County Osteopaths : What causes SPD (Symphysis Pubis Dysfunction)?

“DO’s”

• Get some manual treatment e.g. osteopathy

• Wearing a support belt around your body to hold in the “bump” and support the lower back can help. These come in several forms from a thin strap that just covers the symphisis pubis to a broad Tubigrip which covers the whole bump. You can buy tubigrip in chemists and straps and belts can be bought on the internet. You could try physiomedhomecare.co.uk.*

• Try putting a pillow between your knees in bed at night.

• Take the weight off your back for a while by floating in a warm swimming pool. The Hydrotherapy pool at your local hospital may be available to you at specific times by arrangement with your Doctor or Physiotherapist.

• Antenatal yoga classes may help as they stretch the lower back and hip muscles reducing the strain on the symphysis pubis.

• Homeopathy helps to reduce pain and inflammation safely during pregnancy when orthodox drugs cannot be taken. Consult a qualified homeopath who has experience in treating pregnant women.

It’s a good idea to get some osteopathic treatment after your baby is born as if any underlying imbalances persist they may cause symptoms such as back aches, knee pain or coccyx tenderness.

“DON’T’s”

• Avoid sitting in low chairs – getting out of them will strain your symphysis pubis.

• Avoid heavy lifting and pushing supermarket trolleys.

• Be careful when pushing pushchairs, sudden jolts or going round corners can strain your symphysis pubis.

• Do less heavy work and avoid long walks. When walking keep your stride short.

• Sitting or lying down too much can become painful so keep gently active with frequent short rests sitting in an upright chair, perhaps with a cushion under you.

Pelvic Girdle Pain (PGP) formerly known as Symphysis Pubis Dysfunction (SPD) is pain in one or more of the pelvic joints during pregnancy - usually painful loosening of the symphysis pubis joint.

The symphysis pubis is a joint at the front of the pelvis in the bone just beneath the pubic area. The pain can be so extreme that, if effective treatment is not given, sufferers have been known to need crutches or a wheelchair to get around during late pregnancy.

For “Treatment For PGP / SPD” please see below.

The symphysis pubis is normally a strong joint that only moves a little. However, in pregnancy the pelvic ligaments and joints loosen due to a hormone called Relaxin, which is produced by the body to aid childbirth.

In some women, the symphysis pubis becomes strained so as to be painful whenever the pelvis is moved in a certain way, this strain may cause the pain known as PGP / SPD.

The pain is experienced mostly when particular movements are performed such as turning over in bed, getting out of a chair, going up and down stairs and manoeuvering a supermarket trolley or pushchair. The pain is felt directly over the pubic joint and can be severe.

In many cases there may be an underlying musculoskeletal problem in the lower back, leaving the weight of the bump to drop forwards against the pubic bone and strain the pubic symphysis. The “hollow-back” posture that goes along with this, further strains the lower back and may perpetuate the difficulty throughout the pregnancy if nothing is done. In some cases there may be an underlying problem in the hips, legs, sacro-iliac joints or the sacro-coccygeal joint.

SPD tends to recur with subsequent pregnancies unless effective treatment is given.

Your Doctor may refer you to a Physiotherapist where you may be offered a support belt and advice. Manual treatment may also be offered if the advice and a belt do not help by themselves.

At County Osteopaths we treat PGP / SPD by manual treatment and advice. Our approach involves a thorough assessment where your joints are gently tested to diagnose where the imbalances lie. Treatment consists of working gently on any stiff joints and overly tense muscles to restore them to good working order. The treatment is performed carefully and should not be painful. It is safe to have osteopathic treatment during pregnancy. Osteopaths may also help with other types of pregnancy discomfort such as abdominal aches, rib pain, sciatica, back pain and headaches.

Simple cases of PGP / SPD may improve quickly with osteopathy. Complex cases may be require regular treatment throughout the pregnancy.

What is the long-term outlook for an PGP / SPD sufferer?

The outlook is good as the pain almost always goes soon after the baby is born and if it does not, residual symptoms may be alleviated by manual treatment such as osteoapthy.