So what's this SPD thing then?

[GeorginaA]

Feeling fed up. I was feeling quite healthy when I went into my midwife's appointment this morning, apart from the usual twinges expected at 28 weeks.

Apparently though, the pain in the top of my legs near the groin is SPD. I've never heard of it before, and I'm sure I got this last pregnancy and didn't really think anything of it. Anyway, I've been told some ways to keep it from getting worse and I may be offered physio at a later date. Does anyone know what it is so I can at least start to do some research into it - is it anything to worry about?

Also, my itchy skin may be an indicator of a liver problem, so I'm having a test for that...

Don't feel quite as healthy now

[M2T]

Here you go Georgina.... I'm unfortunate enough to experiencing this at only 17wks. I've been referred to a physiotherapist. I didn't have any of this 1st time around.... I must be getting to old for this lark!

Symphysis Pubis Dysfunction (SPD)
by Christine Hill



What is the common condition that makes standing on one leg or climbing stairs unbearable for some pregnant women? Christine Hill examines SPD
What is Symphysis Pubis Dysfunction?
The symphysis pubis is the name given to where two bones meet at the front of the pelvis. The pelvic bone is roughly in the shape of a heart, and is actually formed by three bones, which are held together by very strong ligaments.

The bones meet to form three 'fixed' joints - at the front (the symphysis pubis) and at each side of the bottom of the spine (the sacro-iliac joints).

Normally, these joints are not designed to allow movement. However, when a woman becomes pregnant, a hormone called relaxin is produced which loosens all the pelvic ligaments in order to allow the pelvis slight movement at the time of birth.

For some reason, the ligaments occasionally loosen too much and too early before birth. This means they can't keep the pelvic joints stable so the pelvis moves, especially on weight bearing. All this is made worse by the increased weight of the growing baby and sometimes the symphysis pubis joint actually separates slightly. The result is mild to severe pain, usually in the pubic area, and is called SPD.

What are the symptoms?
The most common is pain and difficulty when walking. Some women describe the feeling of their pelvis coming apart. The pain is made worse when turning in bed or doing something that involves standing on one leg, such as climbing up stairs, getting dressed and getting in and out of a car.

The pain is generally felt in the pubis and/or the sacro-iliac joints, but can also be experienced in the groin, the inner side of the thighs, the hips and in one or both buttocks.

[M2T]

... and here's some tips on how to keep it at bay as much as possible. Mine seems to be confined to my sacriolitic joint and coccix (sp?). OUCH!

When is it most likely to start?
At any time from the first trimester onwards. Some women can be fine during their pregnancy, but get the condition a few days after their baby has been born.SPD sometimes occurs following a period of immobility, an unusually busy overactive period or a particular activity such as swimming breaststroke or lifting something incorrectly.
Is there any treatment?
Unfortunately there is no way of tightening the ligaments again during pregnancy, so no treatment will be able to cure SPD. This includes any sort of osteopathy, reflexology or acupuncture. However, after the birth the body stops producing the hormone, so the ligaments tighten up and (for the majority of women) the symptoms gradually disappear.

So what can be done?
The most important thing is to avoid doing anything that aggravates the condition, such as standing on one leg.

Sit on a chair to get dressed.
Be very careful to get into a car by putting your bottom on the seat first, and then lifting your legs into the car.
When you get out, lift your legs onto the pavement and then lift your bottom off the seat.
If you go swimming, don't swim breaststroke.
Always turn over in bed with your knees firmly together.
Make sure you get a rest (in bed) every day.
If you already have a child, you will need help, as you will find it difficult to lift him or her.
If the pain is severe, ask your GP for a referral to a physiotherapist, ideally one who has specialist training in obstetrics and is called a Physiotherapist in Woman?s Health. She or he will be able to assess you and may fit you with a pelvic support belt, which helps to stabilise the pelvis. Your GP will also be able to prescribe painkillers that are safe to take in pregnancy.

[GeorginaA]

Thanks M2T.

It sounds like I'm quite lucky as I must have it quite mild. I would say it's annoying enough to be classed beyond just discomfort but not quite where I'd class it as proper pain. I'm trying very hard to train myself to sit properly (I tend to like resting one leg up on the chair in a sort of half-lotus position - horribly bad posture and almost certainly isn't helping) - finding it really difficult though.

Had to laugh when the midwife said to minimize trips up and down stairs - as if ds is going to let me get away with that!

Still, I found somewhere on the net which said that some people think that as a result of SPD you get a quicker and easier childbirth - can but hope!

[GeorginaA]

"Make sure you get a rest (in bed) every day." HAHAHA.... yeah, right

Seriously, though. Thanks for those

[motherinferior]

I've just written an article on SPD, with lots of Mumsnetter quotes; if you want a draft I can send you one - contact me direct! xxx

[M2T]

I know... how does this fit into your life! I have to carry a rather heavy bag with a laptop in it back and forwards from work. I'm thinking I might have to give up work earlier than 34 wks, but can't really afford to. We'll see how it goes at the physio in a MONTHS TIME! Bloody NHS.

