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?

definitely follow up tomorrow.

I'd also contact GP too, especially as GPS are now care coordinators for patients.

also keep a log of all calls, etc you make. Not to use in court - to further your case that they need to speed up if they try and delay....as in "I realise this us our first conversation about this but as you will see I'be been asking for this referral/support.belt etc for x days/weeks"

Oh bless your heart, I so feel your pain.

SPD is something that I had never heard of until I got it with DS at 18 weeks. I was put on crutches straight away and told to rest which wasn't possible as I was still working and had a young DD at the time.

I was told to take paracetamol and have lots of warm baths and all would be fine. Not so. Make sure your MW and GP are badgered all of the time if you're in pain. You can use a TENS and you can take co-codamol as long as your GP/MW knows about both as a TENS can trigger labour which you may want some nights but not yet sweetheart. :)

I had hydrotherapy twice a week, which helped me massively, I had physio at least once a week, and also told to sleep with plenty of pillows and to lie on one side, not on my back.

If you search the site, you'll find lots and lots of SPD threads because no-one knows what it is until they get it. It's horrific. I'm so sorry that you are suffering.

I would (and did) -

a) - invest in a well fitted maternity belt, thick and covers the bottom and the surround of your bump.

b) - take paracetamol, use a TENS and ask for co-codamol. Try to use breathing techniques for for the pain.

c) - DO NOT LIFT OR PUSH ANYTHING YOU DON'T HAVE TO. Even opening a heavy door will hurt.

d) - if you drive, get a swivel seat LIKE THIS you can get them cheaper, Aldi have them in now, DH got me a new one last night for £10.00

e) - Make sure EVERYONE knows you have SPD. You need to give birth on your side if at all and I was told to have NO epidural if you can bear it because them moving your legs about or any pulling, can pull the pelvis apart more, or so I was told but it's up to you. I managed to birth on my side with no pain relief just G&A for a while and then gave up because I just wanted it over with.

f) - Try to see a physio who specialises in this sort of treatment, an internal exam may help too so that the can tell you how and where the SPD is affecting you. GP or MW can advise on that. Be careful who you see, don't let them pull you about AT ALL! Make sure that they lower the bed for you to get on and help you get your legs up, ask for pillows for support whilst in there. If they offer you crutches, take them! I was on them from 20 weeks and induced at 39 weeks.

g) - everything that all other wonderfully supportive posters have said to you so far up thread ^! SPD is a nasty disability and it will not just go away once baby arrives, but then again, it may. As others have said, do not let it go. I ended up having x-rays and MRIs which showed that I have various other health issues but without the initial and still lingering SPD, I wouldn't have found out.

DS is 4 in 2 days and I still have pain, especially when it's cold and damp.

Take good care of yourself and good luck with it all xxxxx

(PS - sorry for any typos, DS is not a sleeper! )

I know you said you can't afford an osteopath/chiropractor but really it's the quickest and easiest way to fix it. There is a relatively simple manoeuvre they can do that shifts the symphisis pubis back to where it should be (and oh God, the relief!) so you might get relief from just one session - and while it's not the cheapest thing in the world, is it not worth it? Can you get it in lieu of your next birthday present or something? Once they have done the manoeuvre on you once, you might be able to do similar yourself (and save money).

Things that helped me were keeping my knees together as much as possible, especially when in bed, only turning over with my knees together, that kind of thing. I saw an osteopath monthly, I think it got down to 3 weekly by the end but I had a 2h train journey to deal with so no more than that, but I have other back and pelvis issues as well (and have had for many years).

I didn't use a belt in the end, although it would have probably helped - it was a bit risky with the other problems I have.

I had horrific heartburn from week 14 and ended up sleeping propped up by a beanbag, rather than extra pillows, because I could create exactly the right shape for all my aches and back problems with it.

Do definitely make sure that they know you have SPD when you're in labour so they're more careful with you; and you may well need to continue with treatment (physio or whatever) afterwards or you could be stuck with a problem for a very long time (simply not worth it). My osteopath fixed up my hyperflexed sacrum and lower back in 2 sessions after giving birth, and I have no SPD issues now.

Personally physio didn't work for me. They just looked and me and gave me a big tubi grip. The support didn't help a bit because my pelvis was rotated on one side so pushing it together was not what was needed, I needed it rotated. Honestly chiro or osteo is brilliant.

