How to Manage Symphysis Pubis Dysfunction in Pregnancy

How to Manage Symphysis Pubis Dysfunction in Pregnancy

Contrary to many opinions, pregnancy does not have to be riddled with aches and pains. The body is designed to adapt to the changes of pregnancy. Pain suggests that the body is not adapting as well as it could be.

The pubic symphysis is the joint at the front of the pelvis. During pregnancy, the hormone relaxin causes a softening of the ligaments around this joint. Whilst this is completely normal, sometimes it can lead to a painful and troublesome condition called 'symphysis pubis dysfunction' or SPD for short. This is where pain is felt in the pubic bone and/ or groin. Pain can also spread to the buttocks, lower back and back of the leg.

SPD is often referred to as pelvic girdle pain (PGP). The pelvic girdle relates to the whole pelvis, including the pubic bone, as well as the sacro-iliac joints at the back of the pelvis. It's thought that approximately 20% of pregnant women suffer from this condition. However, it is amenable to good management and treatment.

SPD can occur at any stage, even as early as 16 weeks due to hormonal changes, so it's not always an issue related to the size of the foetus. If a woman gets SPD, it doesn't have to continue throughout her pregnancy. SPD can be more common for women who are hypermobile, have had previous children or have poor muscular support.

How to manage SPD:

Avoid crossing the legs, as this causes a torsion ins the pelvis.

Keep the legs in the midline of the body. Pay attention when getting in and out of the car and bath.

When walking, take regular breaks to stretch and rest.

Perch on the edge of the bed to put on tights and trousers (as standing on one leg often exacerbates the symptoms)

Sleep with a pillow between the knees at night to maintain support.

Go to an experienced pregnancy yoga teacher who can help to make adaptations so you can be confident of how to move.

If you're the kind of person who usually just puts up with aches and pains, I encourage you to think differently. If you don't respond to symptoms in an appropriate way, you might find that they worsen and require more intervention later. The earlier you get treatment, the less likely you are to be hindered by the symptoms. Untreated, some women end up on crutches to take the pressure off the pelvis.

Osteopathy for SPD:

An osteopath addresses the whole person and not just a syndrome. This means that they consider the implications for the history of all issues in the body. For example, an old ankle strain might have shifted weight-bearing, which put a strain on the pelvis and led to SPD. Or wearing a heavy bag on one shoulder might be causing an asymmetry through the body which causes symptoms in the pelvis.

Treatment may incorporate soft tissue techniques, joint mobilisations, adjustments where needed and gentle cranial techniques.

Support belts have some value, but they can disconnect you from your awareness of the body so best not to overuse them. For example you might want to wear one for your commute, but keep it off during the day at work.

Other things to consider are that SPD needn't restrict you in childbirth. However it's important to learn positions that can relieve discomfort and find ease in your body.

It's also worth getting support for activities of daily living such as loading the dishwasher or cleaning the bath. Whilst important, these tasks don't have to be done by you.

Feel free to get in touch if you have any questions about SPD.