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Best treatment for SPD/PGP/lower back pain?

(65 Posts)
CrispyFB Mon 04-Nov-13 17:35:59

This is DC4. Every single time I get really bad SPD/PGP and lower back pain (which is actually worse than the SPD). It makes it extremely difficult and very painful to walk very far, and I usually end up in a wheelchair for trips to malls, round Sainsburys etc by the third trimester. I'm otherwise very fit and healthy (I walk 40-50 miles a week when not pregnant and even ran a marathon between DC2 and DC3) so it's a bit shit, frankly. I find it very hard mentally to adjust and end up gaining a ton of weight as a result which probably doesn't help either.

This being DC4, I know the routine about not crossing legs, keeping them together, pillow between the knees in bed etc etc. I know the drill on that score.

DC1 I never made my physio referral as the crap midwives told me to put up and shut up, and it wasn't until 34 weeks that I saw my GP.. the appointment came through after her arrival at 36+6.

DC2 I had the physio appointment at a better time but it was like a chocolate teapot. On the plus side I now know that the belts do nothing for me and that I can't use crutches (especially as I have a pushchair to push!) The exercises did nothing in particular, not that I was that persistent I have to confess.

DC3 I tried osteopathy. It is difficult to say if it helped, but at best it may have stopped it being even worse. It just seemed like she popped my sacroiliac joint back in place each time and of course five minutes later it popped out again after I'd gone.

This time.. what shall I try? I'm nearly 20 weeks and my mobility has helpfully dropped off a cliff in the last week.. it is agony even doing the 1/4 mile school run. I never had a school run last time so I could just sit on my backside all day, well okay, not leave the house. The children didn't allow me an entirely 100% backside experience.

So..

Osteopathy with somebody else?

Chiropractor?

McTimoney Chiro?

A decent physio?

Put up with it?

Something else?

I'd go to the BSO in Borough, but it's just too far. I'm in Hertfordshire. So if anyone has any local recommendations (Beds/Bucks/Herts/VERY near Euston as a last resort) I'd appreciate them too!

I'm not expecting any miracle cures (although those would be nice!) but anything that genuinely helps as we're paying out of pocket and we're supposed to be saving for a new house right now.. so it needs to be properly worth it. The osteopathy last time wasn't worth the money if I'd had to pay.. through a fluke my health insurance covered it, but it's a different provider this time and I know they won't now.

CrispyFB Fri 08-Nov-13 23:24:57

Thanks comfyonesie2 - that's very useful to know! Thinking about it, I don't think it's my quads, it's the bits at the side (outside) of my legs just under where the belt is. But I think you know what I meant! I will try it looser tomorrow.

perfectstorm - that would be great, thank you very much! I've just gone past 20 weeks now, due late March but will be having a c-section probably at 38 weeks due to other complications (long story..) so will be delivering second week in March I have estimated. I'm in the SW Hertfordshire area, will be delivering at Watford General anyway!

There seems to be a physio literally just down the road from me who also does clinical pilates who says she does treat pregnant women. The convenience factor is high of course, but no point in going if she's not really going to help much. Especially as I am paying for it out of pocket!

perfectstorm Fri 08-Nov-13 21:33:37

Would you like me to ask Clare Woodward who she can recommend? As she lectures on the subject and goes to conferences, she may well know someone near to you? I'm due in feb/march as well, so we sound close in dates. It's grim.

comfyonesie2 Fri 08-Nov-13 21:28:45

Crispy, re quad ache, you may have the belt too tight. I made this mistake the first few days I had it and then my osteopath showed me how to put it on correctly. It shouldn't be like a boa constrictor! If it feels tight, it's too tight....just close the front and then tighten the Velcro at each side by an inch or so. He said "it should support, not squeeze" otherwise apparently the pelvis can flare out the other way (doesn't bear thinking about!!). HTH

CrispyFB Fri 08-Nov-13 21:21:22

I was on strict bedrest with my second pregnancy from 18 weeks (around the time SPD usually kicks in!) so the pain was not as bad when I did walk somewhere. However being stuck in bed all day made for excruciating pain as you can imagine!

Given I knew what to expect with my third, perhaps the osteopath didn't really help at all, and the pain being a bit better was solely down to me knowing not to overdo it.

I'm amazed at how suddenly it comes on. I mean, I have been a little bit sore if I've walked five miles or something up until around 16 weeks. Then all of a sudden it kicks in. Walking the 1/4 mile to school, turning over in bed, getting up out my chair.. argh. Unfortunately the children sense my weakness and are playing up more than ever right now, knowing I can't stop them very easily sad Ah well, just over four months to go hmm

I need to find myself a decent physio or chiro and use the belt. I might stand a fighting chance with the two - I get the feeling the belt helps hold things back in place after an adjustment so it would be more useful then.

perfectstorm Fri 08-Nov-13 14:07:45

Crispy that was completely my experience, too, though I ran for a bus! Seems the biggest irony here is that the women who hurt themselves most severely are the ones who do all the things that usually make for health. Namely, decent levels of exercise.

