Got lower Backache? & Other Symptoms? Come & Read..

Discussion in 'Pregnancy - Third Trimester' started by Mummy.To.Be, Dec 9, 2009.

  1. Mummy.To.Be

    Mummy.To.Be Guest

    Ever heard of:
    SPD? (Symphysis Pubis Dysfunction)

    Well, I just found out that I have this!
    Seeing a physiotherapist about it, have been
    given an orthopaedic maternity belt and pelvic
    floor exersises to do!

    Thought I'd give a thread for all you ladies who
    wonder what these pains you're feeling could possibly be!
    (I'm no doctor & this isn't advice or a diagnosis
    but something for you to know about and possibly
    ask your GP or MW about if you're concerned!)


    What is symphysis pubis dysfunction?

    The two halves of your pelvis are connected at the front by a stiff joint called the symphysis pubis. This joint is strengthened by a dense network of tough, flexible tissues, called ligaments. To help your baby pass through your pelvis as easily as possible, your body produces a hormone called relaxin, which softens the ligaments. In a non-pregnant pelvis, these do not move or give very little movement if required.

    As a result, these joints move more during and just after pregnancy causing inflammation and pain, known as symphysis pubis dysfunction or SPD.

    What causes SPD?
    We are not sure exactly what causes SPD, but it's thought that if one side of the pelvis moves more than the other when you walk or move your legs, the area around the symphysis pubis becomes tender (Buyruk et al 1999; Damen et al 2001). The amount of discomfort isn't related to the size of the gap in the joint. Many women with a normal-sized gap feel a lot of pain.

    When does it happen?
    SPD can occur at any time during your pregnancy or after giving birth. Many women notice it for the first time around the middle of their pregnancy. If you have SPD in one pregnancy, it is more likely that you'll have it again next time you get pregnant.

    The symptoms may also come on earlier and progress faster, so it is important to seek help promptly. It can help if you allow the symptoms from one pregnancy to settle before trying to conceive another child.

    What are the symptoms?

    Pain in the pubic area and groin are the most common symptoms. But you may also have the following signs:

    •Back pain, pelvic girdle pain or hip pain.

    •Pain around the groin area.

    •A grinding or clicking sensation in your pubic area.

    •Pain down the inside of your thighs or between your legs. It can be made worse by parting your legs, walking, going up or down stairs or moving around in bed.

    •Worse pain at night. It can stop you sleeping well and getting up to go to the toilet in the middle of the night can be especially painful.

    How is it diagnosed?

    SPD is becoming more widely understood by doctors, physiotherapists and midwives. Your doctor or midwife should refer you to a physiotherapist who will have experience in treating it. She will diagnose it by listening to your description of your symptoms and by testing the stability, movement and pain in your pelvic joints.

    How is it treated?

    SPD is often managed in the same way as pelvic girdle pain, and treatment will include:

    •Exercises, especially for the tummy and pelvic floor muscles, to improve the stability of your pelvis and back. You may need gentle, hands-on treatment of your hip, back or pelvis to correct stiffness or imbalance. Exercise in water can sometimes be useful.

    •You should also be given advice on how to make daily activities less painful and on how to make the birth of your baby easier. Your midwife should help you to write a birth plan which takes into account your SPD symptoms.

    •Acupuncture may help, but make sure your practitioner is trained and experienced in working with pregnant women.

    •Osteopathy and chiropractic may help, but again, make sure you see registered practitioner who is experienced in treating pregnant women.

    •A pelvic support belt will give quick relief.

    Self-help tips

    There are things you can do yourself to ease your pain:

    •Regular pelvic floor and tummy exercises can ease the strain on your pelvis. Get down onto your hands and knees and level your back so that it is roughly flat. Breathe in and then as you breathe out, squeeze in your pelvic floor muscles and at the same time pull your belly button in and up. Hold this contraction for between five and 10 seconds without holding your breath and without moving your back. Relax the muscles slowly at the end of the exercise.

    •Avoid moving your legs apart when your back is slumped or you are lying down. Take care when getting in and out of the car, bed or bath. If you are lying down, pulling your knees up as far as you can stops your pelvis from moving and makes it easier to part your legs. If you are sitting, try arching your back and sticking your chest out before parting or moving your legs, as this also helps to stop the pelvis from moving.

    •Avoid pushing through any pain. If something hurts, if possible don't do it. If the pain is allowed to flare up, it can take a long time to settle down again.

    •Move little and often. You may not feel the effects of what you are doing until later in the day or after you have gone to bed.

    •Rest regularly by sitting on an exercise or birth ball or by getting down on your hands and knees. This takes the weight of the baby off your pelvis and holds it in a stable position.

    •Avoid heavy lifting or pushing. Supermarket trolleys can often make your pain worse, so shop online or ask someone to shop for you.

    •When climbing stairs, go up them one step at a time. Step up onto one step with your best leg and then bring your other leg to meet it. Repeat with each step. Only use stairs when you have to.

    •Avoid swimming breaststroke and take care with other strokes. You may feel swimming is helping your pain while you are in the water, but it could make you feel worse when you get out.

    •When getting dressed, sit down to pull on your knickers or trousers.

    Best of luck ladies!
    I know how painful and uncomfortable this can make your everyday tasks!

  2. evilnurse101

    evilnurse101 Member

    Jan 26, 2010
    Likes Received:
    I had a basically flawless pregnancy up until a couple of weeks ago. Figured I'd be doing cartwheels at work up until close to my due date until this hit me. In a matter of a day I was eating my words about how great I was feeling and how I seemed generally like myself throughout the past 8 months (minus the big ol belly and national geographic boobs I mean haha) SPD has thrown me for a loop over the last while and even though my range of motion has improved and I am not feeling quite so much like one of my 99.9yr old osteoarthritic patients anymore I am still finding myself experiencing a lot of shooting pain along my pelvic bone (predominantly the left side). Pain in my groins comes in intervals and worsens quickly after periods of over exertion to the point where I find it difficult to lift my leg to put on my gitchies, step into the car, etc etc etc. My OB put me off work last week to rest and it has been of benefit however I do not feel that I will be able to handle going back to work right away as my job involves a lot of hands on care, walking up and down the ward for most of the 8 hrs, pushing a heavy med carts/ getting down to floor level to do dressings/ treatments at times etc. I am being taken off for another two weeks in order to assess the effectiveness of physiotherapy in the off chance I may be able to return to work until my mat leave start date. I am curious as to how many others have participated in physiotherapy for PSD/ pelvic girdle pain and how effective it was in terms of increasing activity tolerance/ range of motion. I am just shy of 34 wks and wondering realistically whether or not I should expect the physio to be of enough benefit to get me through those last couple of work weeks or whether she'll be taking me off work early for good.
  3. CocoaOne

    CocoaOne Well-Known Member

    Jun 11, 2009
    Likes Received:
    MI'M not sure if I've got the beginnings of this or if it's just normal aches and pains. Does it come on very suddenly or gradually?

    For the past few days I've had discomfort (not really pain) that's a bit like the saddlesore you get from riding bikes- but it's more right at the top of my inside thighs than my pelvis I think. I'm ok going up stairs, walking, sitting etc, but I'm aware of more discomfort at night when I try to turn over in bed which seems to be lessened if I make sure my kness are together. One night I had pain when I was taking my trousers off too, but it's been ok since. I really hope it doesn't progress to SPD because it sounds awful, and like you, I've had a great pregnancy so far!

    I'll mention it to my MW next week. Thanks for sharing :hugs:

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