Pregnancy is a time of big emotions and life changes — unfortunately for some, it can be difficult, either physically or mentally (or both). While pelvic pain of some sort or another is just par for the course for some pregnant people, some of us are exceptionally "lucky" and develop symphysis pubic dysfunction. What is SPD, and what the heck can we do to make it better?
While the phrase "symphysis pubis dysfunction" might sound complicated, if you break it down, it's easier to understand. The symphysis pubis is a joint found in the very front part of the pelvis directly in front of the bladder and contains cartilage that allows for some movement, especially during childbirth. It also works to keep the two bones of the pelvis together and steady during normal activity.
Dysfunction, when paired with symphysis pubis, means that the joint isn't working as it should. As you can imagine, this results in pain that can range from mild (yet livable) to totally debilitating with a major impact on your quality of life. While pregnancy alters a person's pelvic load, hormones can hasten relaxation of ligaments in the area, which can lead to the perfect storm of a pelvic nightmare.
Symptoms can include:
Lynda McClatchie, a registered physiotherapist, notes that SPD can also cause more intense pain during certain activities. "Symphysis pubis dysfunction is fairly common for women during pregnancy and is often quite painful at the lower front of the pelvis when raising a leg, rolling over in bed or moving your legs to get out of bed — anything where your weight is not distributed evenly," she says.
While pregnant people aren't ordinarily X-rayed because it isn't recommended during pregnancy, experienced practitioners can usually diagnose it with a physical exam (yes, this means your care provider will poke around on your sore spots) and possibly pair it with a sonogram to measure symphysis pubis separation.
There are a number of ways SPD can be treated. McClatchie says, "It is sometimes helpful to wear a sacroiliac joint belt — this is a non-stretchy belt that will Velcro quite tightly around your pelvis for external support." She says that often, this will provide immediate relief.
There are other things you can do in your daily life that can also improve your level of discomfort. "Sleep on your side rather than your back and roll onto a side like a log, so you aren’t using your back, abs and legs," explains McClatchie. She also recommends pelvic floor muscle exercises (aka Kegels), which can improve the support structures of your pelvis.
Other measures recommended by health care providers can include acetaminophen, ice, stretching, using a pillow between the knees during sleep, regular breaks from sitting, staying active and careful coordinated movement. In severe cases, lumbar epidural injections can break the pain cycle, and hospitalization for pain relief can become necessary if your condition is severe enough.
If you're having pelvic pain that sounds like it could be SPD, bring it up to your doctor or midwife as soon as you can. While it is generally not dangerous for your baby, it can be and sometimes is debilitating for a parent-to-be. In addition to helping you manage your pain, they will also keep note of your status through delivery and in the postpartum period — because although some symptoms completely resolve, that's not always the case.
Getting help is always a step in the right direction, and your health care provider will be able to work with you to get your pain under control as best they can.
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