Child Birth-Related Pelvic Pain And Chiropracric Healthcare

For some women, postpartum recovery requires extensive treatment from health care professionals long after childbirth. Such is the case with diastasis symphysis pubis, a rare separation of the pubic bones which are usually joined, that has been estimated to occur in 1 out of 300 or 1 out of 30,000 depending on different reports.

This acutely painful condition, which can lead to chronic problems with the pelvis, is most commonly caused by childbirth, yet can sometimes be induced by falls from horseback or other accidental traumas. Diagnosis typically requires radiographic examination. A recent case study investigates the chiropractic management of this condition. 

A 30 year old woman suffering from severe pelvic pain resulting from diastasis symphysis pubis sought help from a chiropractor to close the 17 mm gap that had developed between her pubic bones. But because there was not much existing literature on effective chiropractic procedures to treat this condition, a conscientious evidence-based approach was required. A known risk in treating this condition is chronic pain resulting from ligament injury to the sacroiliac joints, located in the pelvis between the sacrum and the ilium, so great care was taken not to exacerbate the condition. Other potential complications include incontinence and disability. 

A treatment plan was devised which included chiropractic adjustments, trigger point release, electrical stimulation, moist heat, a sacroiliac belt, and specific stabilizing exercises. The electrical stimulation was especially effective in modulating the pain through transcutaneous electrical nerve stimulation (TENS), which was applied to the lower lumbar and sacral regions for analgesic effect. A chiropractic instrument known as an activator was used to make careful adjustments to the sacrum and other surrounding regions. The patient was encouraged to supplement this treatment with Kegel exercises, pelvic tilt and bridge, followed by a progression to core strengthening with a stability ball.

Fast pain relief was achieved immediately after the first treatment. The treatment history reveals a steady reduction in pain as indicated by the patients responses to the VAS (a pain questionnaire) which records patient pain on a ten point scale. The first visit reduced pain to 8/10 and was followed by a reported 2/10 by the fourth visit. Eventually pain was reduced 1/10. The initial 17 mm gap between the pubic bones was closed to 7 mm. 

The effectiveness of the pain management demonstrates the value of more research into the subject of chiropractic therapy for women suffering from diastasis symphysis pubis after childbirth. A collaborative effort between chiropractors, midwives, and obstetricians could be a highly effective resource for women affected by this painful condition. 

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