SPD in pregnancy??

Justie

I sympathise Welshlassie I've been having problems since about week 12 too. When it was first mentioned to 2 GPs and a midwife nothing was done and I was told to just take paracetamol. I kept mentioning it and finally at my 16 week appointment the midwife referred me to the physio. Our hospital have had so many pregnant women with pelvic and back pain that they do a weekly clinic and advice session which covers most of the basic information you need and after that you can then make appointments if needed for individual treatments but I know not all hospitals have the same system and it may take a while to get a referral even as an 'urgent' case.

The information I got from the physio was this:

SPD is a very specific pain (the symphysis pubis is the joint at the front of your pelvis so the dysfunction in SPD is specifically problems in that joint) pain in the symphysis pubis is more likely to occur later in pregnancy because the weight of the baby puts pressure on they joint. Pain earlier in pregnancy is often labelled SPD as a general term but it a combination of the effects of relaxin on the ligaments and the softening of the collagen in muscles that means it's more difficult for the joints in the body to stay in place and with the increases in weight and changes in posture caused by the growing baby there is a combined effect of muscles and ligaments all struggling to keep the skeletal structure in its optimum place.

Much of the pain in early pregnancy is a combination of the softening ligaments in the pelvis and lower back pain. The physio I saw gave us a few basic exercises that are all aimed at releasing the tension in the lower back and strengthening the muscles so that the body is better able to support itself through the pregnancy. The 3 basic exercises are pelvic floor (but pulling up towards the front wall of the pelvis more than pulling up and into the body), pelvic tilt, and bottom clenches. We were told to do 3 holds of 10 seconds whilst seated, lying and standing both morning and evening. To begin with it's unlikely you'll hold for the full 10 seconds but with practice it soon becomes possible. The aim is to be able to hold the pelvic floor muscle whilst breathing normally so that you're not pulling funny faces and holding your breath.

Other things she suggested are to use an exercise ball to sit on as this relieves the tension on the lower back. To sleep with either a body pillow or a rolled up single duvet between the knees - a normal pillow isn't big enough to keep the pelvis at the optimum width (think standing with your legs shoulder width apart rather than legs together). To get a mattress topper or use spare duvets on top of the mattress to soften it so that it puts less pressure on the pelvis when lying on the side. Keeping knees together when getting in and out of the car etc (as though you're wearing a mini skirt and maintaining your dignity). Walking on the flat for half an hour a day if possible. When going up and down stairs to do it toddler style, one step at a time. Going up stairs lead with your good leg, going down lead with your bad. There are corset type supports available or your GP should be able to prescribe a size K tubigrip - the tubigrip is easier to sit in the corset thing is great for standing and walking but impossible to sit in.
Using heat on your lower back will often ease some of the tension so help ease the pain.

I see a chiropractor monthly anyway so have found that a combination of that and the pelvic exercises, sitting on the ball and sleeping on duvets have all helped and as long as I don't over do it I have 3 weeks out of every month where I can actually function without breaking down in Sainsburys (complete with abandoned trolley and staff member getting a wheelchair...). If I could afford to see the chiro more often then I would.
Physios won't treat you if you're seeing a chiro and vice versa btw - as I was already seeing the chiro it's easier for my to carry on doing it and I know it works but one is not necessarily better than the other.

Hope you manage to get some relief - I had 6 weeks where I barely left the house as I couldn't cope with the pain but it is better now because of the exercises etc even though I'm now further on and have a bigger bump etc.

Another quick tip about giving birth btw.
As well as making sure that all those caring for you know you have SPD beforehand get your OH to get some string, lie down in the 'NHS birthing position' and gently ease your legs apart until you begin to feel uncomfortable. Ease the legs in an inch or so then get your OH to cut the string to that length of the gap at your knees. This should then go in your notes and if it comes to an epidural and on your back delivery the string can then be used as a guide to the maximum distance your legs should be apart - it's not great science but it may mean you don't damage your body.