Symphysis Pubis Dysfunction (SPD)

How is SPD treated?

Symphysis Pubis Dysfunction (SPD)
Many women experience discomforts during pregnancy that they had never experienced before. During pregnancy, your body produces hormones and body parts shift to meet the demands of your growing baby. Your body produces a hormone known as relaxin during pregnancy. Relaxin softens the ligaments in your pelvis to enable your baby to pass through your pelvis. Normally, the two halves of your pelvis do not move very easily because the symphysis pubis is strengthened by ligaments. If one side of your pelvis moves more than the other side, you can experience pain and inflammation. This can happen when you walk or move your legs and the pain can become severe.

The most common symptoms of symphysis pubis dydfunction are pain in the pubic area and groin. If you suffer from SPD, you might also complain of back pain, hip pain, or grinding in your pubic area. Sometimes the pain does radiate down the inside of the thighs or between the legs. Women that experience the symptoms of SPD have a hard time walking, going up stairs and other activities that involve separating their legs. It may be hard to get up in the night to use the restroom and getting sleep may be harder.

SPD generally affects women in the end of the first timester or after delivery. However, you can experience symptoms at any point during the pregnancy. If you have the symptoms of SPD in one pregnany, it is likely that you will experience the same symptoms with recurring pregnancies. During later pregnancies, the symptoms tend to start earlier and progress faster.

If you think that you are suffering from SPD, you should contact your obstetrician or midwife for an evaluation. Your doctor will do a series of tests that look at leg movements, stability and localized pain in your pelvic area. Treatment generally involves wearing a pelvic support belt and doing exercises that improve the stability of your pelvis and back. Water exercises or acupuncture can be helpful and often offer relief. Make sure you ask your doctor any questions you have pertaining to the birth of your baby with SPD.

If you suffer from symphysis pubis dysfunction, you should keep in mind several things that will help with your pain. You should try to move around frequently throughout the day, but in small amounts. When you are sitting, make sure that you sit upright and keep your back well supported. If at all possible, it is best to avoid heavy lifting or pushing. Sit down to put your pants, shoes or socks on. Do not try to step into dresses, skirts or pants. When you are climbing stairs, climb them one step at a time. Stretching your legs to far apart at once can make the pain significantly worse. If you must separate your legs, take it slowly and keep your back arched.

Many women do continue to feel the pain after delivery. Generally, the symptoms do improve after delivery and eventually fade away. If your pain is still bothersome, continue to do the pain relief exercises and seek the advice of your caregiver. Women also may have the same symptoms around the time of their monthly menstrual cycle. This is because a woman's body secretes hormones similar to relaxin during menstruation.

Comments: Symphysis Pubis Dysfunction (SPD)

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DawnM - 316 days ago.
dawnht what a horrid experience I am so glad that you and jennifer dawn are ok. i hope the aftermath of the birth isnt too traumatic and you have lots of support. Your story has convinced me even more to follow a home birth like last time and trust my self, not be bossed ablout by the professionals. If I end up being transfer to hosp then so be it but at least at home I will have some control. SPD is incredibly hard to cope with but a traumatic birth on top no mother needs. I will wait it out and let my little one tell me when they are ready just like my daughter evelyn did. I am now on crutches full time which I am finding emotionally hard as well as physically. I am back at work and exhausted by the demands of the day as well as being possitive and upbeat infrom of my classes. I also feel such a burden all the time and so guilty that I cant play with evelyn properly but I keep telling myself May will be here soon and then I'll be back to my old self with a little help from physio. In the grand scheme of things 4 months isnt a long time in Evelyns or my husbands life to be like this and the new addition to our family will be worth it. Lynsey-3 i sympathise completly with how you are feeling I am heeding towards a wheelchair too. I try and take the good with the bad. Cry and let it out if I feel like it and then draw on the strength that we all have inside us when I have to. The end result will be worth it i'm sure.

