Any advice on SPD?

[NoTeaForMe]

I'm 36w+4d and had my midwife appointment today. After explaining the pain I am in she said it sounds like SPD. She says of it gets worse she will refer me to a physio but that really there's is no cure. I now only have around 4 weeks (hopefully!) left so I'm looking at ways to live with it and not make it worse! Any tips?

This support belt made a huge difference to my SPD. It was infinitely better than the NHS free one I got from my physio and definitely worth paying for. I didn't have to take it off when I sat down, and it can be retightened easily while wearing. It was the only thing that got me through a holiday abroad when I was 35 weeks pregnant.

PanPiper you don't know how relieved I am that it sounds like definite SPD. I had a bartholins cyst removed a few months ago and I had convinced myself it was something to do with the scar! I know SPD is no walk in the park but better than the alternative I think!

I'm currently sleeping propped up with 3 pillows because I can't get comfortable lying down, baby too wriggly and hideous heartburn and with a full body length pillow under my bump and tucked between my legs.

Pushing a supermarket trolley or a buggy is totally out for me? It's agony. Spreading my legs isn't too bad at the moment as its more the sharp pain up that's causing me pain.

Right I'll look into a belt quick. If I speak to my midwife tomorrow I wonder how long it would take to get one from her?! Or should I just go to mothercare and buy one?

This time in my last pregnancy I was so comfortable sitting on my bouncy ball but although it's ok while I'm on there the pain of getting on and off makes it not worth it...or is it still worth it?!

Keep your knees together as much as possible (when the physio told me this I thought the advice was 30 weeks too late but it does work). Someone earlier on mentioned the pain free gap. Work this out and then buy a length of ribbon or similar and tie it above your knees so that you can't open them further than the pain free gap. Wear this to work out how to do all your daily things like getting out of bed, into the shower, up and down the stairs etc. I found this really helpful as it meant I could work out how much I could do without hurting myself in the process.
I also used a length of bandage to keep my knees from opening past the pain free gap when I was asleep and it also helped to keep the pillow in place. It does look a bit like orthopaedic bondage though .
My SPD came back at 7 weeks post delivery but I found physio and then pilates amazing and I've not really had any trouble with it since.

Hi, I haven't read through the rest of the replies but thought I would offer my own advice so apologies if it's the same. I had SPD during all 3 pregnancies and ended up with crutches with the 3rd. The things that helped me were:
-physio referral for a support belt. However at 36 weeks you may not get a referral and be seen before giving birth anyway. They also gave me tubigrip so if you can manage to buy any wide enough then do that
-osteopath- I found this invaluable. Not cheap but if you can afford it then do it
-acupuncture- as above
-heat pad
-pillow between your legs at night and any other pillows needed to keep you comfortable. Dh left our bed at this point and slept in the spare room especially as it would take me ages to heave myself onto my other side
-swimming but definately no breast stroke. I just use to use a woggle and gently kick up and down the pool or even walk up and down the pool. Or sometimes I'd just sit nd wallow in the baby pool!
-look online-I think it's the pelvic partnership or something like that who will give you all the advice needed about keeping your legs together so keeping them together when getting in/out the car, sit down when putting trousers/pants on rather than lifting legs. Be careful when climbing stairs. On really bad days I couldn't do it anyway as it was so painful so I would literally have to crawl up.

I can't think of anything else right now. I had good days and bad days but you just need to try and relax as much as possible. Easier said that done if you have other dc but if you can enlist any help from family or friends then do. Good luck.
Ps after all 3 births my SPD disappeared straightaway.

I had bad SPD with my second. When it actually happened I was in a wheel chair as couldnt put one foot in front of the other. After that i was on crutches. I was on crutches through the L & D too, this happend at 38 weeks!
Tips
I would be careful walking up and down stairs,
getting out a car keep your knees legs together and twist round also do this getting off setees and chairs, try to keep your legs together, i know sounds silly but will help.
when getting changed sit on the end of your bed and get changed that way rather than lifting up your leg.
i know someone who had physio and they are back up and about with a few weeks to go
i also know someone who had acupuncture.

