Strain to the anterior joint of the pelvis, the pubic symphysis, can be related to misalignment of the pelvis. It’s most common with pregnancy and childbirth, with estimates that it occurs to some extent in up to 1 in 5 pregnancies. Symphysis Pubis Dysfunction (SPD) is also sometimes referred to as pelvic girdle pain and is closely linked with Sacroiliac joint pain. Whilst it can be very painful and make walking difficult, the condition doesn’t harm the baby. Nevertheless it can be very distressing and make life difficult, especially if the mother is required to look after older children or is expected to work.
Symptoms of SPD
- Pain at pubic bone
- Pain in pelvis and sacroiliac joints
- Perineal pain between the anus and vagina
- Referred pain to the thighs or groin
- Grinding or clicking sound in your pelvis.
Causes of SPD
During pregnancy, hormones such as Relaxin loosen the ligaments and muscles in the pelvis, sacroiliac joints, and hips. This increases pelvic range of motion to allow for childbirth, but can cause the pelvic joints and symphysis pubis to be unbalanced and hypermobile, leading to pain.
Sometimes the hormonal relaxation of the ligaments happens earlier than the last trimester, so the symptoms of SPD can happen well before the birth.
SPD occurring outside pregnancy is rare, but it does happen, from pelvic injuries or osteoarthritis and sacroiliac joint dysfunction.
SPD is aggravated by…
- Walking, especially using the stairs
- Putting your weight on one leg
- Turning over in your bed
- Getting in and out of the car
- Daily tasks such as getting out of bed, getting dressed
- Abducting or widening the legs can be painful, and may lead to a Cesarian section if there is too much pain that would prevent a natural birth, or cause too much long-term damage to the pubic symphysis
- The baby’s weight and position pressure on the lumbar spine and pelvis can aggravate the condition
- The symptoms of SPD tend to worsen as the pregnancy progresses, but commonly settle after the birth
Activities to avoid with SPD
- Twisting, bending and carrying heavy loads
- Carrying a child on your hip
- Sitting on the floor, especially twisted or cross legged
- Standing or sitting for long periods
- Bending and strenuous activities, vacuum cleaning or making the bed.
Chiropractic treatment for SPD
With Chiropractic, the focus is to improve movement in the whole of the pelvis including the sacroiliac joints which will reduce pressure on the pubic symphysis. This encourages the muscles in the pelvis to relax, as well as reducing any muscle spasm, which can help with pain and allow for a more natural, pain-free childbirth.
Treatment can improve your pelvic joint stability and help reduce traumatic stress during parturition (child birth) which helps prevent further ligament damage to both the pubic symphysis and the sacroiliac joints.
Swimming, hydrotherapy and movement in water can be very beneficial, all taking the stress off the joints and allowing for pain-free movement.
Some Chiropractors are more specialized in the treatment having undertaken a Chiropractic paediatric masters and if required you may be referred to one such specialist