dawnht - 320 days ago.
Hello everyone, I have had my baby girl Jennifer Dawn on the 3rd of January. Unfortunately things didnt go too well for me and I had to have emergency C/S. I went in early to be induced after having severe SPD. PLEASE BE AWARE OF THE INFO YOU ARE ABOUT TO READ. DO NOT AND I REPEAT DO NOT ALLOW THEM TO BURST YOUR WATERS IF THE CERVIX OF YOUR WOMB ISNT LOW DOWN ENOUGH AND RIPE TO GIVE BIRTH!!!!!!!! It almost cost us our lives, in an emergency c/s. I am very lucky to be here with my beautiful baby girl and would hate to see this happen to anyone else. GOOD LUCK TO YOU ALL AND TAKE CARE

ssb - 320 days ago.
Lynsey-3, I was induced at 37.5 weeks after I had an amnio that showed my sons lungs were developed. He ended up in the NICU for 4 days in respitory distress from being born early. Also, if your cervix isn't 'ripe' your labor will be MUCH more intense and the likelyhood of having a c-section greatly increases b/c your body wasn't ready to deliver.

lynsey-3 - 320 days ago.
hi, i am currently 29+4 and have severe spd, i am in agony, i am on crutches and the next thing is a wheelchair which i really dnt want, i have been taking paracetamol for the pain and occassional co-codamol which i have now stopped as i was advised by the dr not to take it in the 3rd trimester as it can cause premature labour and problems with the heart and blood clotting or along those lines, i just wanted to know if anyone had been induced early due to spd? i am due to see my consultant again 29/01 and am going to ask about induction then, if i have to wait til 37-38 wks i will but i dnt feel i can go the full 40 wks the way i am i also have 2 other kids that are 6 and 2 so it wouldnt really be practical to be housebound and in a wheelchair. lynsey xx

ssb - 321 days ago.
Hi Ladies! I have 2 kids aged 12 and 1. I too was told that my pain was 'normal'. It has only been since doing more research as my husband and I would like to have another that I discoverd that SPD had a 'name'. I would just like to share with you what I have found. Going to a chiropractor who is certified in the Webster Technique can bring HUGE results in terms of pain relief without drugs. (My OB gave me Vicodin!! Yet told me the pain was normal??) And bedrest. I have spoken to a Chiro in my area and she also had SPD. She said that even though she was still working full time that her pain was relieved for 3-4 days after an adjustment (and keep in mind she was adjusting people while pregnant and with SPD) Both of my kids were born vaginally and while I had SEVERE pain post partum, it did eventually go away. Per my OB he said that I would have the pelvic pain post partum even if I had a C sect. and then I would have to recover from both. (I was ALL FOR C-sect. if it meant not dealing with the post partum pain/recovery period.) I have also found that not delivering on your back in stir ups alleviates a lot of pressure that is put on your pelvis during delivery. With my last delivery you could literally hear a 'POP' when his head came thru the pelvis. And my first thought was 'oh, thank God' , my second thought was 'that can't be right!' LOL Here is the link I found for finding a Chiropractor. www.icpa4kids.com Good Luck everyone! And know that you are not alone, you are not making it up, and you are not being a 'baby'. Unless someone else has experience it, they cannot possible fathom the pain. I can only compare it to breaking your pelvic bone.

dawnispregz - 325 days ago.
Hi - I keep looking on here and keep trying to give support where i can. I had this at 4 months andits the worst pain ever, i had a natural borth, and by natural i mean full on pain- no drugs and vaginal.and i have to go in stirrups which is one of the things my midwife said no to in birth plan, but i had to. And everything was fine. The pain dramatically lessened about 2 days after (you concentrate on feeling like youve been kicked by a horse!!) having spd didnt hinder the birth at all, but it was a concern until i went into labour. So i can understand why ppl think c sections are the best option, i asked if i was to have one because i didnt want to be in spd pain aswell as labour, but the labour and breathing is all you think about when it comes to it. If you ladies what some advice on coping with spd go to my page and read 'coping with spd' blog. And remember - as much as we dont wanna take meds, 1 paracetomol and 1 codeine is fine, and if you makes you rest easier then thats doing the world of good for baby too as baby can sense pain and stress.I used to go all day in pain without anything and then take it at night now and so i could sleep easier, and it worked sometimes and i felt so much better for the nights sleep.

