SPD Pregnancy Pain: What It Is, Why It Happens and How to Ease It

Introduction:

You’re finally pregnant, the scans are going well – and then walking starts to hurt. A sharp pain shoots across the front of your pelvis when you climb the stairs, turning over in bed feels like a major event and putting on your jeans while standing on one leg is out of the question. If that sounds familiar, you may be dealing with SPD in pregnancy.

SPD, short for symphysis pubis dysfunction, is now usually called pelvic girdle pain (PGP) by doctors and physiotherapists. Whatever name you know it by, it’s very common, it’s not your fault and – most importantly – it can be helped. You don’t have to grit your teeth and wait for your due date.

In this guide, we explain what SPD pregnancy pain is, the symptoms to look out for, simple ways to make everyday life easier and how a women’s health physiotherapist can help you stay comfortable and mobile right up to the birth and beyond.

What Is SPD in Pregnancy?

Your pelvis is a ring of bones joined at the front by a joint called the symphysis pubis, and at the back by the two sacroiliac joints. Normally these joints are held firmly in place by strong ligaments and move only a tiny amount.

During pregnancy, your body releases hormones that soften the ligaments to help your pelvis open for birth. At the same time, your growing bump changes your posture and the way you move. Sometimes the joints of the pelvis end up moving unevenly or becoming irritated, and the result is pain – this is what we call an SPD pregnancy.

The Royal College of Obstetricians and Gynaecologists estimates that pelvic girdle pain affects around 1 in 5 pregnant women, so if you’re struggling, you’re in very good company.

SPD Pregnancy Symptoms

Symptoms can start at any point in pregnancy, although many women notice them in the second or third trimester. Common SPD pregnancy symptoms include:

• Pain over the pubic bone at the front, sometimes described as sharp, stabbing or burning
• Pain in the lower back, one or both sides, or across the buttocks
• Pain spreading into the groin, inner thighs or between the legs
• A clicking or grinding feeling in the pelvis
• Pain when walking, climbing stairs or getting in and out of the car
• Discomfort standing on one leg, such as when getting dressed
• Pain turning over in bed or parting your legs

For some women it’s a mild niggle; for others it makes walking very difficult. Both are valid, and both deserve support.

When to get help urgently: pelvic or tummy pain together with bleeding, a fever, pain or burning when you wee, regular tightenings before 37 weeks, or severe pain that doesn’t ease with rest should be checked straight away. Contact your midwife or maternity unit, or call NHS 111.

What Causes an SPD Pregnancy?

There usually isn’t one single cause. Factors that can increase the chances of developing SPD pregnancy pain include:

• Pelvic or back pain in a previous pregnancy
• A previous pelvic injury or fall
• A physically demanding job, or lots of lifting and carrying – including other children
• Muscle imbalances around the hips, pelvis and tummy
• Carrying more than one baby

Having SPD doesn’t mean anything is wrong with your baby. It’s a problem with how your joints are moving, not a sign of complications.

Everyday Tips to Ease SPD Pregnancy Pain

Small changes to how you move can make a surprisingly big difference. The NHS guide to pelvic pain in pregnancy shares similar advice, and many of our patients find these tips helpful.

Keep your knees together

Movements that part your legs tend to aggravate SPD. Getting in and out of the car, bed or bath with your knees together – “like a mermaid” –relieves pressure off the front pelvis.

Go up the stairs by taking one step at a time.

Start with your stronger leg, moving it to each new step first. Then bring your other leg up to the last step. Move down with your more painful leg first. It may take you a bit longer, but is friendlier to your pelvis.

Sit down when you dress.

Donning knickers, trousers and socks on your sitting body prevents any chance of standing on one leg, which causes pain.

Rolling over in bed.

Flex your knee, hold them together, and roll them over from the hips and shoulders at the same time. Silk (or satin) linens and pyjamas will make rolling over much easier.

Plan your day

Break your walking and standing with plenty of rests on your journey. Take relatively shorter steps and consider asking for help while shopping and cleaning. Try to avoid pregnancy on either of your hips.

Engage in physical activities that are comfortable

Mild physical activities can be beneficial for both you and your developing baby: swimming (without using the breaststroke), aquanatal workouts and pilates classes designed for pregnant women can be accommodated. Use your own level of comfort as the ultimate measurement.

Wear a support belt if doing so is comfortable

A support belt can relieve pain experienced by some women, but it should serve as a complement to physical activities rather than a substitute. Consult your physiotherapist about whether this option is suitable for you.

Easy exercises that are of help

Strengthening pelvic support muscles may reduce SPD pain during pregnancy with the help of easy exercises that are often performed at the start; stop any movements that worsen your pain and consult a physiotherapist to make sure you perform these exercises correctly.

• Squeezing pelvic floor muscles: carefully squeeze and lift as though trying to keep yourself from farting and peeing, hold for 10 seconds, and then completely relax. Perform this exercise multiple times throughout the day.
• Deep abdominal pulling in: get into the position of being on your knees or sitting upright, take a deep breath and bring your belly to your backbone, hold your breath for a few seconds then relax. Repeat the whole procedure 8–10 times.
• Pelvic tilts on all fours: with hands under shoulders and knees under hips, slowly round your lower back, then return to neutral. Make sure you keep the movements light and comfortable.
• Side position clam: lie on your side with your knees bent and have a pillow between them. Keep your feet together and raise your top knee a little and then lower it back down. The whole movement should be in small range of motion, so that your pelvis does not hurt.
• Seated knee squeeze: sit with a cushion or soft ball between your knees and squeeze gently for 5 seconds. Many women find this eases pain at the front of the Sitting with knees together: sit with a soft pillow between your knees and press it hard for about 5 seconds. Many ladies report that this exercise can take the pressure off the front of the pelvis.

Taking short breaks and performing the exercises frequently will pay off.

How does physiotherapy play a role in SPD in pregnancy?

Physiotherapy is the primary means of treating pelvic girdle pain. The sooner you start physiotherapy treatment, and the sooner you receive it, the better your results will be. A physiotherapist will:

• Look at your pelvis, hips and back to assess which of your body parts need treatment
• Provide manual therapy that will allow the pelvis joints to move normally
• Teach you some exercises to strengthen your deep abdominal muscles, pelvic floor muscles, gluteal muscles and back
• Show you proper techniques for daily tasks like climbing stairs, dressing and sleeping
• Advise you on the use of support belts, crutches and other assistive devices if you need them
• Help you prepare for childbirth in terms of Labour, such as in which positions you will be able to relax during Labour and how far apart you can spread your legs comfortably

SPD pregnancy symptoms frequently coexist with lower back pain. Our back pain physiotherapy at home can also be helpful if that's your primary issue.

SPD and Delivery of the Child

SPD is not an obstacle to normal delivery in most women. It is useful to know beforehand how far apart one can part their knees comfortably before giving birth and include it in one’s birth plan so that the midwife does not separate the woman’s legs too wide.

It is often more comfortable to work in vertical positions, on knees, in the four-legged position, or sideways rather than lying on the back with legs apart.

Does SPD Disappear after the Birth?

In most cases, SPD pains during pregnancy pass immediately after the delivery of the child, usually within a few days. However, in some cases the pain may persist for some time, especially if it was severe during pregnancy. The physiotherapy after delivery helps recover the strength of the abdominal and hip muscles.

Reasons Why Home Physio is the Best Option for You When You Have SPD

The last thing you need is to travel to a clinic, find parking, and cross a parking lot when every step hurts. You don't have to travel, wait in a waiting room, or put additional strain on your pelvis when you receive physiotherapy at home.

The advise is immediately applicable because your physiotherapist can demonstrate how to handle your own bed, car, and stairs. Read our guidance on what to expect from a home visit if it's your first time, or learn more about home visit physiotherapy.

Why Pregnant Ladies Prefer using FlexAura Home Physiotherapy

FlexAura is a health tech company that connects users to physiotherapists across the UK. FlexAura collaborates with a number of healthcare experts, including physiotherapists who deal specifically with pelvic floor dysfunction or pregnancy-related problems. All physiotherapists collaborating with FlexAura are licensed and fully insured and many of them are able to provide appointments for patients on the same day.

We cover cities including London, Manchester, Birmingham, Leeds, Bristol, Liverpool, Edinburgh and Glasgow. Pricing is clear and upfront: online consultations are £45, home visits are £110 for the first session and £99 for follow-ups, and a 5-session home visit package is £450 – ideal for ongoing support through pregnancy and into the postnatal period. See our pricing page for details. Many practitioners also accept private health insurance, including Bupa, AXA and Vitality.

Frequently Asked Questions

Is SPD the same as pelvic girdle pain?

Yes. SPD is an old term given to pain occurring at the front of the pelvis and is nowadays referred to as pelvic girdle pain (PGP) which is an umbrella term for pain in any of the pelvis joints during pregnancy.

Is SPD pregnancy pain harmful to my baby?

No. SPD affects joints making it painful, but it won’t cause harm to the baby.

When should I go to a physiotherapist for SPD?

You should go when symptoms start. If you seek help earlier, you are expected to experience less pain in a shorter period of time.

Is physiotherapy safe during pregnancy?

Yes. Physiotherapists specialize in pregnancy and know how to treat pregnant women safely.

There's No Reason for You to Accept It

Going through SPD while pregnant can be tiring and very difficult, but there are many ways to get relief from the pain. Given the right information and some changes to the way you move your body, plus some support from a knowledgeable women’s health physiotherapist, you should start to feel better fairly quickly.

Book a women’s health physiotherapist today or call 07782 610 633 for a friendly chat about how we can help.

This article is for general information and isn’t a substitute for personalised medical advice. Always speak to your midwife, GP or a qualified physiotherapist about symptoms during pregnancy.