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Understanding and Managing Symphysis Pubis Dysfunction (SPD) and Pregnancy-Related Girdle Pain (PRGP)
At Santi London, we understand that pregnancy can bring a variety of challenges, including pelvic pain. Symphysis Pubis Dysfunction (SPD) and Pregnancy-Related Girdle Pain (PRGP) are common conditions affecting many expectant mothers. This blog aims to provide comprehensive information about these conditions, their symptoms, and effective treatments to help you manage your pain and enjoy a healthier pregnancy.
What are SPD and PRGP?
Pelvic pain during pregnancy, experienced by 1 in 5 expectant mothers, can range from minor discomfort to severe, debilitating pain. This pain, known as Symphysis Pubis Dysfunction (SPD) or Pregnancy-Related Girdle Pain (PRGP), can make everyday movements like climbing stairs, getting out of bed, or even walking extremely uncomfortable. Nighttime pain can also disrupt sleep, affecting emotional well-being.
Doctors and physiotherapists classify any pelvic pain during pregnancy as PRGP, which includes a collection of symptoms caused by stiffness of the pelvic joints or uneven movement at the back or front of the pelvis.
Understanding SPD
SPD is a type of PRGP caused by a problem with the pelvis, particularly the symphysis pubis joint where two pubic bones meet at the front of the pelvis. The ligaments that strengthen this joint can become weaker during pregnancy due to the hormone relaxin, causing instability, inflammation, and pain.
Understanding DSP
Diastasis Symphysis Pubis (DSP) is another type of PRGP related to SPD, where the gap in the symphysis pubis joint widens too far. This rare condition can be diagnosed with an X-ray, ultrasound, or MRI scan.
Symptoms of SPD and PRGP
The pain from SPD or PRGP can be experienced in various areas, including the hips, pubic bone, perineum, and thighs. Common symptoms include:
- Pain in the pubic area and groin
- Pain over the pubic bone at the front center (level with the hips)
- Back pain or hip pain
- Grinding or clicking sensations in the pelvis
- Pain down the inside of the thighs or between the legs
- Pain exacerbated by parting the legs, walking, climbing stairs, or moving in bed
- Nighttime pain disrupting sleep
- Pain when standing on one leg
- A waddling gait
Occasionally, the pelvic joint may separate, causing more intense pain, a condition known as symphyseal separation or diastasis of the symphysis pubis.
When Does SPD Occur?
SPD can occur during pregnancy when pelvic ligaments soften and become too relaxed and stretchy, struggling to keep the pelvis aligned. Factors contributing to SPD include:
- Previous pelvic damage
- Uneven pelvic movement
- Weight or position of the baby
- Changes in muscle support for pelvic joints
- Prior pelvic injuries or pain
- High BMI or significant weight gain during pregnancy
- Hypermobility in joints
- Multiple pregnancies or large babies
Diagnosing SPD
If you suspect you have SPD, consult your doctor or midwife for a referral to a physiotherapist. Diagnosis involves assessing the stability, movement, and pain in your pelvic joints and muscles. Ultrasound can aid in diagnosis, while X-rays are generally avoided during pregnancy unless necessary.
Treating SPD
Managing SPD involves exercises to strengthen the spinal, abdominal, pelvic floor, pelvic girdle, and hip muscles, enhancing pelvic stability. Treatments include:
- Pelvic Support Belts: These provide relief, especially during activity.
- Gentle Hands-On Treatments: Massage, hydrotherapy, and manual therapies can correct stiffness or imbalance.
- Physiotherapy: Helps make daily activities more achievable and less painful, and can also prepare you for childbirth.
- Acupuncture: Safe during pregnancy and can help reduce pain.
Self-Help Tips for Managing SPD
- Keep Knees Together: When getting up, sitting down, or moving in bed.
- Sleep with a Pillow Between Knees: Helps maintain pelvic alignment.
- Avoid Uneven Positions: Such as sitting cross-legged.
- Take Stairs One Step at a Time: Reduces strain on the pelvis.
- Stay Active: Engage in light exercise without overexerting yourself.
- Supportive Shoes: Wear flat, supportive footwear.
- Avoid Heavy Lifting: Minimize strain on pelvic joints.
Will SPD Affect My Birth Plan?
Many women with pelvic pain can have a normal vaginal birth, but it’s important to discuss options with your midwife. A water birth might be more comfortable, as it allows for easier movement and reduces joint pressure. In severe cases, a cesarean section might be recommended.
Postpartum Recovery from SPD
Postpartum, most women experience improvement in symptoms and joint stability as relaxin levels decrease. If you have had SPD in one pregnancy, you may experience it again in future pregnancies. Early management and physiotherapy can help mitigate pain.
Conclusion
At Santi London, our experienced practitioners are dedicated to helping you manage SPD and PRGP effectively. If you’re experiencing pelvic pain during pregnancy, contact us for a consultation. Our tailored treatments, including massage and physiotherapy, can provide relief and support throughout your pregnancy journey.
For more information or to book an appointment, visit Santi London today and take the first step towards a more comfortable pregnancy.