Hope yours isnt too bad and calms down for you.
my walking went back to normal after a week after having her.
Good luck for the remainder of the birth and delivery x

Please insist on specialist physio. Although SPD usually goes after birth, that is not 100pc, and physio will help you now, in birth and recovery after. Please insist - I don't want to scare you as it's super abnormal, but my sister has been disabled by it (after 2-3 pgs admittedly).
Take care and enjoy your LO

The problem with physio or an osteo is that I'm 37+2 now and surely wouldn't get an nhs referral and appointment before due date/giving birth. We can't afford for me to go private.

I know I need to be more careful but it's hard with a 2.6 year old who wants to dance, play, walk to the park etc.

It's definitely worth speaking to a midwife and asking her for an urgent physio referral plus a belt. Even one or two sessions would help. Sounds like the midwife can't be bothered to refer you as time is tight, but if you do go late then there's even more worth in trying to see them. And they should be able to refer even this late - it's not like you have a bad back that is going to be bad for the next year and beyond, so you just have to wait for your slot. Pregnancy is a time limited thing, all sorts of things do get worse in the last few weeks of pregnancy and services need to be able to react to that. In this case, you need not only immediate physio to provide relief and support, but for advice to help you and to ensure that you don't hurt yourself (in the short term and long term) during birth. After all - going to cost the NHS a lot more to look after you if you have complications as a result of spd, than to have a couple of appointments beforehand that prevent them.

It might even be worth ringing up your local hospital's physio department and finding out what the situation is - probably no chance of self referral, but if you ring up and say that you've been in agony with this but your mw won't refer you, and is now saying that there's no point because it's too late to get an appointment through, they might be able to say that they have got urgent appointments that they can issue if needed even if you don't see someone who specialises in SPD. Or that they were seeing someone who was also suffering with spd but who gave birth 4 weeks early and so just a few appointment slots have opened up. Or they might be able to fit you with a belt if you are happy to turn up and wait and wait and wait and wait for an opening. Or who knows...

Or is there any other way of getting to the help you need - outpatients obs and gynae at your hospital might be able to point you in the right direction, or your gp's surgery might have a good contact or know a way around these things. Or a local teaching hospital that teaches physio - they might not get many pregnant women that are prepared to be worked on by students but they would supervise heavily so you should be ok (and I would imagine they would only use you for senior students rather than absolute beginners!).

But if you don't ask, then they won't ever give you an appointment. For the sake of a couple of phone calls, you might be able to sort something out. It might just be that the midwife is under pressure and can't be hassled to spend the half an hour on the phone that she knows it will take for the physio department to make an urgent appointment as she is already going to be late home and has too much work to do, and she has to draw a line somewhere.

But please try - it's definitely worth a try.

I would honestly just buy the belt online. The one I recommended upthread came really quickly and was a godsend - much better than faffing about with tubigrip (tried that first) or the Boots own SPD belt (tried that too) or the free NHS belt. I suddenly felt as though I could move again! Prior to that I'd been crawling down the landing to go to the loo in the night as I couldn't walk for the pain.

I suffered with SPD badly with my second (very large!)baby. The belt and my chiropracter helped as did not pushing heavy things. THere are also a range of simple yoga excercises that can REALLY help you right up to and through birth. You will need to strengthen up your pelvis again after birth as the Relaxin, the hormone that cause the ligaments to relax in the pelvis and give you the pain will be in your system for up to a year after labour, especially if you breastfeed. You can find a good yoga teacher at the British Wheel of Yoga website or www.birthlight.co.uk love and luck

Don't forget it's not going to go away overnight the moment you give birth. It'll lessen considerably, but the more help you get the better. You know the NHS - the louder you shout, the more help you get. Or just pay - it's worth it.

And, seriously - ice your fanny. As a PP said, it's the inflammation from the bones rubbing together that's causing all the pain.

