osteopathy Bath, Bradford on Avon, Bristol, Wiltshire and Somerset

   
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Osteopathy & Symphysis Pubis Dysfunction


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SPD stands for Symphysis Pubis Dysfunction. It is a musculoskeletal complaint that may affect women during pregnancy. It doesn't indicate any harm to the baby which is still safely held within the protective confines of the uterus.

The Symphysis Pubis is the joint at the front of the pelvis between the two pubic bones. Normally this joint is held together by strong ligaments. The pregnancy hormones allow these ligaments to relax to enable the baby to pass more easily through the birth canal. In SPD the joint can become unstable and painful.

The most common complaint is pain at the front of the pelvis brought on by activity such as walking, climbing stairs or changing position at night. The pain can also radiate into the buttocks and low back or down the thighs. Movement can become difficult and in the most severe cases walking can be almost impossible. The onset of SPD can happen at any time during pregnancy, but usually starts after the first trimester. For some women it is a temporary discomfort, for others it is more severe. As the baby grows the pressure on the joint can sometimes increase and cause further discomfort. Sometimes a shift in the position of the baby in the womb can make a big difference. SPD usually settles down steadily after the birth of your baby.

If you suspect you may have SPD it is important to discuss it with your midwife. She can offer advice and help you plan for the birth. SPD doesn't mean you will need a caesarean, nor that the birth will be difficult.

There are a number of self help measures that are useful:

  • Sometimes a simple pregnancy tubigrip is sufficient, but a ‘sacro iliac' support belt is a better option. Your midwife or osteopath will be able to help. If your SPD is very severe you may have to resort to using crutches.
  • When rising from sitting or getting into a car try to keep your knees together. Try to avoid lifting or pushing heavy loads. Take small steps and don't rush.
  • Don't overdo it: this could make matters worse. Regular rests are important. This can be tricky if you also have a toddler, so accept all the help that is offered.
  • Sitting often relieves the pain, but sofas are not the best place to relax in pregnancy. Instead use a firmer, higher chair and keep your feet flat on the ground or raised on a stool. Don't cross your legs or tuck your knees to one side.
  • In bed sleep with a rolled towel or pillow between your knees, this will keep the pelvis level. When you need to turn over, you could try moving via your tummy rather than your back. However in late pregnancy this is nearly impossible!
  • As for exercise: swimming is often comfortable whilst in the water, but is not really advised with SPD. Breast-stroke in particular can increase levels of discomfort. Take extreme care with stretching exercises like yoga. The wide legged positions in particular are not advisable.

Finally, a visit to your osteopath can help to relieve discomfort and can help the baby find a more comfortable position to rest in the womb and thus relieve pressure.

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If you require any further information or wish to discuss any problems you may have, please contact the Church Street Practice on 01225 868282, or book in for a free 15 minute consultation.