I am convinced I have developed SPD as it feels like someone has kicked me in the crotch (!) but the midwife said it was more likely to be a nerve problem as not feeling it in my hips and the front pubic bone doesn't hurt, just one side and it is more underneath IYSWIM. Does anyone have experience of this and have an SPD diagnosis?
It started literally overnight and hurts when I go from standing to sitting, turn over, get out the car. When standing and walking it aches but doesn't hurt as such.
Sorry for hi-jacking thread OP,

Don't sit at your desk at work for six hours without getting up for a wander round. That was me yesterday, and now my mild twinges have clubbed together into serious pain and audible clicking. Awesome!

letme SPD is very specificly about the pubic bone (Symphysis Pubis Dysfunction), but there is PGP (Pelvic girdle pain) which is more generalised pain in the pubic area caused by all the joints loosening. I had pain like you described with SPD, but also crunching SP joint and severe pain there. In my second PG I had PGP as well as SPD and it caused pain in lots of places, including underneath and up inside my bits!

Get physio. Even if you have to shout till you are blue in the face to get the referral, do, because it will help you after you have given birth. I wasted most of my mat-leave semi-disabled because arsehole patronising GPs kept telling me it would go away when it was not.

As everyone knows, SPD in pregnancy is caused by relaxin causing instablility. HOWEVER as everyone doesn't know, or chooses to ignore, the floating around can cause things to become semi-permanently out of kilter which needs be be physically (hands-on) corrected by some kind of practitioner like a physiotherapist, (you should get an NHS referral) or an osteopath or chiropractor (if you can pay).

It is important to note that things can still be out of kilter when your hormone levels are back to normal, because there was too much mobility when you were pregnant. There is a bit of a red herring about bfing affecting hormone levels so you still get symptoms "which will go away on their own". It is a red herring, you need hands-on treatment.

If you can get a referral asap it will help you in the last weeks of your pregnancy, and if it comes through after you have had the baby, it will help you get better much sooner and get you back to normal quickly. so SHOUT.

the physiotherapist will be able to diagnose exactly what lumps of bone are out of line with what, and physically put them back. It is amazing. You will get given exercises too, to strengthen key muscles and hold it all in place, but the moment that the big lump of pelvis gets punched back into line is incredible and makes all the difference.

Go to an osteopath.
Go to an osteopath.
Go to an osteopath.
Go to an osteopath.
Did I mention, Go to an osteopath? I had TERRIBLE SPD from 5 months on and was in agony - could barely walk anywhere. Constant pain walking, standing, sitting, lying down, etc. The midwives referred me to a physio at the hospital who succeeded in making it worse. Then a friend recommended the Osteopathic Centre for Children (Wandsworth, London). I didn't really want to go because I don't believe in New Age / alternative medicine but I was desperate so went along. Sat for an hour on a bed while they poked me very gently and I thought "what a waste of time". Stood up at the end of it and it was like a Biblical miracle! I was almost totally cured. I actually ran for the bus! It was insane.
After the birth I had massive nerve damage and suffered temporary paralysis in my legs - I couldn't move properly. Again, got an osteo round and she fixed it up in an hour.

Please, please, please try it. It's amazing.

I always pop up to post this on SPD threads, but it might be worth switching to a foam mattress. My SPD improved massively almost over night when I did.

MW are generally crap with SPD unless they have had it themselves. Make a massive fuss at the GP and get referred for physio, pain management, rheumatology and anything else you can think of. Don't be fobbed off or you may be stuck with this permanently. Ask your GP's opinion on the following (which was all advice I got at the hospital pain clinic from specialists).

Wear a TENS machine all day - there are different settings for chronic pain relief to what you use for labour. The machines can be bought for about £30 if you avoid pg suppliers and go to physio ones. This will not, repeat not, send you into labour, despite what ill informed mw and allied health professionals say. If they did, then everyone would be using them to induce births!

Take codeine phosphate 4x day with paracetemol 4 x day for breakthrough pain. Ignore people who say you can't take pain relief drugs in pg. You can, as long as this is properly supervised. If your GP will not prescribe codeine phosphate, get a consultant to. If it is really bad you are also allowed Oromorph 3x day but this may conk you out completely. If you take a lot of opiates you may also need a laxative.

Take at least two warm baths a day to relax your joints and improve blood flow.

Do not just park yourself on the sofa if it hurts, potter very gently instead.

Wear slippy nightclothes in bed to make turning over easier.

Do not push trolleys or do anything particularly physical like lifting.

Some people like belts (although they did fuck all for me).

Keep your knees together at all times (hindsight is the greatest gift LOL!)

Tell everyone you have a serious pg complication and need help and support.

Do not use stirrups for delivery, they can use loop things at the side of the bed if necessary.

Consider a birthing pool for delivery, as the water supports the pelvis.

There's more on the wikipedia entry on SPD which I wrote and which I had checked at the time by a doctor. It may have been edited since then, although it's usually scientifically sound every time I look (they keep the snake oil people off the entry), but as with anything, it's always worth doing a print off and asking your own GP what they think.

Cheapest decent mattress for SPD.

www.johnlewis.com/john-lewis-value-memory-mattress-double/p230943978

Thanks MrsBaffled. Maybe it is that then. I might try speaking to a different midwife and see what he says. Or I might not and just try to ride it out, following suggestions for managing PGP. Only have 4 weeks to go so hopefully won't get too much worse.

