Symphysis pubis dysfunction
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Symphysis Pubis Dysfunction (SPD) is a mild to severe pelvic joint pain that is experienced by some expecting mothers after the first trimester of pregnancy or after childbirth. SPD affects approximately one in 35 women, says Ann Johnson, superintendent physiotherapist in women's health at Leeds General Infirmary. [1]
As the name suggests, SPD affects the symphysis pubis, the joint where two of the four pelvic bones (the sacrum and coccyx at the back, and the two hip bones at the sides) meet at the front of the pelvis. The pelvic joints are held together by very strong ligaments that are designed not to allow movement. However, when a woman becomes pregnant, her body produces a hormone called relaxin that gradually loosens all the pelvic ligaments to allow slight pelvic movement at the time of birth. A widening of 2-3 mm at the symphysis pubis during pregnancy above the normal gap of 4-5 mm is normal. Occasionally, the ligaments get loosen too much and too early before birth, thereby causing pain to occur. In severe cases, diastasis symphysis pubis results.
The main symptoms of SPD are pain in the pubic area, groin, the inside of your thighs and sometimes in your lower back and hips. A clicking sound may sometimes be heard while walking as though the bones are grinding together, and pain is even more severe, when the pregnant woman turns in bed or does something that requires standing on one leg, such as getting dressed, climbing up stairs, or getting in and out of a car.
SPD usually occur during the second trimester of pregnancy onwards, with some women feeling fine during their pregnancy, but getting the condition a few days after delivery. Unfortunately there is no known treatment for SPD. After childbirth, however, the body stops producing the relaxin hormone, thus enabling the ligaments tighten up. For the majority of women, the symptoms gradually disappear.
