Symphysis Pubis Dysfunction (SPD) in pregnancy- The “Golden Rule” for sufferers

Lifespan Osteopathy Essendon / Pregnancy  / Symphysis Pubis Dysfunction (SPD) in pregnancy- The “Golden Rule” for sufferers
Symphysis Pubis Dysfunction (SPD) in pregnancy- The Golden Rule for sufferers

Symphysis Pubis Dysfunction (SPD) in pregnancy- The “Golden Rule” for sufferers

Symphysis Pubis Dysfunction (SPD) hurts.

A lot.

But what exactly is it?

What are the causes?

And more importantly, what can you do to prevent or manage it?

Woman Suffering from Symphysis Pubis Dysfunction (SPD) in pregnancy

What is Symphysis Pubis Dysfunction (SPD)?

Symphysis Pubis Dysfunction, commonly abbreviated to “SPD”, is pain or dysfunction arising from the joint where the two halves of your pelvis meet at the front. This is directly over the space in between your legs.

Other names for symphysis pubis dysfunction include:

  • Peripartum pelvic pain,
  • Pregnancy-related Pelvic Pain (PRPP),
  • Pregnancy-related pelvic girdle pain (PGP) (which we’ve written about here), and
  • Anterior or posterior pelvic pain

Symptoms of SPD include:

  • “Shooting” pain in the joint in the front of your pelvis, between your legs. Some women describe this as a feeling of “being kicked in the crotch”, or sometimes call it “lightening crotch”.
  • Radiating pain into the lower abdomen, back, groin, perineum (the area between your vagina and back passage), thigh, and/or leg.
  • Pain on movement, especially:
    •  walking,
    • standing on one leg, or
    • moving your leg out to the side
  • Pain with activities of daily living, including:
    • bending forward,
    • standing on one leg,
    • rising from a chair,
    • going up or down stairs, or
    • rolling over in bed
  • Pain relieved by rest
  • Clicking, snapping or grinding heard or felt within the symphysis pubis region
  • Painful sex
  • Occasional difficulty passing urine

What are the causes of Symphysis Pubis Dysfunction (SPD)?

Unfortunately, no one really knows for certain why some women will develop symphysis pubis dysfunction (SPD), while others seem to sail through pregnancy with ease.

When you’re pregnant, especially towards the latter months, you’ll have higher circulating levels of the hormone “relaxin”.

The role of relaxin is generally to help soften the ligaments of the pelvis, to prepare your body for the delivery of the baby through the birth canal.

It seems that women who are predisposed to developing SPD (because of the risk factors outlined below) are susceptible to developing pain because of this loosening.

What are the risk factors of Symphysis Pubis Dysfunction (SPD)?

Studies have shown there are a number of risk factors that make some women more likely to develop symphysis pubis dysfunction (SPD) than others.


Predisposing factors for SPD and pelvic pain during pregnancy:

  • a family history of SPD- i.e. your Mum or sisters also suffered it
  • you’ve experienced symphysis pubis dysfunction at another time in your life already, such as in a previous pregnancy
  • early onset of menstrual periods,
  • oral contraceptive use,
  • carrying multiple babies at once, e.g. twins or triplets,
  • high body weight,
  • high levels of stress,
  • low job satisfaction,
  • history of low back pain,
  • previous pelvic or back pathology, trauma, or injury
  • lack of regular exercise,
  • hypermobility, or
  • an above-average sized baby or overdue pregnancy.

Factors that have been associated with symphysis pubis dysfunction after giving birth:

  • breast feeding- it’s thought that this keeps the pregnancy hormones circulating a little longer in your body,
  • developmental hip dysplasia in your baby.

What is the “Golden Rule” for sufferers of Symphysis Pubis Dysfunction (SPD)?

If you’re pregnant and suffering from pelvic girdle pain (PGP), then it’s VITAL that you adhere to our “Golden Rule” of PGP in pregnancy, which is…

Avoid putting all of your body weight on one leg as much as possible.

This is because when you do this, you’ll put a lot of shearing forces through either/both the pubic symphysis (where the two halves of your pelvis join together at the front- a.k.a. “the groin”, “the crotch”), or the sacroiliac joints- where the two bones that most people call their “hip” bones join onto the Sacrum (“tailbone”).



How do I avoid or manage Symphysis Pubis Dysfunction (SPD)?

Some of the ways you may be unintentionally doing this include and some potential solutions include:

  • Putting on or taking off your pants or socks– sit down while doing this
  • Washing or drying your feet- a sturdy plastic stool/chair in the shower or bathroom may help
  • Going up and down stairs-  use a lift where available.  If you’re at home, place a basket at the top or bottom of the staircase and accumulate a few things before carrying one slightly larger load, rather than going up and down multiple times.  Be careful not to overload the basket, however, so it is not too heavy.
  • Getting in and out of the car- sit down on the seat first, and swivel both knees in or out of the car together.

Once you’re aware of the aggravation that putting your body weight on one leg can cause you, there will be a number of other ways you find yourself doing this throughout the day.  Wherever possible, have a think about the task, and try to come up with a better solution.  PGP can be quite debilitating, so if you can avoid aggravating it, you’ll be much better off in the long run.

If you would like more information, we’ve also discussed PGP in previous posts.  This includes treatment options here, and self-management strategies here.

If you would like more personalized advice, give us a call on (03) 9372 7714 or book online today.