DawnM - 326 days ago.
Dawnht i wish you all the best tomorrow let us know how things go. I'm sure everything will be fine and you'll be cuddling your beutiful baby very soon. What a great way to start the new year!

dawnht - 327 days ago.
I have 2 days to go and will be induced on the 2nd January. I am planning on a normal delivery with diamorphine for painkiller or epidural, not sure which but will see how it goes. I really can't wait,this week has seemed almost like a month. I went to see the Obstetrician last week and he wanted to keep me in hospital for Christmas and the New Year ugh imagine how depressing that would be. They have been kind enough to give me stronger painkillers which are more effective than paracetemol and have been told it should be safe to breast feed after taking solpadol 30/500. So with luck I will hopefully have a very good labour and delivery on the day I am induced, as I have also found out she is almost engaged, (DAWN)The exercise techniques you have so kindly shared I will no doubt be trying them out in a few days time after the birth. I have forgotten what my tummy muscles look like, let alone where they are hiding. I wish I could have held on a little longer as I am sure she would not be long to come now, but I have already put 50% of my normal body weight on and she is already going to be on the 9lb side of the scales, and gaining rapidly by the day. I can barely walk now even with crutches, I'm also fed up of moaning lol. Well, hope you have a very good New year and will post details on how well my delivery went hopefully in the next couple of days. HAPPY NEW YEAR TO ALL

DawnM - 328 days ago.
Hope everyones doing ok. Dawnht how close are you now? I'm sure that your delivery will be fine. Go with the flow is my best advice. I had my scan and the little monkey is fine but secretive so we still don't know if we're expecting a boy or girl. We're planning on a 4d scan so we can find out for sure - i'm so impatient. My physios been fab and has given me very simple excercises to do on an excercise ball. Mainily sitting on it with a straight back, tummy held in like when you have on tight jeans and legs planted firmly on the floor. Then rocking my pelvis forward and back. Keeping in the same position (without rocking) lifting one heal of the floor, like i'm on tip toes then back again. They are not hard work but it makes you use your core muscles and already there and improvement. I can certainly do these for the rest of the pregnancy without pain and with results! The hospital have been fab too and are still supporting my choice to have a home birth so I am pleased about that. I want to trust my body again with a midwife I trust and understands SPD and not feel pushed around by the 'professionals'. All in all I am feeling positve today - Christmas has probably helped with that! I'm nervous about returning to work and the reaction I'll get after being off for a month and how I'll manage on crutches - but one day at a time!

lucysagoodgirl - 331 days ago.
my baby girl is 7 weeks old now and i have spd but the good news is it is getting better. I still cant turn over in bed, walk for a long time, or lift any thing heavy and im also finding being intimate with my parnter difficult. I can get in and out the bath now, which is lovely. I didnt think i would ever be able to do that again. Getting up and down the stairs is also getting easier but my partner does have to be here to help me. I feel for anyone that has or has had spd. It does get better just dont push yourself and keep ur spirits high. xx

californiamade4 - 336 days ago.
Well,I assume that I have this as I have been having pain when walking in my right thigh. Today, I can barely even turn over in bed or make it to the bathroom as my right thigh,hip and pelvic area are all hurting badly when I move. It's kinda scary.

suzi - 337 days ago.
so i am 5 weeks pregnant. I have a 9mpnth old I suffered almost my entire pregnancy with tailbone and hip and lower back pain. I dont get the pubic pain but I was in sooooooooooooooooooooooooooooo much pain with hip and lower back from 13weeks on. do you think I have this????? I already started getting pain with this pregnancy. Im so scared i cried and could barely get through my days last time and now all over again with a 9month old

trina2383 - 342 days ago.
Wow... seems to be what everyone says when they find this page so I'll say it 2! WOW!!! I have been dealing with SPD my entire pregnancy... some days it hurts so bad I don't even want to get out of bed. For a while I thought it was just all in my head and it would go away.... HAHAHA!! It has only gotten worse for me and NOTHING seems to help. I'm 3 cm dilated and 75% effaced and getting a little....ok a lot worried about labor! Each step I take is bad enough.. I've actually passed out because of the pain... so what's going to happen once the contractions come full force? Do any of you feel like your pubic bone is about to just fall out? Has your hip gone out while walking?