A headsup would have been so, so valuable - this time, that pain threatens and I sit down and don't move for the rest of the day, plus have a memory foam mattress. The pain is, so far, manageable... and the relief of a decent, expert physio who does hands-on realignment just up the road is the biggest possible reassurance.

I cannot believe it's my second pregnancy, I was in a wheelchair for part of my first, and I only now know that realignment is possible. Appalling.

CrispyFB Fri 08-Nov-13 13:51:53

Exactly - I was told I could (and possibly should!) be as active during pregnancy as before for the sake of me and my baby. Which is why I first put my pelvis out running for the train. I didn't even have to run, I liked to do it, and I guess I overstretched a step. I could barely get off the train afterwards. Of course I put it down to just pulling a muscle(!) and continued once I recovered to try and stay fit, just doing more damage along the way. I did quit trying eventually but by that point it was because I physically couldn't try any more. Okay, so I'm an idiot partially, but I'm also somebody who is determined not to let a bit of discomfort get in the way of fitness.. after all if I'd quit when it hurt I'd never have managed a marathon.

If just ONE medical professional had said that for a sizeable minority of women, they do have these issues and not to overdo it, I would never have been so stupid. Instead of handing out stupid Emma's Diary and Bounty "freebies", most of which encourage you to exercise, why not give out actually USEFUL information about things like PGP/SPD instead?

Update on the Serola belt. It's so far doing nothing for the central groin pain (where the symphisis pubis rubs together) but it seems to be helping with the lower back pain. However it is causing a new ache in my quads on the outside. Kind of funny really as it's the same discomfort I get when skiing which I think is down to my physiology (and possibly a little bit of technique, but not entirely by any means) as I have very tight quads.

perfectstorm Fri 08-Nov-13 10:28:24

Yeah, my last pregnancy was appalling because I was told you could be active to the level you were before pregnancy - no warning whatsoever that a double-jointed woman might want to be watchful for ligaments protesting!

It was 2008 for me. I now live in the Cotswolds.

BoffinMum Fri 08-Nov-13 06:50:36

And of course it exists in other cultures, although I suspect race may be a factor, as well as age, and the fact British women force themselves to be pretty physical in pg (Paula Radcliffe syndrome). In fact I was still training in the gyn at the time my pelvis fell apart, I think I shouldn't have been.

BoffinMum Fri 08-Nov-13 06:47:47

I am indeed in Cambs, and Addenbrookes should be embarrassed at their shortcomings in this area. I complained formally to PALS in full Boff mode (scary). When did you have problems?

perfectstorm Thu 07-Nov-13 23:44:57

(This bit tokenistic group sessions teenage apprentice physios was so familiar, plus the CB22 part made me wonder - also the very, very good MP we had in the constituency at the time!)

perfectstorm Thu 07-Nov-13 23:20:39

I saw red when I heard the psychosomatic bollocks (a GP, thankfully not mine, who knew nothing about it but was insisting it wasn't present in all cultures and must therefore not exist...). I thought I'd strained a muscle in my groin when I first got it as I had no clue what it was. I was very, very active and massively overdid it because I had no idea that was bad. I was really hurt when I went to the hospital physio clinic who made me do pelvic floor exercises, a maternity pilates class (I managed one, and then was in such pain I never went back) and gave me a belt.

Boffin Mum you aren't in the Cambridgeshire region, are you? I was. One of the nation's top teaching hospitals, and I got sod all help.

BoffinMum Thu 07-Nov-13 23:07:18

I only managed to get treatment when my MP got involved. Suddenly the hospital found the nine lost (or presumably ignored) referrals and started providing treatment instead of fobbing me off with tokenistic group sessions teenage apprentice physios who knew less about pilates, etc than I did.

BoffinMum Thu 07-Nov-13 23:04:13

Of course it's not psychosomatic. If you still have at after pg and they scan you it's bloody obvious, right there.

There is a great reluctance to trial any reasonable treatments on pg women as it's expensive to do the ethical controls. That's the root of the problem.

CrispyFB Thu 07-Nov-13 22:58:08

Wow, that's awful. There is a huge amount of lack of knowledge over the subject which is shocking given it affects such a sizeable proportion of pregnancies to some degree and many in a very severe and life-limiting way.

It so is NOT psychosomatic for the reasons you say - I had no clue about it whatsoever with my first pregnancy and was baffled when I could barely get up out my chair and make it to the bathroom without leaning on every surface en-route. I thought women were still supposed to run marathons or something (thanks, Paula Radcliffe..!) and clearly so does most of the rest of the world, including medical "experts".

perfectstorm Thu 07-Nov-13 21:16:56

I had to have an internal exam with a registrar obstetrician at 36 weeks. She told me to lie on my back and flop my knees wide apart. I said, "I have quite bad SPD, that's way past my safe separation distance..." and she said impatiently, "It'll be fine, just flop your knees."

