Symphysis pubis dysfunction (SPD) is a group of symptoms that cause discomfort in the pelvic region. Treatment may help reduce pain and improve muscle function and hip joint stability.
SPD usually occurs during pregnancy, when the hip joints become stiff or move unevenly. It can happen both in front and behind the pelvis. SPD is also sometimes known as pelvic girdle pain.
This condition is not harmful to the baby but can be very painful. In some, the pain may be so severe that it affects mobility.
Who does it affect?
People who are pregnant are more likely to feel pain from this joint. If you are pregnant, the pelvic area may be painful during pregnancy, during labor, and after delivery. The pain may be from the front of the pelvis, the back, or both front and back. The pelvis may even be loose and wobbly.
Although you don’t have to be pregnant to feel pain in this joint, sports injuries can cause the hip bones to jam or dislocate around the joint area. The cartilage of this joint can wear down over time so that it is less able to support the pelvis bones. Infections and inflammatory conditions can damage the joint.
Causes of pelvic pain during pregnancy
From loosening of the hip joints to pressure from the weight of a growing baby, there are many reasons why people experience pelvic pain and discomfort during pregnancy. The most common causes of benign pelvic pain during pregnancy include:
- Symphysis pubis dysfunction (SPD)
- Round ligament pain
- Accommodation pain
- Diastasis recti
- Ovarian cysts
- Pressure from your baby’s weight
- Urinary tract infection (UTI)
- Braxton hicks contractions
- Constipation
- Vulvodynia
- Miscarriage
- Ectopic pregnancy
- Preterm labor
- Placental abruption
- Uterine fibroids
- Preeclampsia
- Uterine rupture
- Ovarian torsion
- Appendicitis
- Kidney stones
Symptoms
SPD symptoms can vary from person to person, both in severity and presentation. The most common symptoms are:
- Pain in the front center of the pubic bone
- Pain in the lower back on one or both sides
- Pain in the perineum, the area between the anus and vagina
- Sometimes the pain radiates to the thighs, and you may hear or feel a grinding sound in the pelvis.
Pain is often more pronounced when:
- Using stairs
- Putting your weight on one leg
- Walking
- Turning over in your bed
It may also be challenging to open your legs. This can make daily tasks such as getting out of bed, getting dressed, or getting in and out of a car difficult.
How common is SPD in pregnancy?
The incidence of diagnosed SPD is about 1 in 300 pregnancies, although some experts think that up to 25 percent of all pregnant women experience SPD.
Causes
The most common cause of SPD is pregnancy. During pregnancy, hormones such as relaxin are released to relax the ligaments and muscles of the body:
- Hips
- Stomach
- Pelvic floor
- Pelvis
This loosening is meant to increase the range of motion and aid in labor, but it also means that the joints may become unbalanced and move more than usual. This can cause discomfort or pain.
Although this laxity is intended to aid in labor, sometimes these hormones begin to be produced early in pregnancy, so you may experience symptoms of SPD long before delivery.
A child’s weight and position are also thought to affect hip pain. SPD symptoms worsen as the pregnancy progresses.
It is much less common for Symphysis Pubis Dysfunction to occur outside of pregnancy, but it does happen. Other causes of SPD range from pelvic injuries to conditions such as osteoarthritis. In some cases, there is no known cause.
Diagnosis
Early detection can help manage SPD. If you are pregnant and experiencing pelvic pain, talk to your doctor or health care provider. They can refer you to a physical therapist who can assess the stability and strength of your hip joints and muscles. They also help you plan the activities you can do.
Prevention
You can do very few things to prevent Symphysis Pubis Dysfunction during pregnancy. However, it’s more common if you’ve already had a pelvic injury, so it’s always important to take every step to protect this vital area of your body.
What is the difference between Symphysis Pubis Dysfunction and Pubic Symphysis Diastasis?
Both pubic symphysis dysfunction and pubic symphysis diastasis involve the pubic symphysis joint. With symphysis pubis dysfunction, you may feel pain or tenderness in your pelvic area because there’s more movement in that joint than you’re used to.
With pubic symphysis, the joint is completely separated. It may detach due to pressure during delivery. Sometimes the joint is removed (symphysiotomy) if the doctor uses forceps during delivery or has to cut the joint to allow the baby to pass. Pubic symphysis diastasis is rare in 1 in 300 to 1 in 3000 natural births.
