SPD / PGP / Pelvic Pain

What is SPD / PGP?

An adult’s pelvic girdle is a heart (ish) shaped formation of three bones attached to one another by strong ligaments. The three bones are the sacrum, and either side of this the hip bones which are connected by the sacro-iliac joints. These bones are then connected at the front by a ligament called the symphysis pubis. When the symphisis pubis goes out of alignment or becomes overly releaxed Symphysis Pubis Disfunction (or SPD) can occur. This is also sometimes referred to as Pelvic Girdle Pain (or PGP).Normally the ligaments of the pelvic girdle are not very flexible, but when you become pregnant you will produce a hormone called relaxin. Relaxin helps to softens the ligaments to allow some pelvic movement for the birth of the baby.


Diastasis Symphysis Pubis (DSP)

is a more extreme but less common condition which causes severe and often excruciating pain and is normally detected by Ultrasound or X-Ray.

There are several reasons that experts attribute as to the cause of pelvic pain during and post pregnancy although there seems to be no universal agreement on this. However, it is commonly thought that the hormone, relaxin, may be a large part of the problem as it causes the ligaments to become too loose too soon. This can result in mild to severe pain at a time when a woman needs the support of her pelvis more than ever due to the extra strain and weight putting pressure on the pelvic area.

What causes SPD?

Experts consider many factors that may cause pelvic pain or SPD although there is no common agreement on this. These factors include misaligned pelvises, previous pelvic problems, previous problem births, high hormone levels prior to pregnancy, or overproduction of hormones during pregnancy.

PGP or SPD can occur from around the 12th week of pregnancy onwards, but it is also recognised as a postnatal issue. Some women may suffer from it during pregnancy, after pregnancy or both and with every pregnancy or sometimes just one of their pregnancies.

Symptoms of SPD

The symptoms of SPD vary from woman to woman but can include:-

Pain and tenderness in the area of the symphysis pubis joint

Pain in the hips, lower abdomen and groin

Pain in the inner thighs and in the buttocks

Walking and other activities such as climbing stairs, bending to pick things up, getting in and out of cars, lifting things, moving in bed and spreading the legs past a certain point can all exacerbate the pain. There can be a clicking feeling or noise during hip movement.

You may also feel as though you are waddling or shuffling to minimise the pain when moving.

How can SPD be treated?

Always consult a doctor or your midwife if you are experiencing pain (over and above the normal aches of pregnancy) in the pelvic area particularily if you feel you need medication to aid with the management of pain associated with SPD.

GPs and other health care professionals will know which painkillers or anti-inflammatory drugs are suitable for your particular stage of pregnancy. If SPD has started after the birth of your baby, or continued from pregnancy you should still see a doctor if you are breastfeeding and in need of medication.

There are other treatment methods available including TENS machines, pelvic supports/belts, pelvic floor exercises, physiotherapy and/or massage.

Massage for the treatment of SPD

Massage can be extremely beneficial in reducing pain from general pelvic pain experienced during pregnancy as well as for the pain of SPD. It is also beneficial as a way of relieving muscle tension, reducing muscle/joint pain, promoting health during pregnancy by increasing the delivery of nutrients and oxygen around the body and promoting general well-being and relaxation.

Massage during pregnancy can help support the physical changes of pregnancy by improving muscular and hormonal imbalances. It is also possible to help mobilise and re-align the pelvic girdle giving pain relief and increased stability in the area. In addition, the general stimulation of the skin, and all of the systems working beneath it (skeletal, muscular, etc) will encourage the production of your bodies natural pain relief - endorphines. After your baby is born it is important to continue with regular massage which will help in the realignment of the pelvis and correct posture.

Self Help for the management of SPD

There are a range of things that you can consider on a daily basis to minimise the pain of SPD during pregnancy which include:

Rest as much as possible. Try to have some daily bed rest.

Think about your posture when doing daily tasks. For example get into the car by sitting on the seat first, and then lift your legs inside, get dressed while sitting on a chair rather than standing etc

Try to keep your knees together when turning over in bed.

Avoid lifting additional weight such as shopping bags and toddlers (easier said than done!)

Avoid positions where your legs need to be open i.e straddled accross something (!!)

Listen to your body - if you are walking or doing the shopping and your pain levels increase then you are walking too far or doing too much shopping!

Book an appointment

To book a pregnancy massage or post natal / new mum massage