Best treatment for SPD/PGP/lower back pain?

[CrispyFB]

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.

[Want2bSupermum]

I tried everything and chiro was the only thing that worked for me. Im here in the US and my obn sent me to a specialist chiro who works with pregnancy issues 99% of the time.

The chiro had me use a foam roller with ridges in it. It worked really well and during my 2nd pregnancy I didn't need to go for any appointments. I used the roller 3 to 4 times a day for 5min clips from the day I got a positive test.

[rij78]

I had bad spd with my first and particularly after the birth as DD's shoulders got stuck and had to have MacRoberts manoeuvre (imagine breaking the legs off a chicken!). My issue seems to be that the bones on my groin seem to grind as i walk.

Anyway was in agony after DD and it didn't fix for months - quite frustrating as beforehand was quite fit. Since then I do tend to get the odd bout of spd before my period and early on with this second pregnancy (currently 38 weeks). Swimming front crawl (no breaststroke) has really helped as have the exercises from this physio's book: www.rosttherapy.com/index.php?show=patientnews
Haven't had to wear a support belt this time round and feeling a lot stronger despite not being able to do as much sport. Would recommend the book.

[comfyonesie2]

OP if you look on the Serola website, you can work out what size you need and buy second hand on eBay. I got mine for £16, barely used. I really hope you find it good.

[Tillyscoutsmum]

Sorry OP. I've been at a children's party. Yes. That's her!

Good luck. Hope it helps

[octanegirl]

Another vote for the Serola belt. It's excellent. I could barely walk without it.
As for Acupuncture...I must say I can't see the science behind how acupuncture can help with a musculo-skeletal issue....

[Littleen]

Got this issue, and have tried many things without success, also lot of exercises that really don't do anything at all. I found the most boring solution (imo anyway) works best. Avoiding walking on asphalt etc, but go for walks on grass and sand, the longer the better. Feel a little worse for the rest of the day, but at least for me it then hurts a lot less for 2 days after! My physio recommended it, and it's the only thing that works for me, but I find it sooo boring to go for walks, it's a proper chore :P But worth it though.

[LilacBreastedRoller]

The NHS physio wrote me off with crutches, the osteopath i saw didn't help but private hands on physio treatment had me fixed in two sessions. Get in touch with the Pelvic Partnership charity, they are lovely and wiil suggest therapists in your area who have been recommended by other sufferers.

[Onlyanother18years]

Hi I went swimming 3 times a week- might not be easy to fit in but I used to go in the evening. The weightless feeling was great and I felt I was at least doing a little exercise. I used to feel really refreshed after I came out and it helped me get some sleep. Like someone said above, no breast stroke though.

[DziezkoDisco]

I tried everything, only acupuncture worked for me, and stopped my terrible sciatica. Also rest when possible (not easy with no4! As I well know)

[CrispyFB]

Thank you everybody for the mass of replies! I was somewhat stunned to see the thread so busy since I last visited, but then spotted it is discussion of the day.. ahhh!!

I am trying to rest as much as is possible, and not overdo it if I can. I've already realised in the last week or so that I can't just walk into town any more (a mile away involving two steep hills) and will have to fork out the £1.50 for parking. Bleh. I just wish the living room tidied itself Mind you, DS (2) has weirdly started tidying away his toys without asking this last week into the correct boxes, bless him. My other two DC would never (and still don't!) do that without a fight!

My Fitbit stats are starting to look seriously miserable and I am sliding down my friend high score charts.. ah well, I'll live!

Anyway, some great information there, that I hope is of help to not just me but to anyone else suffering from this awful curse. Am sad but not surprised to see so many people reporting similar experiences to mine as regards NHS physios.

I've ordered one of the Serola belts - it's been dispatched already, comfyonesie2 I should have thought of a second hand one on eBay, whoops!

LilacBreastedRoller I'd forgotten to look at the Pelvic Partnership site, despite often recommending them myself to others. Duh. I'll do that now.

Onlyanother18years - I do like swimming but I am rubbish at crawl and spend my entire time doing breaststroke. It's probably a technique thing because as mentioned I'm otherwise usually fit. Even when I was marathon training I could never manage more than four lengths of crawl in a row without swapping back to breaststroke, but I could breaststroke all day I think.

supergoogler - I have never heard of Amatsu! Learn something new every day. I'm not that far from Rickmansworth - I'm in that part of the world at least!

littleen - very interesting about walking on soft grass/sand etc - I'd not heard that before.

Tillyscoutmum - sadly Tewkesbury is too far, boo.

rij78 - thank you for the book recommendation - I will take a look.

Thanks again to everyone who has replied. I'm going to take a closer look at local chiros and hands on physios (I never knew there were different sorts!) and try the belt out as a starter. I may well give acupuncture a go if needs must!

[impatienttobemummy]

Osteopathy Mark Rush in St Albans, Herts. And deep tissue massage once a month

[BoffinMum]

I know a good physio in CB22 who helps take the edge off things.

Whilst suffering myself I wrote the wikipedia entry on SPD which was checked medically at the time, and seems to still be there in its genuine form. I basically did a kind of mini literature review from all the gold standard documents on the subject (you can see them all in the references). Some GPs are too nervous to prescribe proper pain relief medication but obestetricians are often more gung-ho, so that might be the way forward. Remember that you can use a TENS machine as well - you can get medical ones for £35 and you need to position them higher up and use different settings to what you might do in labour. Ask the obstetrician to get the info for you from their chronic pain team.

Also if I was going through it again, I might invest in a Laz-E-Spa inflatable spa pool). Floating about in warm water helps blood flow and relieves pain too (I had that fact checked out by a top anatomy lecturer in a medical school).

Best of luck, anyway.

[Nursee007]

An osteopath who specialises in woman and childbirth....mine was called Carragh McAree and she practises in teddington. I saw her weekly from about 22 weeks and got 3-4 days of decent relief each time, I swear she kept me out of a wheelchair. the BSO or the pelvic partnership should be able to put you in touch with someone closer to you who has specialist knowledge and experience. I was SO miserable with my SPD ( came on at 18 weeks ) and am SO frightened of it happening again ( which, as we all know, is a large possibility! ) that's it's completely put me off the idea of having any more children, so I really do feel for you, having to cope with it whilst having small ones to look after. Be kind to yourself and do as little as possible, ice the sore areas ( even if it means sitting with a ice pack on your fanjo, it does help!) and take all the painkillers you can ( I'm allergic to codeine so couldn't take it....!)
Support belts did nothing for me....and I tried LOADS!

[perfectstorm]

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.

[BoffinMum]

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).

[CrispyFB]

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

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.

[Want2bSupermum]

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...

[Tillyscoutsmum]

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 ) and lots of googling before I was even aware of what it was :-(. It's terrible

[BoffinMum]

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.

[BoffinMum]

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.

[LilacBreastedRoller]

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.

[CrispyFB]

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 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!

[perfectstorm]

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.