Chiropractic Management of Pubic Symphysis Shear Dysfunction in a Patient With Overactive Bladder, 2014

Topics: fascia, symphysis pubis dysfunction, pubic symphysis, pubic symphysis diastasis, urinary bladder overactive, manipulation chiropractic, manipulation osteopathic

Authors: Robert Cooperstein, Anthony Lisi and Andrew Burd


Objective: The purpose of this case report is to describe chiropractic management of a patient with overactive bladder (OAB) and to describe an hypothetical anatomical basis for a somato-vesical reflex and possible clinical link between pelvic and symphysis pubis dysfunction to OAB.

Clinical features: A 24-year-old nulliparous female with idiopathic OAB, with a primary complaint of nocturia presented for chiropractic care. Her sleep was limited to 2 consecutive hours due to bladder urgency. Pubic symphysis shear dysfunction was observed on physical examination.

Intervention and outcomes: The primary treatment modality used was chiropractic side-posture drop-table manipulation designed to reduce pubic shear dysfunction. After 8 treatments in 1 month, the pubic shear gradually reduced while nocturia diminished and consecutive sleep hours increased from 2 to 7. At 1-year follow-up, the nocturia remained resolved.

Conclusion: The patient reported in this case responded favorably to chiropractic care, which resulted in reduced nocturia and increased sleep continuity.

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