Saremac - 343 days ago.
Wow, I can't believe I just found this! I am certain this is exactly what I have!! I am 20 weeks + 5 days, and am miserable!! I am so glad I am not just crazy!!!

dawnht - 343 days ago.
Hi Dawn, Thank you for caring to write. This page is a huge comfort for me, especially when I'm close to tears with the pain. I read on and see others in the same situation. I feel guilty in a way as I am so lucky to be pregnant. My eldest son is 18 going on 19 and my daughter is almost 16. I hadn't planned to have anymore at the time. But as time passes things change and you have different views. I had an ectopic pregnancy this time last year and had the awful methotrexate (cancer drug) to kill the cells and thought thats it no chance now. So as you can imagine I was overjoyed when I found out I was pregnant in May of this year. But everyone seemed to dwell on the fact that I was too old at 42 to have children and the fact that I have gained 20 kilos/40 pounds didnt help either. So like a nut I just grinned and bared it. The rest is history, but it is important to get help asap and after care as well, as the exercises during pregnancy can only be of great benefit if caught early enough. And even when the physio discharges, there is nothng to say you can't still keep doing the exercises. I must admit I was kind of worried about delivering normally, but thank you Dawn you have eased my mind a little. I think as it is getting closer now I am panicking more and can't really see past my 'nose end' so to speak. Well good luck with your scan. And hope you get your physio real soon and all the help you can get.

DawnM - 344 days ago.
Hi all. Really good to read your comments. I had SPD with my last pregnancy and was in alot of pain as my jobs quite active. I managed it with a support belt and lifestyle changes eg no bending to do the washing and keeping my legs together. I had a normal birth for all those who are worried it is possible. My baby came very fast, I went from being 1cm dilated at the hospital to being sent home and deliverling within an hour on the bathroom floor! The actual birth was 20mins and the ambulance only arrived as the head crowned. Having said that I think it was the best way for me. I had no pain relief so was able to listen to my body, I only had my husband so no-one telling me how to give birth or what position to be in, again i just listened to my body. My daughter was born perfect and due to the spd I streched and was able to give birth and have no tearing or stitches! However having said that if a C-section is the best way for you then go for it. At the end of the day the safest most stressfree way is the best way for a baby to be born. A happy mom helps a happy baby. Dont let the 'professionals' bully you, do whats best for you. All this hasn't put me off I am now mother to a 17 month toddler, pregnant again (21 wks), and planning a home birth. Unfortunatly due to a fall at work the SPD is much worse much earlier this time. I am on cruthches and using a support belt. Not ideal with a toddler. Anyone got any advice for making life easier? I feel guilty all the time I cant play with her or pick her up as much and she doesn't understand. On another note I am under a different hospital now and have been told that if I had been given physio after the birth to strengthen my core then the SPD wouldnt have been so bad so early. As it is I am still weak from the last pregnancy and have streched before so am streching easier this time. I urge anyone who has this to seek physio or do yoga pilatates etc as soon as you can after the birth if you intend to be pregnant again. My 1st physio signed me off quickly, i wish i'd have know to be pushier and demand after care. Good luck with it all. I have my 20wk scan today so can't sleep- very excited!

dawnht - 344 days ago.
Hi Ellie, I'm currently under the physio and find the best thing to do is close my legs as far as they will go. I know it's hard to do sometimes especially if you have a huge bump like me between your legs, but it does actually help a little. Find a flat wall a press the middle of your back for 5 secs and while in this position do the pelvic floor exercise, bum in and squeeze like you would to stop peeing mid stream. Repeat 10 times twice a day. its also good to advise the midwife/doctor that delivers your baby that you have pain and suspect SPD there are techniques they can adapt to to help deliver your baby more comfortably (eg. on your side) they also advise no stirrups. I hope you are able to insist to your OB that there is a problem, afterall it is your body and you know what is going on.

sarahc - 346 days ago.
hi guys. just thought I'd give my 2pennies worth... i had spd from about 19 weeks pregnant and ended up having an emergency c section. I have an amazing little girl who is now 11 months old and it was all worth the pain! I just wanted to say that if they offer you a c section dont get too upset about it. i was at first but it was so much easier than i thought it would be and the recovery was so much quicker than they said. in the end if id continued trying to push her out then i may have done more damage to myself so the section was definitely the best way to go. just wanted to share this not to scare or upset anyone who really dreads a c section but to say how much better it was than i thought. good luck to you all.... oh and the spd did go away almost immediately after the birth so some good news! x

dawnht - 347 days ago.
It's such a comfort to read all your notes. For a long time (beginning of second trimester) I had been noticing discomforts. At first I thought it was the bed and went out immediately and bought a new mattress and topper. It worked for a couple of weeks then it didnt seem to do anything. I thought it was just one of those pregnancy things and I should just grin and bear it. I am now 35 weeks, and thankful to the sympathetic midwife I saw a couple of weeks ago, she noticed I could hardly walk and refered me to a pysciotherapist. A little late I know, as I have had to use a wheelchair to shop for the last 8 weeks and what I thought was doing good was forcing myself to climb stairs and get into my car. when infact I was doing more damage than good. But knowing I am not on my own is a big relief as I find much comfort from all your notes and tips.