Pregnancy complications
Symphysis Pubis Dysfunction is not medically harmful to the baby, and most women with this condition can still give birth naturally. However, chronic pain can lead to sadness or even depression, sometimes thought to negatively affect the child.
Although the symptoms of SPD do not completely disappear until after childbirth, many things can be done to minimize the pain. That’s why it’s so important to get help.
Avoid the following activities if you have Symphysis Pubis Dysfunction:
- Crossing your legs
- Sitting on the floor
- Sitting in a twisted position
- Standing or sitting for long periods
- Putting your weight on only one leg
- Twisting and bending while lifting
- Carrying a child on your hip
- Lifting heavy loads, such as wet laundry, a toddler, or shopping bags
- Vacuuming
- Pushing heavy objects, such as a shopping cart
- Carrying anything in only one hand
Treating SPD during pregnancy
If you are suffering from this pregnancy symptom, there are things you can do to ease your discomfort, including:
- Avoid stimuli as much as possible (sit down, get dressed, and avoid heavy lifting and pushing).
- Place a heating pad or ice pack on the pubic bone. If you use a heating pad, don’t leave it on for more than 10 minutes, as it can raise the baby’s temperature.
- Use a hip support belt. They are readily available online and “corset” the pelvic bones into place during pregnancy.
- Do Kegels and pelvic tilts. Regular exercise helps to strengthen the pelvic muscles.
- Ask for pain relief. If the pain is severe, ask your doctor about pain relievers.
- Consider physical therapy
- Try to feel relaxed by considering the temporary nature of this period and the possibility that the pain will disappear after your child’s birth.
The bottom line
Symphysis Pubis Dysfunction is a relatively common problem that usually occurs during pregnancy. Dysfunction of symphysis pubis or pelvic girdle pain makes it harder to bear during pregnancy. Of course, it is better to know that the occurrence of this disorder does not cause problems for the child.
The main cause of symphysis pubis dysfunction is the relaxation of the mother’s muscles during pregnancy. Many physiological changes occur during pregnancy, one of the most important is the release of relaxin hormone. This hormone helps to relax the ligaments and muscles, and finally, the person has an easier delivery. But if the level of this hormone exceeds a certain limit, the coordination of the joints will be lost, leading to disorders such as inefficiency and pain in the symphysis pubis.
SPD does not directly affect the fetus but may make pregnancy more difficult due to decreased mobility. Some women may also have difficulty giving birth naturally.
Symphysis Pubis Dysfunction symptoms often subside after childbirth. If your symptoms still do not improve, talk to your doctor. If you are looking for a doctor to help you during pregnancy and delivery, Dr. Naim provides the best prenatal care in Los Angeles.
Additional questions
- What is the best sleeping position for SPD?
Lie on your side and place a pillow between your knees and bent legs. This will lighten the pelvis load and support the baby as it grows.
- Can massage help Symphysis Pubis Dysfunction?
Massage can be very helpful in reducing the pain from general pelvic pain experienced during pregnancy and also for SPD pain.
- When does SPD start?
SPD can start at any point in pregnancy but is most common during the third trimester, and many women experience it in the second trimester.
- What is Braxton Hicks Contractions?
Braxton Hicks contractions are felt during pregnancy and may be mistaken for labor contractions. Unlike true labor, Braxton Hicks is irregular in frequency, less intense, and usually goes away with a change of position.
- What is Vulvodynia?
Vulvodynia is persistent, unexplained pain in the vulva. The vulva of the female genital area includes the skin around the opening of the vagina. It can happen to women of any age. Vulvodynia can become a long-term problem that is very uncomfortable to live with, but many things can be done to help relieve the pain.
References
https://www.whattoexpect.com/pregnancy/symptoms-and-solutions/symphysis-pubis-dysfunction
https://www.healthline.com/health/symphisis-pubis-dysfunction#prevention
https://my.clevelandclinic.org/health/diseases/22122-symphysis-pubis-dysfunction
https://www.babycenter.com/pregnancy/your-body/pubic-symphysis-dysfunction_40007958
https://www.pampers.com/en-us/pregnancy/pregnancy-symptoms/article/symphysis-pubis-dysfunction
https://www.parents.com/pregnancy/my-body/aches-pains/pelvic-pain-during-pregnancy/