Just to say that while it was much better after giving birth (ie. I could walk), it wasn't gone. Two years on (i'm really stubborn and was convinced willing it to go away would do the trick) I had physio and it made a huge difference (though I still get twinges when I do a lot). So get referred ASAP after the birth or have some private sessions if necessary. Depending on where you live, the NHS may provide a Pilates course postnatally too.

Having said all that, the worst is over once the baby is out. So it will soon start to improve

another good tip I was given by NCT teacher is if you ask for A treatment/referral etc and it s refused, ask the person to write in your notes that you asked and they said no. It might persuade them to give it a go.
All that said, hope you are one of those who recover super quick

I find sitting on a birth ball helps as it keeps my posture straight, I try not to recline on sofa (this is really hard at 38 weeks!) as this makes me really stiff when I get up again. Either lie on side with pillow in between knees or sit with your knees lower than your hips with your feet/legs/hips/pelvis aligned.

I stopped walking - I can only do 5 minutes at a time, and I stopped carrying my toddler. Especially don't carry heavy things up the stairs.

My physio told me to act like an old lady - I.e if you do housework, do 5-10 mins then rest, don't do it all at once.

y y to the chiropractor if you can afford it. I had awful SPD the first time round, but saw a chiro the second. It was soooo much better as she kept the joints in the right place relieveing the inflammation. I was still relatively mobile by the end, which was great :)

Do keep your knees together at all times, and use the pillow between them as you sleep. Don't move things with your feet, or do things that require a twisting action (eg pushing a shopping trolley or loading the dishwasher).

Finally, tell EVERYONE when it comes to delivery, and don't allow your legs to be flung open into stirrups. That happened to me and 9 years on I am still suffering :( If you do need stirrups, ask two people to open your legs slowly and simultaneously to prevent joint damage. There are birth positions that work better for SPD as well.

Had it at 36 weeks first time, 16 second time and kicked in at 5 weeks this time. So i am researched to the hilt...... Am now 22 weeks and in less pain than i was at 6 weeks due to being really really strict following the following 'rules':
Imagine you are wearing a short skirt and no knickers at all times - so get in and out of cars thinking this, turning in bed, walking sitting etc
No buggy, no trolleys
No hoovering (or ironing but i don;t do this anyway)
NO lifting. Including 2 year olds who are crying. Sit down, and call them to you. Get a little life rucksack with a lead for necessary trips - and get one yourself which makes it more attractive to your little one. I can;t carry a bag on one shoulder or in one hand as the imbalance is too hard on my pelvis.
Small steps - always. No fast movements - so don;t cross the road if you think you may have to speed up before the other side.
Call the physio dept. Not all midwives and GPs know enough about it. My local hospital has a group advice/support session every week you can book into.
Rest. Lots. I recommend resting on sofa after lunch with your 2 year old and dozing off if you can in front of CBeebies
If you need to lie down on your back, try to get yourself at 30 degree angle bend in the middle
If you see an osteopath/chiroprator do your research. i saw an osteopath last time who said they could do it and were rubbish - this time i travel to see a proper expert and she puts my pelvis back in line whcih helps now and will help afterwards. Worth every penny - and i don;t have to go that often as she does it properly.
Get a belt if you think it will help YOU. Different belts suit different people.

If you are any near Wiltshire let me know if you want local recommendations for osteopath!

Hi there, lots of great tips already.

My Obstetric Physio said to remember the mantra "short skirt, no knickers" !

i.e. always behave and manoeuvre yourself as if you are wearing a short skirt with no knicks (which you do not want to reveal!), especially when getting in and out of cars. Splinting your legs is very bad for SPD.

Make you movements as symmetrical as poss and sit down to put shoes on.

My first pregnancy and long after with SPD was just awful and it was discovered too late, but for my second my local hospital ran a pregnancy, physio pilates class which helped a lot.

Lastly, for people who have had it very badly, consider seeing a specialist osteopath in case you have some structural problem which is exacerbating it.

