Symphysis Pubis Dysfunction (SPD)

SPD

The symphysis pubis is a stiff joint that connects the two halves of your pelvis. This joint is strengthened by a dense network of tough, flexible tissues. Your body produces a hormone called relaxin, which softens your ligaments in order to help your baby pass through your pelvis. Your pelvic joints move more during and just after pregnancy. This can cause inflammation and pain. 

Symptoms 

Pain in the pubic area and groin are the most common symptoms, though you may also have the following signs: 

Back pain, pelvic girdle pain or hip pain.

A grinding or clicking sensation in your pubic area.

Pain down the inside of your thighs or between your legs. It can be made worse by parting your legs, walking, going up or down stairs or moving around in bed.

Worse pain at night. SPD can prevent you from sleeping well. 

Causes of SPD

SPD is thought to be caused by a combination of hormones that you produce during pregnancy, as well as the way your body moves. If one side of your pelvis moves more than the other when you walk or move around, the area around the symphysis pubis becomes tender. 

The size of the gap in your joint doesn't bear any relation to the amount of pain you may feel. Many women with a normal-sized gap feel a lot of pain. You may be more likely to develop SPD if you started your periods before you were 11, or are overweight.

When does SPD happen?

SPD can occur at any time during your pregnancy or after giving birth. You may notice it for the first time during the middle of your pregnancy. 

If you have SPD in one pregnancy, it is more likely that you'll have it next time you get pregnant. The symptoms may also come on earlier and progress faster, so it is important to seek help promptly. It can help if you allow the symptoms from one pregnancy to settle before trying to get pregnant again.

How is SPD diagnosed?

SPD is becoming more widely understood by doctors, physiotherapists and midwives. Your doctor or midwife should refer you to a women's health physiotherapist. Your physiotherapist will test the stability, movement and pain in your pelvic joints and muscles.

How is SPD treated?

Exercises, especially focused on your tummy and pelvic floor muscles. These will improve the stability of your pelvis and back. You may need gentle, hands-on treatment of your hip, back or pelvis to correct stiffness or imbalance. Exercise in water can sometimes help.

You should also be given advice on how to make daily activities less painful and on how to make the birth of your baby easier. Your midwife should help you to write a birth plan which takes into account your SPD symptoms.

A pelvic support belt will give quick relief.