Symphysis Pubis Dysfunction (SPD)

Symphysis pubis dysfunction (SPD) is a condition that, according to some statistics, affects one in 35 women. It most often occurs during pregnancy or after birth and causes intense pelvic pain that is so severe it can make it difficult to climb stairs or even walk.

The pain is caused by the movement of the pelvic bones. In front of the pelvic bone structure is a cartilage that fills the gap between the bones. During pregnancy, the body releases a hormone called relaxin that makes this cartilage and the cartilage in all joints more flexible. The purpose of relaxin is a good one in that it's meant to make the pelvic bones more flexible for birth and delivery. Unfortunately, with some women, there's too much play in the cartilage and the pelvic bones separate. A large and extremely painful gap between the bones occurs.

The condition is also called Pelvic Girdle Pain (PGP), most commonly in Europe. It is not a normal ache or pain of pregnancy and unfortunately too many medical professionals write-off the excruciating pain experienced as just "one of those normal discomforts of pregnancy."

When Does It Happen?

SPD can cause pain as early as the first trimester of pregnancy. Women who have had the condition in a previous pregnancy are more likely to notice the pain sooner. Having SPD with one pregnancy doesn't guarantee you'll have it with subsequent pregnancies, but your risk is higher.

Birth can also trigger SPD especially if the labor is long and difficult and too much strain is placed on the pelvic area.


Most women will have extreme pain in the pubic area and groin. Some women might also experience pain in the buttocks, hips, lower abdomen, inner thighs and the sacroiliac joints in the lower back. With this condition the bones have separated so it's common to feel a clicking or grinding in the pubic area when walking. Simple tasks like getting out of a vehicle, climbing stairs, getting in and out of a shower or putting on pants can be extremely difficult and painful. Any action that involves separating your legs makes the pain stronger.

Testing and Diagnosis

Some healthcare professionals don't recognize that SPD is a serious problem. Some aren't even aware of the condition. But thankfully more doctors and midwives are becoming aware of it and no longer write off the pain sufferers experience as a normal pregnancy symptom.

Testing and diagnosis while you're pregnant could include an ultrasound or an examination to determine stability and movement in your pelvic areas. After birth, MRIs or x-rays are occasionally used for diagnosis. In most cases, healthcare professionals who are aware of the condition are usually able to provide a diagnosis based on the information you provide about your symptoms.

A fast diagnosis will allow you to get treatment sooner. If you strongly suspect that you have SPD and no one appears to be listening to you, be sure to get a second opinion. There are things you can do to manage the pain even if you're not able to get rid of it entirely.

SPD Treatment

Symphysis pubis dysfunction cannot be cured but the pain and discomfort can be reduced. Proper treatment can keep you mobile which is important since women have has such severe SPD that they're unable to move around and must rely on a wheelchair.

Get a referral to a physiotherapist who specializes in SPD/Pelvic Girdle Pain. They can align your pelvis and give you exercises that can help keep that alignment. A physiotherapist can also let you know which exercises you can safely do to strengthen the muscles around the joints to help provide better support. A support belt might help hold the pelvis together.

Painkillers during pregnancy are limited because of the possible damage to the developing baby.


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