Osteopathy can be wonderfully effective in relieving pain and discomfort during pregnancy and in the recovery period. Perhaps the most common presentation of pain we see is symphysis pubis pain (pelvic pain), which is related to something called SPD..
What is SPD?
Symphysis Pubis Dysfunction (SPD) is the term used to describe pain that is experienced in the back, front and sides of your pelvis during pregnancy. The pain is often felt below the tummy, directly over the pubic bone, around the sides of the hips and in the lower back. 1 in 5 pregnant women experience mild pain/discomfort in the back but particularly the front of the pelvis during their pregnancy. If these symptoms persist after a few days and start interfering with day-to-day life then you should get your midwife, doctor or osteopath to examine you as you may have SPD.
SPD is common and I treat many pregnant women at the clinic for this. The sooner it can be identified and assessed, the better it can be managed, helping to reduce the impact of SPD on your life.
The red shading in the image below indicates areas of pain that can be experienced in SPD
*Image credit: Sydney Women’s Physiotherapy
Signs and symptoms
Below are some of the signs and symptoms you may experience during or after your pregnancy.
- Difficulty in walking
- Pain during normal day-to-day activities
- Clicking and grinding in pelvic area
- Pain and/or difficulty moving your legs apart (getting in and out of the car)
- Difficulty lying in certain positions (side lying)
- Pain when weight-bearing on one leg (putting your trousers on, getting out of the bath tub, walking up and down stairs)
- Limited movement with/without pain during hip movements (turning in bed)
- Pain during sexual intercourse
As you can see there is a wide range of symptoms and for some women the pain and discomfort is far more debilitating that for others. If SPD is diagnosed and managed correctly in the early stages, then it is possible for the symptoms to completely resolve. In a small number of cases, however, the symptoms may persist after the birth of your child. These cases are particularly common in women if left untreated.
Causes of SPD
There isn’t always an obvious reason for the cause of SPD. Normally it is due to multiple reasons, which include:
- Hormones released by the body during pregnancy can cause a laxity in the ligaments and muscles which can destabilise joints
- A change in activity of the muscles in your pelvic floor, pelvis, hips and stomach can lead to a destabilisation in the pelvic girdle
- A previous accident, injury or weakness affecting your hips or pelvis
- Sometimes the position of the baby could produce symptoms related to SPD
You are at increased risk of developing SPD if:
- You have previously injured your pelvis
- Your job is physically demanding on the body
- You have previously suffer with SPD during other pregnancies
- Your body weight has increased before and/or by the end of your pregnancy
Management and treatment
If your symptoms do not settle with general advice given to you by you midwife or doctor, you might want to think about coming to see an osteopath. We will take a detailed case history and will assess your pelvic alignment and stability. We will decide on the relevant treatment and management approach for you and offer specific advice to help assist you through this painful condition.
Osteopathic treatment will aim to improve your pelvic and spinal joint position and stability and relieve pain and improve muscle function. Treatment may include:
- Mobilisation of the pelvic and hip joints
- Exercises to relieve tight muscles and stiff joints and to assist in strengthening and improving the stability of your hips, pelvis and lower back and stomach
- Exercises performed in the water
- Advising on equipment such as a support belt to assist in the management of your symptoms
- Advice on: back care, lifting objects, carrying toddlers and/or new born babies post pregnancy
- Types of pain relief (e.g. Ice/heat and TENS)