AIBU unreasonable to wonder if my local obstetric physio team doesn't really care ...

[BoffinMum]

I have got a debilitating version of SPD which got dramatically worse four weeks ago, and the GP and hospital ante-natal clinic both arranged for emergency referrals for me to the NHS obstetric physio team. I am now more or less housebound, have applied for a Blue Badge and Disability Living Allowance, can't look after my children or do anything around the house, etc etc.

Since then I haven't heard a peep out of them, although by shuffling up there in great pain I managed to get a pair of mismatching crutches out of them a fortnight ago by making a big fuss.

Is it really all that unreasonable to expect some sort of proper help and therapy a bit sooner than this???

This is awful. I can imagine no other grop within the community who would be arbitrarily denied treatment like this. Shall we kick up a fuss and start an online Downing Street petition or something?

I couldn't get to Argos for crutches, which is why I shuffled up to the hospital - their parking is nearer where the crutches are. What a dreadful state we find ourselves in.

No it isn't. I had useless care for my SPD in my first pregnancy, but luckily I had a supportive midwife second time around who arranged for me to have weekly physio from 16 weeks into my pregnancy. You MUST make a big fuss about this. can you find out who the head of physio is / head of midwifery / consultant obstetrician (or all three!) and phone them up and plead for some more help? Good physio can make such a difference to severe SPD.

Sorry if I sound a bit dim, but can someone tell me what SPD is?

Symphysis Pubis Disfunction/Disorder

Symphysis pubis dysfunction, otherwise known as pelvic girdle pain. 3% of pregnant women suffer from this pregnancy complication.

Basically your pelvic joints click and grind when you walk, and your muscles go into spasm. In pregnancy you can't take anti-inflammatories so there isn't much you can do about effective pain relief.

Best practice guidelines state that proper diagnosis and manipulative treatment should be the mainstay of any medical intervention, with core stability and pelvic floor exercises to help. However many women report that these are hard to do until the pelvis has been stabilised via maniulation. Maternity belts and tubigrips are also sometimes recommended but there is no evidence to suggest these actually work - for some people they make the pain worse.

In extreme circumstances, women end up with the pelvis separating completely, or with major mobility problems for a period of years after the pregnancy, but this is extremely rare.

YuleWitch, it's actually not the amount of relaxin, it's your body's reaction to it. If they measured you, they would find you had the same amount of hormones as everyone else.

Do you know, I am beginning to think I know more about this sodding condition than most of the physios around here! Too much time at home on the internet reading medical papers!

Oh my god! That sounds really painful, how can they not treat this ailment with the seriousness it obviously deserves.
Surely if they (gyno's) treat it as soon as is possible, it would save a lot of pain and nhs money in the long run?

What exactly is the corrective procedure for this? Or is what I have just read all there is?

Boffin (huge hugs sweet pea) please please kick up a fuss doctors/obs are so rubbish get a referal to orthopeadic consultant if you can they may be able to help you more (and give you the crutches/tools you need to attempt daily life) the highest form of pain relief you can have while pregnant is solpadol (apparently, which i have for my back) it helps for approximately an hour and a half (i only take one but you can take 2 at a time it may last longer) and yes thats not long and you have to wait another 3 hours to have some more relief but its worth it just to have even an hour of feeling like a normal human. Try to get some off the doctor if you can dont be brushed aside just becaus you are pregnant doesnt mean they can just forget about your pain and discomfort (which they often do).

I've always managed to get a referral to physio for same-day

but you do have to keep on and on about it

can you self-refer to the physio? If not demand that your midwife/doctor does it while you are there - it just takes a phone call

be nice about it but make it clear that you need help

Having said that, there isn't much they CAN do if you are really bad, so don't get your hopes up too much

There's no way that this isn't going to make you feel like crap - not only are you in intense pain, there's nothing more depressing than being restricted in what you can do.

There's nothing that I can say that other people haven't already said better - but remember that no matter how awful it all is now, it's temporary - you're over half-way through your pregnancy & it's not very long until you get to meet your beautiful baby boy & it'll all seem worth it when you look at him.

Thanks guys.

I will get some Solpadol. I am seeing the doc at 5.30 as well to chase the referral a bit more. He is very nice so this might help.

But a bit of me thinks we sholdn't bloody well have to chase these things. If we stopped having children the world as we know it would end. We deserve the best treatment for donating our wombs to the furtherance of the human race, not this.

Ooh, you make it sound so grand. I'm not sitting here, bumming around in my pyjamas. I'm currently donating my womb to the futherance of the human race. Oh yes.

That's terrible. I saw my midwife with bad SPD and by the time I'd got into the room she said 'so that's one urgent obstetric physio then!'