lucysagoodgirl - 361 days ago.
I have my baby girl nov 17th she was 8lb 12oz and 24 hours later i had the worst pain in my pevis area and couldn't walk or move my right leg at all. A doctor came to see me and told me i had SPD. Im home now and my partner has to do everything for me. Im on crutches and wear a support belt. Hopefully i wont be like this for long. I cant wait to take my little girl out for a walk in her pram and take my son to school.

Poppy~Ella~Rae - 361 days ago.
im really worried im due today and i have had SPD since i was 26 works havent been able to work since because couldnt stand all day and have a support belt and im on crutches, the pain is so bad and im now worried that if i go right over i will have a big baby and it will damage my pelvis more shouldnt i have been induced by now my doctor is stupid and i asked him this on tuesday all he said was just rest itl be ok, i see a midwife on monday when i will be 40 weeks + 4 days im hoping she gives me a sweep. i just wondered did anyone else with this go over and still have a good labour and birth? x x

Spike - 362 days ago.
I ca re3aly sympathise with anyone who has this condition. I started getting symptoms at 15 weeks, by 20 i couldnt dress myself and could hardley walk, 25 weeks was given crutches... they dont realy help much, it very hard to actualy walk without using your pelvis... 30 weeks, i could not longer stand for more than a minet or two without bursting into tears, 32 weeks now and i cant do anything! I cant look after my son, I cant cook, I cant clean, I cant dress myself, i can bar;ey use the toilet (hurst soooo much toactualy sit, once sitting is fine, but god its hurts getting up and down, I cant even lie down! cant lie flat cause my baby is very big and puts too much preasure, cant lie on my left or right sides cause once i do actualy go to sleep and my muscles relax, my pelvis kinda flops and gets stuck like that, then ive got to VERY slowley and then once i get to a sitting position you hear it go pop like when you crack your knucles and my poor bub goes nuts! physio told me i can do nothing, and crutchers are it, midwives keep telling me to get over it, and the doctor just says year, it will go away after the birth! meanwhile I feel soooo useless, i cant even look after myself, let alone my son, my husband has been a god send! hes been doing everything! 3 more weeks left till they induce me and i can not wait, baby decklan already weighs almost 6 pound and im almost 33 weeks

dawnispregz - 375 days ago.
hi girls i have just written a blog called ' helpful tips on coping with spd.' if anyone is suffering from this then check it out, there could be some gems of help in there!!! x x

dawnispregz - 376 days ago.
Oh and a vaginal birth is not outta the question - they wont do a c section unless there is no other way. do dont worry about that, that was one of my concerns, i delivered vaginally and no pain relief!!!! x

dawnispregz - 376 days ago.
PregoNes - cant believe that she said this is normal, it isnt at all, and i actually got told by my physiotherapist and my midwife, and they said it 1in4 women but still not normal at all. My man had to dress me from 4 months on, and unfortunately the effects of spd do not get better at all the further along, and for some unfortunate people the effects can remain for every period after child birth as the hormone Relaxin is present is released in every period just like it is in pregnancy. Heres the things that my physiotherapist told me: Walk upstairs/steps backwards or sideways as forwards will create pressure pushing onto the pelvis. To get in bed sit on the egde, shuffle back as much as possible and then 'glue' your legs together before putting them in. To get outta bed, 'glue' your legs together again and put both feet on the floor at the same time. To bathe, stand right next to the bath side on , place your hands on the bath and get your tummy as close to the side of the bath, so your practically laid on top, so you dont have to lift your legs that high to get over the top, and the same to get out. Get your man to dress you from waist down, but if not possible then sit down to do socks, pants,trousers - and if undies are too much trouble and no one to help - then dont wear them, the pain to put them on isnt worth it at all!Lol The good news is, that after i gave birth i felt soooo much better,and i can actually run now and is only 5 weeks ago, and i was a right mess, i was crawling upstairs in the last month as even walking backwards was killing me, and i was wearing tubigrips,support belts and using crutches. and ive had a period and no effects from that. I do have a blog 'SPD' on my page so if anyone wants to look at that and relate youre more than welcome.