Pelvic pain in pregnancy (SPD)

Symphysis Pubis Dysfunction (SPD) is a condition where the joint connecting the two sides of the pelvis, called the symphysis pubis, becomes less stable due to the loosening of ligaments during pregnancy. This can lead to significant discomfort and pain, particularly in the pubic area, groin, hips, and lower back. SPD falls under the broader category of pelvic girdle pain (PGP), which refers to any type of pelvic pain during pregnancy. In rare cases, a more severe form called Diastasis Symphysis Pubis (DSP) may occur, where the gap between the pubic bones widens excessively.

**Symptoms of SPD**
Common symptoms of SPD include pain in the pubic area and groin, lower back pain, hip pain, and a grinding or clicking sensation in the pelvis. The pain can worsen with activities that involve parting the legs, walking, climbing stairs, or even turning over in bed. Many women find that the pain intensifies at night, disrupting sleep and making it difficult to perform daily activities.

**Causes of SPD**
During pregnancy, the hormone relaxin is released, which helps to soften the ligaments in the pelvis to prepare for childbirth. However, if the body doesn’t adapt well to this increased flexibility, it can result in SPD. Factors that increase the likelihood of developing SPD include previous pelvic injuries, a history of pelvic girdle pain in previous pregnancies, a high BMI, and joint hypermobility.

**Diagnosis and Treatment**
SPD is typically diagnosed through a physical examination by a healthcare provider, who may refer you to a women’s health physiotherapist for further evaluation. Physiotherapy is the primary treatment for SPD, focusing on exercises to strengthen the muscles supporting the pelvic girdle and improve stability. Other treatments include manual therapy, acupuncture, and using a pelvic support belt.

**Self-Care Tips for Managing SPD**
– Stay as active as possible without overexerting yourself.
– Follow a physiotherapist-recommended exercise routine.
– Avoid activities that worsen the pain, such as sitting cross-legged or carrying heavy objects.
– Use pillows between your knees while sleeping on your side.
– Seek help with daily chores and avoid heavy lifting or pushing.
– When climbing stairs, take one step at a time to reduce strain on your pelvis.
– Consider using a birth pool during labor to ease pressure on the joints.

**Postpartum Recovery**
Most women recover from SPD within a few weeks to months after giving birth. Continuing physiotherapy postpartum can aid in recovery. Some women may experience twinges of pain around the time of their menstrual cycle due to hormone fluctuations. If you had SPD during one pregnancy, it’s likely to recur in future pregnancies, so early intervention and management are crucial.

Taking steps to manage SPD during pregnancy can significantly improve your comfort and quality of life, helping you to enjoy this special time with less pain and worry.