Symphysis Pubis Dysfunction, also known as SPD, is a common painful condition associated with pregnancy in which the ligaments responsible for the proper alignment of your pelvic bone become relaxed and stretchy. As a result, the symphysis pubis or the pelvic joint becomes unstable, causing moderate to severe pain along with certain other symptoms.
What Causes Symphysis Pubis Dysfunction during Pregnancy?
Your body produces special hormones during pregnancy to help the fetus grow properly and to prepare for childbirth. Relaxin is one such hormone that relaxes your ligaments and makes them stretchy so that you can easily deliver the baby. But sometimes, the relaxin starts functioning too early and the ligaments around the pelvic bone become loose and unstable long before the baby is developed enough to come out. This leads to instability and pain in the pelvic area.
Symphysis Pubis Dysfunction Risk Factors
The following factors contribute to the chances of developing SPD:
- Gaining excessive body weight during pregnancy
- Having an elevated BMI (Basal Metabolic Rate)
- Multiple pregnancies
- Expecting a large baby (sometimes, gestational diabetes leads to gestational weight gain which increases birth weight) or twins
- Poor posture, strenuous activities and jolting movements
- The position of the fetus
- The health and capacity of the connective tissues often affect the stability of the pelvis
- A history of a fracture or trauma to the pelvis
Symphysis Pubis Dysfunction Symptoms
Apart from the lower abdomen and pubic pain and discomfort, SPD may also lead to the following symptoms:
- Severe pain that tends to get worse when you lift your legs for getting into bed or a car
- Difficulty to move the lower part of your body when you wake up in the morning
- Pain that gets worse when you lie on your back
- Pain that worsens when you try to turn over in your bed
- Reduced range of movement of the hip bones, causing difficulty walking
- Pain shooting down your buttocks and legs (sciatica)
- A clicking sound near the pelvic area when you walk or move your legs
- Urinary incontinence (rare cases)
In some very rare instances, the pelvic joint may get dislocated noticeably, causing serious pain in the pelvis, hips, groin and buttock. This condition is known as Diastasis Symphysis Pubis.
Symphysis Pubis Dysfunction Diagnosis
The diagnosis involves a thorough examination of your medical history while the doctor may also ask you a few questions about your daily routine and lifestyle. Diagnostic tests like ultrasounds can also be used for confirming the diagnosis. X-rays are not used for this purpose unless necessary.
Symphysis Pubis Dysfunction Pain Management
SPD is a common disorder and does not always require medical treatment. You can keep the pain under control by following the guidelines mentioned below:
- Get plenty of rest
- Try lying on your side instead of on your back
- Make sure to lift both legs together during activities like getting in a car and rolling in bed. Squeeze the knees together instead of separating them as this helps to stabilize the pelvic joint.
- Improve your postures and walk straight
- Make sure to use a pillow to support the lower back region when sitting. It helps to use lots of pillows and cushions on your bed
- Using a cushion for support while travelling in the car is also helpful
- Avoid sitting straight in an unsupportive chair for a long time as it causes further pelvic strain
- Do not wear heels higher than 3 to 4 cm for reducing the strain on your lower back
- Never sit with your legs crossed even during an exercise or yoga session
- Avoid any exercise that involves standing on 1 foot, bouncing or jarring
- Avoid riding on a bike as this puts further strain on the pelvic joint and increases the chances of dislocation
Symphysis Pubis Dysfunction Treatment
The treatment often varies depending on the symptoms present.
- Home Remedy: Applying insulated icepacks on the pelvic area can help to reduce pain and swelling. You can use this remedy once every few hours, making sure that the application time never exceeds 5 to 10 minutes.
- Physiotherapy: Manual therapy and relaxation exercises can be useful for relieving the pain. Physiotherapy increases the range of movement of your hips, pelvis joint and spine. Exercises that focus on strengthening the pelvic floor muscles are particularly useful for this purpose.
- Acupuncture: Applying controlled pressure on certain pressure points on your body can reduce the pain considerably.
- Pelvic Support Belts: Rigid and non-rigid pelvic support belts or girdles available in the market can provide significant relief from the painful symptoms. These devices help to correct the alignment of the pelvic bones, thus reducing the severity of the symptoms. The corsets are custom fitted by physiotherapists so that they can adjust properly to your abdomen. The support belts can be worn throughout the day and also during the night so that you are able to sleep.
- Osteopathy Treatment: In some cases, a gentle osteopathy treatment can be helpful for fighting the condition. Make sure to contact a certified osteopath as a wrong treatment session can aggravate the symptoms considerably.
- Medications: Analgesics can be used for relieving severe pain that cannot be managed by any of the above remedies. However, it is essential to consult your physician before taking any medicines to avoid any unpleasant side effects.
- Homeopathy: There are certain homeopathic medicines that can successfully reduce the pain and inflammation. But, it is not advisable to use any such remedies without consulting a certified homeopath.
How Long Does Symphysis Pubis Dysfunction Last?
Usually, the pelvic joint regains its stability gradually after childbirth. The ligaments in the pelvic area become firmer once the body stops producing the hormone relaxin. As a result, the painful symptoms of SPD begin to subside slowly, going away entirely after a certain period.[ref]