Followed by telling me if I didn't have an appt by Thursday (this was Mon) for the next week, to phone them up.

Although all they could do was tell me not to commute any more as my joints were all in perfect nick except the hormone-affected ones. which meant at least i recovered v rapidly after birth. the support belt helped a bit, codiene kept me sane.

the red cross lend out wheelchairs free but the chairs are often a bit crap and the places are rarely open. if you want to hire a chair i highly recommend www.wheelfreedom.com - i got a chair from them for 8 weeks for about £50.

phone your physios. good practice for chasing everyone involved in all medical treatment...

Have you read 'Children of Men' by PD James? Better than the film. Lots of human race furtherance in there.

I haven't, no. I shall add it to my list

I have had pretty mild SPD and still got a referral to the physio with an appointment within 2 weeks! You are being messed about unacceptably. While you should not have to do this, my experience has taught me that it's the squeaky wheel that gets the grease. Phone them every day and ask them for an appointment. Request that they ring you back if they can't give you one at the time. If they don't call back, ring again later that day. After 3 days of this say you will be making a formal complaint as you are unhappy with the service, and keep ringing even so until you get one. It's important to be polite in all this but annoyingly persistent. Often they will sort it out to avoid having to speak to you again. But whatever gets a result...! Good luck.

Quick update, I have been to the lovely GP who was as cross about it as me, and has promised to chase them up forthwith with a Special Letter and a Phone Call. I will give him a day or two and then do as you suggest, Eightieschick.

PS Thanks for wheelchair tip, notcitrus, and I will follow that up too.

Other good news - I really wanted to take DC 2 and DC3 to the panto this year to make up for hardly having attention from me during all this, but it was sold out on the website for Xmas week, plus I was very worried I could not cope in a busy theatre, even with DH's help while he is on leave.

I got in touch with the box office and explained I had SPD and what it was. The manager found me a great box at a reasonable price conveniently near the lift, bar and loo, where we could all sit in peace without me getting up and down every minute or two as other people squeeze past, struggling up and down stairs and so on.

I am so chuffed about this, because it will make Xmas much more fun for the DCs, and it will be great to have an outing.

Hi boffinmum

poor you

Mine never really went away, but I read some Swedish research that said it takes about 6 years for your body to recover from SPD, so I stopped waiting till I was better and just got stuck in to pregnancy #2...
I'm 26 weeks PG and doing ok so far, but had horrible SPD in my first PG's last trimester so we'll see... Luckily this time it's been managed better - I was referred for physio by my GP (didn't even bother with the midwives/obstretric route this time), however she just gives me excercises to do and has sent me to a pregnancy/physio/pilates class at hospital - I think the NHS way is to make you do it yourself, so I'm not getting any manual relief from her, you really have to ask them for that IME.

Anyway enough about me just wanted to fill you in and give three tips I hope will help you:

-I have been seeing an osteopath who actually massages and manipulates me every three weeks, it's pricey but worth every penny. Takes a day or two but I always feel better for it.

-I've been taking a natural anti-inflammatory called Ginger, Curcumin and Boswellia safe for use in pregnancy, as paracetamol alone won't do anything about the inflammation.
Also taking Omega 3 fish oil It's from the body of the fish, not liver, so safe in PG. This is ace because not only does it help with stress and mood (vital with SPD which can be so depressing) but Omega 3 can reduce inflammation by inhibiting production of pro-inflammatory eicosanoids (whatever they are). Also great for boosting baby's brain too.

-Thirdly, I found out that you can call your local social services to ask about borrowing a monkey-pole to help you turn in bed - I felt that loads of damage was done when I turned in bed, I'm sure you know the ripping and crunching sounds/feelings...

Really hope you find some relief

Lotster, what brilliant tips. The natural anti-inflammatories sounds really inspired.

I was doing proper pilates with a physio and at home by myself right up until when this happened, so I haven't got much faith in the DIY route. I will ask the obs physios for actual hands on massage instead, and be very assertive now you have encouraged me.

Juicyjolly, the best practice guidelines in the research and professional literature suggest:

1. Prompt diagnosis from a specialist obstetric physio or similar.
2. Manipulation from physio, osteopath or chiropractor.
3. Core stability exercises (eg Pilates) specially designed for pregnancy.
4. Possibly use of rigid or non-rigid obstetric belt and/or Tubigrip if this doesn't make the problem worse (which it apparently does in 25% of cases).
5. Provision of Occupational Therapy items and advice including crutches, wheelchair, etc if required.
6. Special care in labour not to splay legs; minimal use of lithotomy poles and special techniques if this has to be the case.

It is also possible to give special epidural treatments to reduce muscular spasm and break the pain cycle, but this is rarely done as the emphasis tends to be on conservative treatment. Or apparently no treatment, as we have all found!