Characteristic symptoms of symphyseal separation include suprapubic pain and tenderness with radiation to the back of legs, difficulty in walking and, occasionally, bladder dysfunction. Documentation of symphyseal separation can be made by history alone, but x-ray and ultrasound are frequently used to confirm the diagnosis. Trauma or obstetric interventions such as application of force to move the thighs or the use of forceps may also trigger separation. The change in gait and the pain when walking may not be noticed until 24 hours or more after delivery. We really don't understand why this occurs in some women, but there may be a genetic predisposition to this.
Scandinavian countries report a high incidence.
Treatment is usually conservative, including bedrest, pelvic binders, the use of walkers and mild analgesics, which usually result in a complete recovery with four to six weeks. The occurrence of a symphyseal separation should not significantly alter the management of subsequent pregnancies, and the same types of conservative therapy are recommended for any recurrence of symptoms. Recurrent separation of the symphysis pubis could occur during subsequent deliveries, but generally is no worse than the first occurrence. I would try to get a referral to a good physical therapist who is experienced in this condition. Use of a binder or lightweight maternity girdle may help as well.