[M2T]

Really MI! Fantastic..... I'll do that if you don't mind.

[GeorginaA]

I've just told dh about the stairs and bedrest thing - he said "and the NHS is providing free childcare during all this?"

[GeorginaA]

Thank you motherinferior - have sent a message via contact another talker

[GeorginaA]

Also found a .pdf booklet on it at spd info booklet - haven't looked through it yet (printing it off - I hate reading these things on the computer screen) but you may find it useful too, M2T.

[Slinky]

Had a "flare-up" yesterday - and DD2 is 4.5 years old

Took ages for my SPD to calm after birth of DD2 and still occasionally had pain the week before a period. The last few months or so have been fine and no problems.

However, went to a wedding on Saturday - had a bit too much to drink, then ended up on the floor doing "ooops, upside your head". Yesterday, in terrible pain with my pelvis

[GeorginaA]

Ugh Slinky - poor you

[harman]

Message withdrawn

[stace]

Hi all, i dont have it yet but did have it post nataly (SP?) after DS. Am having huge twinges/pains in pelvis, hip joints and ovary areas so probably do have the beginnings. Anyhow reason for posting was to let you know what my obst and MW said absolutely no splitting the legs (LOL) no swimming breast stroke and no squwatting ('scuse spelling) for yoga or anything. Basically give up on any pevic yoga excercises immediately.

Wishing everyone well!!!

[GeorginaA]

Hmm, I actually find the squatting/pelvic yoga exercises quite relaxing and eases the pain for a bit. Am I doing myself damage then?

[stace]

i found them good too but my MW was adamant that what we are actually doing is stretching the ligaments that are already prone to being too lax and was quite fierce at telling me to stop.
So ........ its up to you or check it out with your MW.

[tillymint]

Have come alittle late to this thread.
I was in agony from week 20 with dd2 last yaer. But apparantly I'd managed to twist my pelvis aswell.
I saw an osteopath afterwards who corrected the pelvis quickly making a huge difference. Also found the hip pain I had been experiencing since dd1 was born in 1998, was due to fallen arches in my left foot. Another possible side effect of SPD. Now wear shoe inserts which help a great deal.
I am 3 months pregnant now, and SPD kicked in weeks ago. Have decided to spend my family allowance visiting osteopath every fortnight to keep my pelvis straight. She works wonders. I also wear my support belt whenever I walk. Sumo - belt dh calls it.
I can't push a shopping trolley, or the buggy up hill without incurring serious pain.
Mother Inferior - would love to read your article/report on SPD.

Hope we can keep this thread open, as I suffered so much last year yet found very little support. MW doesn't believe it exists, physio issues leaflet and belt only. Actually chatting to people who KNOW what it is like would've made a real difference.

[stace]

tillymint, i so know what you mean when i was suffering last time i did not know what was wrong with me and i just felt so isolated and scared to death i thought i had something terminal and no one would tell me. Its such a relief to know what it is and to chat to others that are also suffering.

[sweetkitty]

has anyone any suggestions for relieving SPD a bit? I'm in bloody agony tonight . Seeing midwife next week will mention it to her. I'm so worried that I won't be able to work up until 36 weeks as planned.

[squirmyworm]

hi there - I had SPD from about 24 weeks - noticed it because of loud (gunshot like!) clicking from my nether regions when I turned over in bed (seemed like a good trick at the time). Was never painful - just uncomfortable. Went and got an elastic belt that kind of crunches around your hips to keep the whole pelvic bit stable - it was grossly uncomfortable (this was july/august!!) but seemed to help

Oh and georgina - we must have parallel pregnancies because I also had to have a liver function test after itching. Nothing was found and it went away after a few days.

good luck!

[squirmyworm]

sweet kitty - worth saying - despite spd and slowing down a bit I managed to work to 38+2 days......(I think I did sleep for about a week after that though!)

[squirmyworm]

sorry that sounded a bit jolly hockey sticks on re-reading - particularly when I saw you were in pain with SPD. I only worked to 38 because I absolutely had to.... Hope the midwife can suggest something x

[GeorginaA]

squirmyworm - thanks for that - going to keep my fingers crossed re: the liver function tests!

Have been drinking water like it's been going out of fashion to try and "flush any toxins" out (god knows if it'd make any difference, but I figured sticking to the recommended 8 glasses a day religiously wouldn't hurt and might actually help).

[squirmyworm]

good luck - I was really gutted to learn I'd need a blood test (complete and utter wimp) and kept back tracking - 'y'know, I don't think it's itching at all now' 'no, I'm sure it's gone' 'maybe it was that new body cream' etc but they dragged me off and made me have one

seriously I was quite relieved to have it done and have my mind put at rest. a friend of mine lost a baby to OC (the thing they look for) and it could/would have been saved had they diagnosed it and done an early section apparently.

[squirmyworm]

oh god now it sounds like I'm a scaremonger (I am such a clumsy poster tonight!!) It's really really rare and even if you did have any kind of problem (which I'm sure you won't) - you will have loads of time to sort it

eek
I think I'd better go to bed
Night georgina - good luck - sure you'll be fine
x