Symphysis Pubis Dysfunction in Pregnancy

What is Symphysis Pubis Dysfunction (SPD)?

SPD, also known as pelvic girdle pain (PGP), is defined as mild to severe pain over the pubic symphysis, which can extend down into the groin and medial thighs. Some studies report that up to 50% of pregnant women have some type of PGP prior to 20 weeks gestation.

The pain may be related to an underlying problem that has not previously caused pain, or may start after an injury, often minor, during pregnancy or birth. There may be factors which can make it more troublesome including weak ‘core stability’ and pelvic floor muscles, previous injuries, spinal problems, muscle tensions or other structural imbalances. Such underlying conditions combined with the increasing weight of the growing baby and softening ligaments affect the normal transference of weight and movement through the pelvis and hips.

What are the symptoms?

The foremost symptom of SPD is pain or discomfort in the pelvic region, usually concentrated around the pubic symphysis at the front. Pain can also extend to the sacro-iliac joints at the base of the spine, the groin, thighs, hips, lower abdomen and back.

The amount of pain women with SPD experience can vary. Some women only feel occasional mild discomfort whist in more extreme cases, pain can be severe and disabling. Symptoms can appear anytime from the end of the first trimester and may even occur after birth. Symptoms most commonly appear around mid-pregnancy.

Symptoms are aggravated by anything that puts a shearing or pulling movement through any of the joints of pelvis, particularly the pubic symphysis, in particular…

How does osteopathic treatment help?

If a patient is seen early enough within 16-22 weeks, we can normally get symptomatic relief after 4-5 treatments.

Using osteopathic techniques, we can…

What can someone suffering with PSD or lower back pain in pregnancy do to help?

PELVIC AND BACK PAIN IS NOT NORMAL DURING PREGNANCY. Ask for help as soon as you discover pain and consult with a good manual therapist (osteopath).

Should I avoid any exercises?

What exercises are recommended?

• Core stability exercises for pelvic floor

• Strengthening of the deep abdominal muscles (they are the only muscles that can attach directly onto the pubic symphysis). This needs professional advice and if you are working with a trainer they should speak to your osteopath.

Post-Natal Recovery

If you had pubic pain during pregnancy, it is advisable to see an osteopath or manual therapist as soon as you can after birth to ensure that your pelvic joints are aligned to speed up your recovery and to receive specific advice about starting exercise ASAP!

Many women find that the pain and discomfort felt during pregnancy soon go after the birth. However, it is important that the first few days and weeks are spent resting as much as possible; still no weight bearing or long strident walks.

After this, you may start doing appropriate gentle exercises to strengthen your core abdominal and pelvic floor muscles.