Thanks again!

Hello, a lot of people have already replied, so I'm echoing what they have said.

I had really bad SPD, which got a lot worse after a fall at work. What I would say is that there are different degrees of SPD, and my midwife was most unsympathetic, I think she had dealt with a mild case in the past and had no idea how much pain I was in. You may need to really push for additional help, I was eventually given crutches, but no pain killers before or after the birth, no support band, and was told physio wouldn't do anything. In fact she told me to stop making a fuss, and think about the poor women who had caesarians! I had been in constant pain for 4 months, and couldn't stand up for several weeks after the birth! There is help available (as I found out much later) and you may need to push for it.

Make sure everyone who is involved with your birth knows about the SPD, have it printed on your t shirt if necessary. It being in your notes is not enough. I was put in stirrups, and my legs pulled further apart when taken out of them.

I would recommend satin pajamas, they only way I could move in bed.

The carrier bag on car seat.

Pilates, not sure about during, but I did this from a few months after and it helped a lot.

Go up stairs one at a time. (I couldn't go on my bum as I couldn't get up again at the top or bottom of the stairs) It doesn't matter how long it takes.

Get in and out of the bath by putting a phone book next to the bath, step onto that, standing sideways to the bath, then lift your leg, bending backwards from the knee only, and try to get that foot into the bath, then do same with other leg.

Sit on a dining type chair rather than the sofa.

I never found a way to get nickers or socks on, get your partner to do that!

Hope it gets better after the birth, and you get as much support as possible.

You can write 'no stirrups - SPD' on your thighs!

I got SPD at 4 months with my ds, it was horrendous, but affected the joints at the back of my pelvis rather than the classic front pain. I agree with a lot of the tips already onb here, but here's what I did:

Maternity physio - self-refer, exercises didn't help, but I got a support belt for free which was a life-saver

Cranial Osteopathy - expensive, but worth it as it helped more than anything else

Walking - they tell you not to walk, but for me keeping mobile was the best thing as long as I was wearing support belt

Stairs - I used a walking stick as physio didn't give me crutches 'til later on

Lifting/Twisting - DON'T! I ordered groceries online as shopping trolley was a killer (I am actually 9 weeks pg now with dc2 and have taught ds to climb in and out of highchair, carseat, buggy so I limit any lifting as it is expected I will get SPD this time around too)

Sleeping - pillow between knees

General moving - try to keep legs together when getting up/down, avoid putting weight on one leg, sit to put on socks etc. Walk-in shower easier to get in/out of than bath

Hope this helps anyone else and I'm keeping my fingers crossed if it does happen this time I know the signs and will be able to seek help immediately.

The OT people came around to my house with loan gadgets and a wheelchair to help me. The wheelie tray trolley was one of the most useful things.

i've been hovering on this thread hoping to hijack some info for myself! I've got a crunching lower back, pain in lower back more one side than another, and some frontal pain on either side. not sure if its spd or pgp. However, not to hijack without contributing, i've booked an osteo appointment for sat morn and its a standard £20 for one session. so for anyone considering trying it out i'd say its well worth trying (no breaking the bank)? if it makes a difference i'll be back to let you know!

I've read a few posts on here saying natural birth can be more painful if you have SPD. I had a c section last time (failed induction) and have been given the option of an elective c section or a VBAC this time. I was leaning towards trying for a VBAC, however as I have told I am likely to get SPD again and have now read this I'm wondering whether I should just have the elective c section. Is anyone in a similar situation?

I would have thought the baby would come out easier with SPD as the pelvis joints are much more stretchy than normal?

They strongly discourage CS as it will mean having two problems to recover from, and most people find the only compensation is that yes, births are a bit easier. Anecdotally I think that might well be right.

Sorry to hijack myself here, but does anyone know if pins and needles in one hip, right where the leg meets the pelvis, plus stiffness in the same spot, like the area really needs to be stretched, might be SPD? I'm only 11 weeks. :(

I am actually planning to call the midwife and ask about this, but it looks like she's only available for an hour in the mornings; the line's been engaged the rest of the day when I've been able to call.

It's not crippling, just annoying, and I'm afraid of making it worse. Was jogging/walking this week until this happened. Will try icing my hip tonight.

JustGas, I am not sure but actually the best advice might be to stop running and so on, and to have a warm bath (good for circulation) and rest up. Gentle yoga or pilates may prevent later problems.

MWs don't get SPD, you might be better off seeing a sympathetic GP.

Justgas - is it at the back of the front of the pelvis? If it's at the back, it might be sciatica. But definitely stop jogging and change to a less hard-impact exercise.

Did anyone get crutches from physio I did and they really helped too apart from on stairs where they seemed a bit too risky! Agree with the avoiding stirrups one in labour so painful!