Warning: some mention of sex.
SPD may be referred to as PGP. The first acronym means symphysis pubis dysfunction. The latter means pelvic girdle pain. Both cover the often excruciating pain caused by excessive movement of the pelvic and pubic bones during pregnancy.
I had this condition when I was pregnant with Nathan, and I have it again with this little one, now due in about 4 weeks, all being well.
Symptoms include (but are not limited to) sharp pain straight down the centre of your pubic bone, pain around the inner thighs, pain around the pelvis (side, front and/or back) and other lower back and torso pain. You may also hear clicking and popping, or feel like the bones are grinding together.
I can no longer roll over in the night without a huge ‘clunk’, as something in my pelvis moves, accompanied with a pain that brings tears to my eyes every single time. I am on crutches and have a big tuby-grip bandage around my bump. Even with these support mechanisms in place, I’m in agony much of the time.
I am NOT an expert, but here are some tips I can offer, from both my own experience and from others’ good advice.
1/ As soon as you feel pain, see your midwife. Just because something is common, it doesn’t make it normal. Get checked out.
2/ Get referred for physio. It can help, and your physiotherapist can recommend supports and crutches if necessary.
3/ When you speak to your physio, mention every pain you’ve had, and what makes it worse and what eases it. If you think you might forget something, write a list before you go in. I had a sharp pain in my buttock which turned out to be sciatica, so different exercises were given to support that. Pain happens for all sorts of reasons.
4/ Don’t try and be ‘tough’. If the pain is making you cry or not be able to sleep, or stopping you getting to work or getting tasks done, then when your physio asks ‘Where is the pain on a scale from 1-10?’ You say ‘8’.
9 and 10 are where you would be moaning in pain constantly or passing out, so don’t try and play it down.
5/ Walk up stairs sideways. (Thanks Debi!) Keep your knees together as much as possible. Don’t vacuum, don’t mop, lift as little as possible.
6/ Sex: Missionary is out, spreading your legs is not a good idea! Same for straddling your partner. Even if it feels good at the time, the stress on your pubis can lead to agony later on. All fours might work for you, or alternatively lying on your side; anything that keeps your legs as close together as possible.
7/ Painkillers: ibuprofen isn’t usually recommended in pregnancy, normally paracetamol is fine, but please, please check with your midwife or GP before self-medicating. I am now on a low dose of codeine, but this may not be suitable for you. See your GP. And finally, on that note…
8/ Don’t be fobbed off. One of my GPS didn’t know what SPD was or why I was asking for pain killers. Get a second opinion if you don’t feel like your care professional is taking you seriously. Get your midwife to intercede for you, or ask for advice from your physiotherapist.
If lack of sleep and pain is affecting your mental health, you can also get support for this. Please don’t be afraid to ask. It’s really, really hard to be in pain and tired all the time. Asking for help is completely normal.
Pelvic Obstetric Gynaecological Physiotherapy
Royal College of Psychiatrists, mental health in pregnancy: