Identifying and treating Symphysis Pubis Dysfunction

>> Friday, January 20, 2012

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Tiffany wrote in this week as she is 22 weeks pregnant and experiencing moderate to severe pain in her pelvic bones and pubic symphysis. The pain is worsening as her pregnancy continues and the baby gets heavier to carry. As the pain worsens it affects her ability to walk and move around normally. She hopes to deliver vaginally but with all the pain and instability of her pelvis, not sure if it will be possible. I know many of you can relate to her pain and worries because you are or have experienced this in varying degrees. So let's see what is happening, okay?

It has an actual name, Symphysis pubis dysfunction, or SPD, and is one of those weird pregnancy conditions that sound bizarre. It means the ligaments that normally keep your pelvic bone aligned during pregnancy become too relaxed and stretchy. In fact it can be worse with second and third pregnancies, because it is easier for ligaments to stretch once they've stretched before. It’s like when we try to blow up one of those small balloons the first time and almost pass out doing it. But once it's been blown up it is easy to blow up again and again. Subsequent pregnancies put a woman at greater risk for this to happen. This in turn, can make the pelvic joint or the (symphysis pubis) unstable, causing strange sensations and pain.

The reason SPD can happen in pregnancy and then be gone after delivery is due to is because of a hormone we make only during pregnancy called relaxin. It’s, purpose is to make your ligaments stretchy so your baby can ease his or her way into the world. But sometimes relaxin does its job too well, making the ligaments around your pelvic bone during pregnancy too loose and too soon, before the baby is ready to deliver. This causes instability and pain in the pelvic bone.

SPD affects the other pelvic ligaments. It can feel like someone kicked or like your legs won’t hold your weight. Walking, standing, or rolling over in bed can be painful as one side of the joint shifts more than the other. In rare cases,the joint may gape apart noticeably, a condition called diastasis symphysis pubis, which can cause serious pain in your pelvis, groin, hips, and buttocks.

So what can you do to make it better or at least bearable? You can try stabilizing those floppy ligaments by wearing a pelvic support belt. This holds the pelvic bones in place during pregnancy. You can also try, try pelvic exercises that are commonly illustrated in many pregnancy books if your doctor approves. It is usually recommended that women with SPD give birth in an upright position, with knees slightly apart. t is also suggested that a woman tie a ribbon around both legs to ensure that the gap never exceeds her maximum comfort zone. Typical advice given to women includes avoiding strenuous exercise, prolonged standing, vacuum cleaning, stretching exercises and squatting. Other advice includes the following:

* Brace the pelvic floor muscles before performing activity which causes pain.
* Rest the pelvis, sitting down for tasks where possible.
* Avoid lifting and carrying.
* Avoid stepping over things.
* Use cautious movements when weight bearing.
* Bend the knees keeping legs 'glued together' when turning in bed.
* Place a pillow between the legs when in bed or resting.
* Avoid twisting movements of the body.

The hormone “relaxin” affects all ligaments in the body, so it's possible that other joints will be giving you problems as well, such as shoulders and wrists. If the pain is severe, ask your practitioner about pain relievers. Massage and chiropractic’s can also be of benefit.

But for most moms, once your baby is born and relaxin production ceases, you will have complete resolution and be back to normal in a few weeks after birth. I hope this helps you understand and gets you through the discomfort it creates by alleviating your fears.

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