A combination of postural changes, baby, unstable<unk>  joints under the influence of pregnancy hormones, and changes in the centre of gravity can all add to the varying degrees of pain or discomfort. In some cases it can come on suddenly or following a fall, sudden abduction of the thighs (opening too wide too quickly) or an action that has strained the joint.<unk>  can begin as early as the first trimester of pregnancy. Pain is usually felt low down over the symphyseal joint, and this area may be extremely tender to the touch. Pain may also be felt in the hips, groin and lower abdomen and can radiate down the inner thighs. Women suffering from<unk>  may begin to waddle or shuffle, and may be aware of an audible clicking sound coming from the<unk> .<unk>  can develop slowly during pregnancy, gradually gaining in severity as the pregnancy progresses. During pregnancy and postpartum, the symphyseal gap can be felt moving or straining when walking, climbing stairs or turning over in bed; these activities can be difficult or even impossible. The pain may remain static, e.g., in one place such as the front of the<unk> , producing the feeling of having been kicked; in other cases it may start in one area and move to other areas. It is also possible that a woman may experience a combination of symptoms. Any weight bearing activity has the potential of aggravating an already unstable<unk> , producing symptoms that may limit the ability of the woman to carry out many daily activities. She may experience pain involving movements such as dressing, getting in and out of the bath, rolling in bed, climbing the stairs or sexual activity. Pain may also be present when lifting, carrying, pushing or pulling. The symptoms (and their severity) experienced by women with<unk>  vary, but include: * Present swelling and/or inflammation over joint. * Difficulty lifting leg. * Pain pulling legs apart. * Inability to stand on one leg. * Inability to transfer weight through<unk>  and legs. * Pain in hips and/or restriction of hip movement. * Transferred nerve pain down leg. * Can be associated with bladder and/or bowel dysfunction. * A feeling of the symphysis pubis giving way. * Stooped back when standing. * Malalignment of<unk>  and/or back joints. * Struggle to sit or stand. * Pain may also radiate down the inner thighs. * Waddling or shuffling gait. * Audible ‘clicking’ sound coming from the<unk> . Severity The severity and instability of the<unk>  can be measured on a three level scale.<unk>  type 1:The<unk>  ligaments support the<unk>  sufficiently. Even when the muscles are used incorrectly, no complaints will occur when performing everyday activities. This is the most common situation in persons who have never been pregnant, who have never been in an accident, and who are not hypermobile.<unk>  type 2:The ligaments alone do not support the joint sufficiently. A coordinated use of muscles around the joint will compensate for ligament weakness. In case the muscles around the joint do not function, the patient will experience pain and weakness when performing everyday activities. This type often occurs after giving birth to a child weighing 3000 grams or more, in cases of hypermobility, and sometimes after an accident involving the<unk> . Type 2 is the most common form of<unk>  instability. Treatment is based on learning how to use the muscles around the<unk>  more efficiently.<unk>  type 3:The ligaments do not support the joint sufficiently. This is a serious situation whereby the muscles around the joint are unable to compensate for ligament weakness. This type of<unk>  instability usually only occurs after an accident, or occasionally after a (small) accident in combination with giving birth. Sometimes a small accident occurring long before giving birth is forgotten so that the<unk>  instability is attributed only to the childbirth. Although the difference between Type 2 and 3 is often difficult to establish, in case of doubt an exercise program may help the patient. However, if<unk>  Type 3 has been diagnosed then invasive treatment is the only option: in this case parts of the<unk>  are screwed together. (Mens 2005) Psychosocial impact<unk>  in pregnancy seriously interferes with participation in society and activities of daily life; the average sick leave due to posterior<unk>  pain during pregnancy is 7 to 12 weeks. In some cases women with<unk>  may also experience emotional problems such as anxiety over the cause of pain, resentment, anger, lack of self-esteem, frustration and depression; she is three times more likely to suffer postpartum depressive symptoms. Other psychosocial risk factors associated with woman experiencing<unk>  include higher level of stress, low job satisfaction and poorer relationship with spouse.
Pelvic girdle pain
Pelvic pain
Testicular pain
Back pain
Penile pain
Middle back pain
Low back pain
Xiphodynia