Surgery for pubic
symphysis dysfunction

Is surgery right for pubic symphysis dysfunction?

For most people, no. Pubic symphysis dysfunction (pain and instability in the joint where the two pelvic bones meet) is usually part of supports the weight of the upper body (bony ring that supports the weight of the upper body), and it most often improves with education, movement support, and guided exercise, especially after delivery.^1,2,3

Surgery may only come up in rare situations, such as:

• A true pubic symphysis separation (diastasis) after childbirth, where the joint gap is much wider than expected and the pelvis feels mechanically unstable^8,9
• Ongoing, severe pain and disability that does not improve with well-guided conservative care, and where a specialist confirms a structural problem that surgery can address^8,9

Even then, surgery is not an automatic “next step.” The decision depends on your symptoms, function, exam findings, and imaging when needed. A good plan is shared decision-making with your obstetric clinician and a pelvic health specialist, focusing on what matters most to you: walking, sleeping, caring for your baby, and feeling stable again.^1,3

Common surgical options for pubic symphysis dysfunction

Surgery is uncommon for typical pregnancy-related pelvic girdle pain^1,3. When it is considered, it is usually for pubic symphysis diastasis or severe instability.

Possible options a surgeon may discuss include:

• Non-surgical stabilization first (pelvic binder or brace)
• Surgical fixation (plate and screws across the pubic symphysis)
• External fixation (temporary stabilizing frame that stays out of the skin temporarily)

What to expect during recovery

Recovery depends on what problem is being treated.

If you have typical pelvic girdle pain without joint opening, the “recovery plan” is usually focused on rehabilitation, not surgery.^1,3

If you have pubic symphysis diastasis and surgery is needed, recovery commonly includes:

• Early protection and support (binder/brace, careful movement, pain control)^8,9
• Gradual return to walking and daily activity, often with assistive devices  (like crutches) at first^8,9
• Rehabilitation that rebuilds strength and control in the hips, pelvic floor, and trunk, progressing back to stairs, bed mobility, and caregiving tasks³
• Monitoring for complications, like infection, blood clots, or ongoing pain, because surgery cannot guarantee full relief^8,9

During pregnancy or soon after delivery, many cases can be assessed without routine imaging. When imaging is needed to rule out another condition or confirm diastasis, clinicians typically choose the safest appropriate option for the situation.⁷

Can surgery be avoided?

In most cases, yes.

Guidelines consistently recommend starting with:

• Education and load management (small changes to daily movement that reduce strain on the pelvis)
• Exercise-based rehabilitation that improves pelvic, hip, and trunk support
• Optional support belts or garments for comfort during daily tasks^1,3,4

This approach is recommended because pregnancy-related pelvic girdle pain is usually a load and movement control problem, not something that “needs fixing” with a procedure.^1,3

How Sword can support you before and after surgery

Physical therapy can play an important role in preparing for surgery, supporting recovery, and, in some cases, helping people manage symptoms without surgery. Sword offers physical therapy programs designed to support you at different points along that journey.

Sword supports recovery before and after surgery, with care designed to fit into your life. You receive high-quality physical therapy at home, guided by licensed clinicians and supported by smart technology.

• Care that adapts as your body and recovery needs change
• Licensed physical therapists guiding your care at every stage
• Non-invasive, evidence-based physical therapy programs

Support for preparation, recovery, and long-term movement health

Clinical insight

European guidelines for pelvic girdle pain recommend clinical diagnosis and conservative care first, using education and targeted exercise to improve load transfer and daily function, and reserving imaging or invasive options for unusual or severe presentations.¹