I couldn't walk for a week afterwards. The woman is now a consultant obstetrician. At one of the nation's top teaching hospitals.

It's horrifying how ignorant and casual people are. I've even heard a (male) doctor insist it's psychosomatic - this despite most women who suffer never having heard of it prior, and not understanding what in hell is going on when first affected.

CrispyFB Thu 07-Nov-13 18:18:49

Amen to all this. The reason I never got care in my first pregnancy until too late was because I was told to get on with it angry even though I could hardly walk and was in tears. The midwife just sighed, handed over a tissue, and went back to nattering with her friend. And that's a MIDWIFE.. somebody who is supposed to be on our side.

I know of people who are permanently disabled as a result too, so I have counted my blessings each time that I've made a mostly full recovery.

Belt arrived today, will try it out later!

LilacBreastedRoller Thu 07-Nov-13 17:54:51

So true, Boffin. I couldn't walk when the NHS told me to just get on with it. The same clinic gave my DH multiple treatments for a minor knee niggle, which only prevented him from going running. When the private physio saw me she reckoned my sacro-iliac joint had dislocated. Under what other circumstances would a person with a dislocated joint be told to just be brave and hope it would all be ok in four months? It's scandalous misogyny.

BoffinMum Thu 07-Nov-13 13:16:03

BTW the important thing with medication is to take it religiously by the clock at the correct dosage, whether you are in pain or not at the time. This is the palliative care approach to pain management and it works well.

BoffinMum Thu 07-Nov-13 13:14:20

It is a serious pg complication and 10,000 women suffer from it a year. Some will have their life expectancy reduced as a result. Others will become depressed and of that group, some will take their own lives. Others will have terminations. I don't see how things can get more serious than that.

Perfectstorm - I hope Claire is able to work her magic on you. I only has two sessions and the difference was amazing.

Boffin - the wiki entry is great. Wish I'd read it at the time. It took me months of being fobbed off by midwives ("it's just pregnancy aches and pains. Everyone gets them to an extent. Man up" basically confused) and lots of googling before I was even aware of what it was :-(. It's terrible

Want2bSupermum Wed 06-Nov-13 18:11:36

Boffin Fabulous that you wrote the wilki entry. I read it when I had it and it was very helpful.

My obn took it very seriously. She told me that it can remain after birth and that I was at higher risk for needing a hip replacement later in life if not treated during pregnancy during multiple pregnancies. She didn't want to give drugs and gave me a list of people to go see (acupunture, physio, chiro).

Don't get me started on the NHS and their idea of care during childbirth...

CrispyFB Wed 06-Nov-13 17:49:50

Thank you very much everyone for all your replies and suggestions. So much to think about and I am sure it has been helpful for others as well thanks

Mine has always (mostly) gone away after birth - massive improvement in the first day or so, then a more gradual one over the following year. It is then mostly gone, although at certain times of month it flares up and if I overdo it (like, seriously overdo it - 20 mile walks etc!) I get the lower back pain back occasionally. I can live with that. Hoping that happens again this time or I'm screwed! Knowing it goes away is the only thing that helps me cope mentally. I am dreading becoming infirm in old age, I won't take it well at all. SPD has been a real eye opener as to what it might be like.

BoffinMum - Yep, and it makes me furious. I bet if it happened to men there would be a lot more research and help. Thank you for all your hard work on the Wiki entry too.

fuckwittery Wed 06-Nov-13 08:44:24

I've seen a few chiropractors in pregnancy in the herts area (three babies and moved around) and would recommend Karyn Clark at Evergreen Chiropractic clinic in Letchworth; also Paula at Herts and Beds Chiro in WGC and Jo MCCarey at Saffron Walden Chiropractic clinic (she may be a bit far from you).

BoffinMum Wed 06-Nov-13 07:51:25

Because people don't obviously die from it, it's ignored as a condition. The assumption is that it will just go away after childbirth (four years on in my case and it still hasn't).

perfectstorm Tue 05-Nov-13 23:44:26

Nursee007 mine returned (I'm 24 weeks) 2 weeks ago and I cried, I was so scared. With DS it began at 13 weeks and was chronic by now so I really hoped taking it easy meant I'd escaped it - seems not. I am so desperate not to repeat what happened last time. I had to use a wheelchair in shopping centres by the end as walking more than a few feet at a snail's pace was beyond me. I am so, so grateful Tillyscoutsmum has been able to rec someone local.

I'm not remotely scared of childbirth, and I birthed an almost 9lber over 3 days with just a water pool and gas and air. I'm scared shitless of a return of SPD. It's so painful and yet so little seems to be done to help women with it on the NHS.

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