Pubic Symphysis Dysfunction vs. Pelvic Girdle Pain: What’s the Difference?
Lisa Clarke, DC
Chiropractor
Many pregnant and postpartum women experience pain at the front of the pelvis and are told they have “pelvic girdle pain”. Others hear the term “pubic symphysis dysfunction” (or “symphysis pubis dysfunction”). Are these the same thing? This article clarifies the terminology, explains why this pain happens, and outlines how evidence‑based conservative care can help you feel and move better.
Understanding the Definitions.
Pelvic Girdle Pain (PGP) is pain that comes from any of the joints in the pelvis. This can include one or both of the sacroiliac joints at the back of the pelvis and/or the pubic symphysis, the joint at the front of the pelvis. The pain may be felt anywhere around the pelvis between the top of your iliac crest to the bottom of your bum and may radiate down into the thigh.
Symphysis Pubis Dysfunction (SPD) is sometimes also called pubic symphysis dysfunction and refers specifically to pain and irritation at the joint at the front of the pelvis, where the left and right pubic bones meet. People often describe sharp or aching pain over this joint, especially with walking, standing on one leg, or moving the legs apart. The term may also be used to describe a separation or widening of the joint past 10mm (called pubic symphysis diastasis) or an inflammation of the bone in this area (osteitis pubis).
So, pelvic girdle pain is the umbrella term and pain in the pubic symphysis sits under that umbrella as one particular pattern of pelvic girdle pain. In other words, you can have PGP at the back of the pelvis, the front of the pelvis, or both. If pain is just at the front, your healthcare provider may call it SPD.
Why Does Pelvic Girdle Pain Happen in Pregnancy?
During pregnancy, hormones soften the ligaments that give stability to the joints of the pelvis. The muscles now have to work differently to support the joints and the load of a growing baby. For many people, the pelvis adapts well; for others, extra movement or reduced muscle control around the joints leads to pain that is often noticed with daily activities such as walking, stairs, rolling in bed, standing on one leg (putting pants on), or getting in and out of a car.
Pelvic girdle pain can continue after delivery, start for the first time postpartum, or dissipate as the body recovers. Postpartum, pain often shows up with weight-bearing through the legs, rolling in bed, lifting and carrying baby, or longer walks and household tasks.
When to See a Professional.
You should seek help from our chiropractor at Proactive Pelvic Health if pain is interfering with daily life – walking, stairs, sleep, caring for baby, or enjoying movement – or if you feel worried and unsure what is causing your symptoms.
Note: skip straight to seeking urgent medical attention if there is new trauma to the pelvis, or you can’t bear weight at all, loss of sensation around the pelvic floor, fever, or new problems with bladder or bowel control.
How Can a Chiropractor Help with Pain in the Pelvis?
Dr. Clarke starts by ruling out pain that could be coming from other areas such as the low back, and checking for any signs or symptoms that need medical referral. She then uses simple movement and loading tests to see which pelvic joints are involved, whether the sacroiliac joints, the pubic symphysis, or both, and how well your muscles are helping those joints handle everyday forces.
The goal of treatment is to normalize movement and build muscular support around the joints for effective load transfer. As a result, everyday activities like walking, rolling in bed, and lifting your baby become easier and less painful.
Chiropractic care for pelvic girdle pain is most effective when it combines multiple forms of therapy. Your care plan may include:
Education and reassurance about what’s happening and why it’s usually not dangerous.
Activity and ergonomic advice for sleep, stairs, feeding, lifting, and walking.
Individualized stabilizing exercises for pelvic floor, hips, and trunk.
Advice on appropriate use and placement of a pelvic support belt to reduce pain while you build strength and control.
Hands-on manual therapy or manipulation as one part of care, especially for short-term relief.
Referral to someone who can provide support for mood, stress, and fear of movement when pain is more persistent.
How Long does Pelvic Girdle Pain Usually Last?
Most people with pregnancy-related pelvic girdle pain improve after birth, especially with early, active care. Even when pain continues into the postpartum period, many see better function and less pain with a well-structured program that addresses both the joints and the muscles that support them.
If pain shows up for the first time after birth, seeking care early shortens time to recovery and getting help with mood may help speed along the process.
Key Takeaways for Pregnant and Postpartum Readers.
Pelvic girdle pain and pubic symphysis dysfunction are common, real, and treatable. Understanding which joints are involved, seeking care early, and working with an evidence-based musculoskeletal clinician on a multimodal plan can help you move with more confidence and get back to the activities you value.
References
Vleeming, A., Albert, H. B., Östgaard, H. C., Sturesson, B., & Stuge, B. (2008). European guidelines for the diagnosis and treatment of pelvic girdle pain. European Spine Journal, 17(6), 794–819. https://doi.org/10.1007/s00586-008-0602-4
Weis, C. A., Nordin, M., Albrecht, K., & Gleberzon, D. (2022). Best-practice recommendations for chiropractic care for pregnant and postpartum patients: Results of a consensus process. Journal of Manipulative and Physiological Therapeutics, 45(7), 469–489. https://doi.org/10.1016/j.jmpt.2021.10.002
Simonds, A. H., Abraham, K., & Spitznagle, T. (2022). Clinical practice guidelines for pelvic girdle pain in the postpartum population. Journal of Women's Health Physical Therapy, 46(1), E1–E38. https://doi.org/10.1097/JWH.0000000000000236
Clinton, S. C., Newell, A., Downey, P. A., & Ferreira, K. (2017). Pelvic girdle pain in the antepartum population: Physical therapy clinical practice guidelines linked to the International Classification of Functioning, Disability, and Health from the Section on Women's Health and the Orthopaedic Section of the American Physical Therapy Association. Journal of Women's Health Physical Therapy, 41(2), 102–125. https://doi.org/10.1097/JWH.0000000000000081