Manual therapy for postpartum symphysis pubis diastasis: a case report

Symphysis pubis diastasis (SPD) is a rare childbirth complication, involving a pubic symphysis separation of ≥10 mm, occurring in about 2.8% of women. Risk factors include fetal macrosomia, prolonged labor, and instrumental delivery. Symptoms include severe pelvic pain and mobility issues. Conservative treatments like physical therapy and pelvic bracing are first-line, with surgery reserved for refractory cases. Traditional Chinese medicine (TCM) manual therapy offers a non-invasive alternative with promising outcomes.

A 32-year-old primigravida experienced SPD after a prolonged labor, resulting in a 25 mm pubic symphysis separation. Initial treatment with analgesics and exercise therapy provided limited relief. She subsequently underwent TCM spinal correction therapy, which involved manual techniques to relax soft tissues, realign the pubic symphysis, and stimulate acupoints to improve qi and blood circulation. After two sessions, her pain significantly decreased, and a follow-up computed tomography (CT) scan showed a reduction in the symphysis gap to 10 mm. By 1 month post-treatment, she reported complete resolution of symptoms and resumed normal activities.

TCM spinal correction therapy could offer rapid and effective relief for postpartum SPD, providing a nonsurgical approach. This case highlights the potential of TCM in managing SPD, particularly for patients seeking conservative treatment options. Further research with larger sample sizes is recommended to validate these findings and explore the mechanisms underlying TCM's efficacy in SPD management.