Symphysis pubis dysfunction ( SPD) or Pelvic Girdle Pain ( PGP)
I suffered with SPD in both of my pregnancies and I shudder when I think about it and remember the pain. One pregnancy was definitely worse than the other and I think knowing about it, what it is and how to try to manage it helped. Hearing women’s stories of their symptoms helped put mine into perspective and I now think I got off lightly (although I didn’t think so at the time).
There are many causes of pelvic pain in pregnancy with PGP being one of the causes. PGP is caused by stiffness or movements of the pelvic joints in pregnancy. One in five women are affected. It can cause inflammation and pain and can occur at any stage of pregnancy. Hormonal changes in pregnancy are not the cause of PGP as many people think. Yes, hormone changes can cause the ligaments to soften but in PGP it is usually caused by an underlying pelvic stiffness or back problem, a slip or fall during pregnancy, or postural problems that can cause irritation to a joint. This may be work related or due to something you do repetitively. The pain and symptoms of PGP may take up to 6 weeks postpartum to ease although some women will notice an improvement sooner than this. If your pain is continuing for longer than 6 weeks after the delivery of your baby please speak to your GP.
PGP is caused by the pelvic joints becoming unstable or stiff which can cause inflammation and pain. Some pain is more of a dull ache but women affected with bad pain can find maintaining normal activities difficult with an impact on emotional wellbeing also. Please speak to your midwife or GP if you feel the pain is affecting your mood.
Symptoms
- Low back pain
- Pain worsens when walking/climbing ( due to the legs being parted)
- Low back pain
- Clicking /grinding sensation in pubic area.
- Pain in the perineum ( between your vagina and anus).
Can it be treated?
Yes the symptoms can be treated and you do not need to suffer in silence. Your baby is is not affected by PGP but you may need to speak to your midwife or GP for advice/support and they may advise referral to a physiotherapist.
Your GP or midwife will be able to advise on analgesia that is safe to take in pregnancy to help ease the pain. Some women will opt to manage the pain with alternative therapy alongside medication and physio or instead of. A therapist with experience in PGP would be advisable to ensure the right and safe therapy for you. You can also help reduce the symptoms by avoiding anything that may aggravate the PGP, such as avoiding standing for long periods of time and anything that involves parting legs, including breast stroke when swimming. If you are having treatment with a physiotherapist they will be able to advise on care during labour and delivery.
The Pelvic, Obstetric and Gynaecological Physiotherapy ( POGP) network offers advice including remaining as active as possible (pain allowing) but avoid activities that make the pain worse. There is lots of support and guidance available through the NHS and other recognised organisations so you are not on your own.