SPD – Symphysis Pubis Dysfunction (Pregnancy Pelvic Pain)

This is pelvic pain that arises predominantly in pregnant women due to the softening effects of pregnancy hormones on the ligaments that support the pelvis. Classically it is felt at the front of the pelvis, but can also be experienced in the groin and low back, and can vary from mild to extremely painful. Typically walking, climbing stairs, getting in and out of the car or bath and standing all aggravate the symptoms.
Medically, not much can be done, since the options for pain-killers in pregnancy are very limited, most medical advice revolves around management, for example:-
• engage your core muscles & pelvic floor, avoid lifting & carrying or stepping over things
• avoid ‘straddle’ movements of the legs, bend the knees & keep the legs ‘glued together’ when turning over in bed, getting out of the car etc.
• avoid twisting movements of the body, sit down for tasks where possible
• avoid sitting in low sofas – try to sit on higher chairs with arms for support
• place a pillow between the knees at night when sleeping on your side

In extreme cases, crutches or a wheelchair may be necessary, but for most women it isn’t that severe, and there are some aids which may help:-
Sacro-iliac support belt e.g. Serola . This stabilises the ligaments of the pelvis and provides support for the muscles of the back – I have a loan belt at the practice which you can try before deciding whether to buy your own, every mum-to-be I have lent it to has gone out & bought their own, which may not be scientific evidence for whether it helps or not, but certainly says something!
Axiss Car Seat – for those mums who already have another child between 9 months & 4 years, getting them in & out of the car can involve all sorts of movements on the ‘things to avoid’ list – straddling, twisting & lifting! The Axiss Car Seat has a lockable swivel so that you can turn the seat to face the door to get your child in and out before turning it back & locking it in position. Comes highly recommended by a patient who has suffered from SPD in all her pregnancies.

From an osteopathic viewpoint, with many of the pregnant ladies I see who are suffering from SPD, there are often other areas of the body that are in some way restricted or limited (for example, sacro-iliac joints themselves, pelvic floor & diaphragm tension, old ankle/knee/hip injuries, tension in the upper back and neck) which means that the whole body is not adjusting to the postural and physiological changes of pregnancy as well as it could. Often by working on these other areas, releasing tension, getting stiff joints moving etc., the impact of the changes on the pelvic joints themselves can be reduced, helping mums to be more comfortable during this period of change and preparation for the birth.

To discuss your individual circumstances, please call Helena on 07805 650667 for further information.