Chronic post partum osteitis pubis managed with chiropractic

Bobby Fano D.C., Linda Mullin, D.C.

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Abstract

Introduction: This case report describes a 32 year old female who was referred to a chiropractic office with MRI confirmed pregnancy induced osteitis pubis of two years duration. The patient was unable to walk unassisted due to pain. While osteitis pubis is well documented in athletes with repetitive use injuries that are healed with rest, the literature does not discuss chronic post partum osteitis pubis that remains unresolved after rest.

Methods: Initial treatment of chiropractic adjustments utilizing contact-specific, high velocity, low-amplitude adjustments (ie, Gonstead technique) were applied to sites of pelvic subluxations with mild improvement. Strengthening exercises to the abdominal and contralateral adductor muscles were used as adjunct therapy to stabilize the pubic symphysis.

Discussion: Pregnancy creates unique structural stresses to the female body. In the three joint complex of the pelvis, asymmetry of movement can create excessive instability in other parts of the complex. Adjustments serve to normalize motions and remove these stresses. In this chronic case, the addition of strengthening exercises provided complete restoration of symmetry and resolution of pubic pain.

Conclusions: After failed conventional care of rest and orthopedic supports, chiropractic adjustments and therapeutic exercise resolve the patient’s pain and normalized her functional ability.