Find out what causes the pregnancy-related condition symphysis pubis dysfunction, or SPD, and how it can be treated.
Posted: 22 April 2009
Symphysis pubis dysfunction, or SPD, is a fairly common pregnancy-related condition where the pelvic joints become unstable, causing mild to severe pain and mobility problems.
What causes SPD?
In pregnancy, the joints that hold your pelvic bones in place need to loosen so your baby can move through your pelvis during birth. A hormone called relaxin softens the ligaments of the joints to allow for movement.
Sometimes, relaxin softens the ligaments too much and they may overstretch, causing the joints to become unstable and misaligned. This puts a strain on all the joints of the pelvis and prevents one of the joints, called the symphysis pubis, from properly supporting the pelvic bones during movement, causing pain.
Carrying the growing weight of your unborn baby worsens the strain on the pelvic joints, this increase in your weight also affects your centre of gravity, adding to the problem.
What are the symptoms of SPD?
- Pain or discomfort in the pelvic region, usually around the pubis symphysis joint at the front.
- Possible pain in the sacro-iliac joints at the base of the spine.
- Possible pain in the groin.
- Possible pain in thighs.
- Possible pain in hips.
- Possible pain in lower abdomen.
- Pain that worsens when you walk.
- Pain that worsens when you put weight on one leg, such as when using stairs or getting in or out of a car.
- Pain that worsens when you stand up.
- Pain that worsens when you stand for a period of time.
- Pain that worsens when you shift position in bed.
- Pain that worsens when you part you legs.
- You may hear your pelvic joints click as you move.
Expert Tip
You may need to be referred to an osteopath and be advised to keep your legs together when getting in and out of bed or the car, and to avoid activities such as swimming breaststroke.
Anne Richley, midwife
The amount of pain you feel with SPD can vary greatly from the pain other SPD suffers experience. You may feel occasional mild discomfort, or in more extreme cases pain can be severe and for prolonged periods.
Symptoms of SPD can appear anytime from the end of the first trimester. Usually the first symptoms appear around mid-pregnancy.
SPD can continue for a while after birth, and it may even worsen. It usually clears up within a few months of the birth though.
Diagnosing SPD
You need to get a diagnosis from your GP, obstetrician or midwife. Make sure that you give them a full list of your symptoms and don't play down the pain if you want to be helped.
Once diagnosed, you should be referred to an obstetric physiotherapist to treat the SPD.
If you'd like info about pregnancy and birth delivered straight to your computer every week, check out the new Pregnancy Desktop from NHS Choices
