Abstrait

Symphysiolysis and Pregnancy Related Pelvic Girdle Pain – Mystery Resolved?

Gil Pomp

Symphysiolysis, also referred as Pregnancy Related Pelvic Girdle Pain (PRPGP), is a common disabling illness in pregnancy with symptoms ranging from pelvic discomfort to inability to move out of bed. The diagnosis is mostly clinical. Imaging of the symphysis pubis joint can be performed by US or MRI. Current treatments include oral pain medications, NSAID’s (until 28-30 week of pregnancy. Pelvic Support belt, physiotherapy, hydrotherapy, lifestyle modifications, bed rest - are some common recommendations to ease the pain in intermediate to severe pain. More severe cases are treated by local injection of steroids and local anesthetic agents to into the pelvic joint or around it - done in “pain clinics”. Extreme cases demand surgical interventions or constant regional nerve block (“epidural”). The new novel treatment hereby described, evolved from the incidental observation that bilateral inguinal subcutaneous injection of local anesthetics easily and rapidly blocks pain transmission and brings temporary relief to moderate and severe pelvic joint pain. The technique was utilized for 4 years in severe postpartum cases and recently was offered as a treatment option to moderate to severe cases of Symphysiolysis in pregnancy. This treatment (Bilateral Subcutaneous Inguinal Therapy - “BISCUIT”, or “Dr. Pomp’s Injections” as referred by some) is currently given in outpatient clinics and has the option to become a self-administered home treatment (patent pending). Since Oct. 30th, 2019, when “patient zero” received this treatment (offered for the first time for a pregnant patient) in the setting of pain clinic in a tertiary center (Hadassah Medical Center, Jerusalem) until the end of 2019, this therapy was given to 77 pregnant patients. Overall 281 treatment cycles were performed. During that period of time, the commercial use of this technique was registered as a patent, and effort is done developing a device for patient’s self-use.Symphysiolysis, also referred as Pregnancy Related Pelvic Girdle Pain (PRPGP), is a common disabling illness in pregnancy with symptoms ranging from pelvic discomfort to inability to move out of bed. The diagnosis is mostly clinical. Imaging of the symphysis pubis joint can be performed by US or MRI. Current treatments include oral pain medications, NSAID’s (until 28-30 week of pregnancy. Pelvic Support belt, physiotherapy, hydrotherapy, lifestyle modifications, bed rest - are some common recommendations to ease the pain in intermediate to severe pain. More severe cases are treated by local injection of steroids and local anesthetic agents to into the pelvic joint or around it - done in “pain clinics”. Extreme cases demand surgical interventions or constant regional nerve block (“epidural”). The new novel treatment hereby described, evolved from the incidental observation that bilateral inguinal subcutaneous injection of local anesthetics easily and rapidly blocks pain transmission and brings temporary relief to moderate and severe pelvic joint pain. The technique was utilized for 4 years in severe postpartum cases and recently was offered as a treatment option to moderate to severe cases of Symphysiolysis in pregnancy. This treatment (Bilateral Subcutaneous Inguinal Therapy - “BISCUIT”, or “Dr. Pomp’s Injections” as referred by some) is currently given in outpatient clinics and has the option to become a self-administered home treatment (patent pending). Since Oct. 30th, 2019, when “patient zero” received this treatment (offered for the first time for a pregnant patient) in the setting of pain clinic in a tertiary center (Hadassah Medical Center, Jerusalem) until the end of 2019, this therapy was given to 77 pregnant patients. Overall 281 treatment cycles were performed. During that period of time, the commercial use of this technique was registered as a patent, and effort is done developing a device for patient’s self-use.