?

These are low-risk strategies that many people find helpful, especially during flares:

• Keep movements “together” when you can. For example, when getting out of bed, try rolling as a unit and bringing legs off the bed together, instead of twisting and separating legs widely.^1,4
• Shorten your stride and avoid wide steps during painful periods, since larger steps can increase strain at the front of the pelvis.^1,4
• Use pacing, not pushing. Break longer chores into smaller chunks with short rests so pain does not spike late in the day.⁴
• Support for high-demand moments. A pelvic belt or supportive shorts may reduce symptoms during walking or standing tasks for some people.⁵
• Protect sleep when possible. Sleep disruption is common in pelvic girdle pain, and improving positioning and symptom control can help you recover.^1,4

If pain is not improving, is getting worse, or you notice red flags (fever, sudden inability to walk, new numbness or weakness, bladder or bowel changes, or pain after a fall), contact a clinician promptly.^1,4