I couldn't work out why my SPD never really went away and didn't realise I had had a twisted pelvis from bad posture (for most of my life) until four years after my first was born. The Osteo I saw spotted it straightaway, yet I had spent hundreds and hundreds of pounds on physios and a previous osteopath all of whom only ever managed my symptoms. If I'd seen him much earlier he could have possibly saved me from the interventions necessary for my births. I didn't go because he was miles away down in Kent, wish I had gone earlier now, as he is inexpensive and can make a lot of difference in a few sessions.

His name is Quentin Shaw and he is a world renowned expert in his field of classical osteopathy for SPD and spinal problems. He changed my life (and my posture!). He's in Tunbridge Wells which may not be local, but he has women who travel from Scotland and Ireland to see him because he's so good. He's had women come in in a wheelchair and walk out on crutches after one session / come in on crutches and walk out without them etc., and then continue to improve. (p.s. I not his friend and don't work there or anything!) His colleague Matt is brilliant too.

Hope it goes away quickly for you and everyone else on the thread, it's the most debilitating, shitty, miserable thing and so hard to explain to anyone who doesn't understand.

Links:

Tunbridge Wells Osteopaths
Pelvic Partnership for advice

Hee hee, x-post pics re: short skirt no knickers!

If you still have problems after giving birth, shout and shout and shout! DD2 is now 14 months and I am waiting for my physio referral. I thought it would go away on its own and it didn't. Although it is much better most of the time, it flares up with sciatic-type shooting pains down my buttocks and thighs if I walk a lot in unsupportive shoes/carry DD a lot/hoover etc. I finally got pissed off about a month ago and went to the doc to be referred.

And don't let the MWs put your feet up on their hips to give birth. With DD1 they got me to do this (which I now know is banned for their sake as well as yours) and I was in agony for months afterwards.

I had SPD in my third and it rapidly progressed from twinges to not being able to walk (had three kids in three years so my pelvis has not been stable for quite some time!).

lie on as soft a surface as possible (a duvet between you and the mattress...i had to take to sleeping on the sofa)
dont hoover or iron (anything that makes you twist or seperate your legs for stance)
one step at a time (it takes forever and is frustrating but stops that shooting pain)
dont stand for too long
use the pushchair to take some weight when walking
walk at your pace (dont try and keep up)
get a gym ball (it automatically realigns your posture...same as sitting on the loo but more comfy...I took to sitting solely on it form 35 weeks)

my eldest was 18mths when i got quite bad and aside form doing the absolute necessary i did nothing! and it really is the best prevention method :( i didnt lift them into/ out of cots, i didnt change nappies on the floor. i didnt cook tea and my other half was working 50 hours pw. you need people to take over, as hard as it can be to let them. It can affect your labour, so try to stay off your back (birthing chairs or squatting is best) and dont think it will go away straight away (10 weeks later I am fighting with my gp for some treatment as i dont feel comfortable getting rid of my crutches just yet)

It's quite painful today, I'm trying to sit as upright as possible. Is the bouncy ball a good idea or not? It hurts so much getting off it that I'm not sure if I'm doing more damage than good?!

I tried calling my midwife but she didn't reply so I have sent a message to her asking about a support belt and physio referral. Hopefully she'll get back to me quickly.

I'll remember the mantra "short skirt, no knickers" it's in my head!

I need to start doing less, I know that now. I guess I've just been thinking that there's only a few weeks left and I can push through. Today has taught me that that's just not right and I can't do that!

It's not so much upright as possible, as straight as possible, so there is no bend in the spine or pelvis. Make sure you are symmetrical wherever you sit, and absolutely no crossing of any bits of your legs.

I loved the ball but there are ways of getting off it - having a high-backed chair in front of you so you can pull yourself up for example. DHs are also useful for this

And be ultra-careful when it's wet - slipping is as bad for your pelvis as you can get.

Is it wrong that I was a bit excited to see this made it onto the "discussions of the day" bit?!

not at all.

I was excited I'd posted on a discussions of the day thread which is v sad of me

My midwife didn't reply by the way. Where does that leave me?!