What Is Symphysis Pubis Dysfunction?
Symphysis pubis dysfunction (SPD) is also known as pelvic girdle pain (PGP). It is a condition in which the pubic symphysis joint, a joint in the pelvis, becomes more flexible. This occurs due to the loosening of the ligament because of the increased production of special hormones during pregnancy; these hormones are released in the body to help prepare for childbirth. Therefore, all the movements in the pelvis can be painful. When this joint moves, it can cause pain in the pelvic bone, which might affect the mother's mobility. However, there are ways to ease pelvic pain. The discomfort and pain usually reduce or completely disappear after the baby is born.
What Can Cause Symphysis Pubis Dysfunction?
About one in five pregnant women is thought to be affected by symphysis pelvic disease. During pregnancy, hormones such as relaxin are produced to loosen muscles and ligaments in the pelvis, pelvic floor, stomach, and hip. This loosening helps increase the range of motion to aid in giving birth. The joints can become more mobile and unbalanced than usual, which can cause discomfort or pain. That extra movement allows the right and left pelvic bones to widen when it is time for the baby to be born. These changes in ligaments and muscles can make vaginal childbirth easy and possible.
Usually, this loosening is intended to help with the birth, and sometimes, this hormone production starts in early pregnancy. So, some women may experience the symptoms of SPD long before the time of childbirth. The baby’s position and weight are also thought to affect pelvic pain. And it is believed that the symptoms of symphysis pubis dysfunction tend to worsen as the pregnancy progresses.
Who Can Develop Symphysis Pubis Dysfunction?
Some pregnant women are more prone to symphysis pubis dysfunction than others. Following are some risk factors that might make women more likely to develop this condition:
- Previous history of pelvic injury or damage.
- Previous history of lower back or pelvic pain.
- History of symphysis pubis dysfunction in a previous pregnancy.
- Overweight.
- Uneven movements in the pelvic joints.
- Pregnant with twins or multiple babies.
- Any job that puts increased demand on the pelvic joints and muscles.
- Certain baby positions may increase the risk of symphysis public dysfunction pain.
What Are the Symptoms of Symphysis Pubis Dysfunction?
The intensity of the pain depends on how pressure and weight get distributed throughout the body. And how a woman moves her body can make the pain better or worse. The weight of the fetus or multiple fetuses can also put pressure on the joint, worsening the pain. Usually, the intensity of the pain gets closer to the delivery. The symptoms that can occur are as follows:
- Mild discomfort in the pelvic region.
- Sudden shooting pain arising from the pelvis.
- Steady pain radiates throughout the lower abdomen, perineum (the space between the vulva and anus), groin, back, thigh, and leg.
Symptoms other than pain can also arise, which include:
- Trouble during peeing or pooping.
- Hearing grinding or clicking sounds from the pelvis.
- Feeling fatigued without any clear cause.
Certain movements can also worsen the pain:
- Walking.
- Bending forward.
- Climbing up or down stairs.
- Raising a leg or standing on a leg.
- Getting inside and out of the car.
- Turns over on the bed.
- When rising out of bed or out of a chair.
How Is Symphysis Pubis Dysfunction Diagnosed?
Early diagnosis can help treat symphysis pubis dysfunction. The diagnosis of symphysis pubis dysfunction is made after reviewing the patient's symptoms and carrying out both a medical (to check if the patient is pregnant), physical examination (to check for pain, tenderness, or swelling.), and a history check (an injury that could have harmed the pubic symphysis joint).
The doctor may look closer at the pelvis joint through an ultrasound, CT (computerized tomography), or X-ray. It is usually not advisable for pregnant women to have X-rays, so the healthcare provider should choose another safe option for the patient.
What Is the Treatment for Symphysis Pubis Dysfunction?
The treatment is provided to ease the discomfort and pain if a woman suffers from these symptoms. Physiotherapy is the first choice for the treatment of SPD. Physiotherapy aims to improve muscle function, minimize pain and discomfort, and improve pelvic joint stability and position.
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Physiotherapy - A physiotherapist can provide therapy to ensure that the pelvis, hips, and spine joints move normally. They will also suggest exercises to strengthen the pelvic floor, stomach, back, and hip muscles. Hydrotherapy is also advised in some cases. During this therapy, the patient does the exercises in the water. Because being in the water can take the stress off the joints and allow the patient to move more easily, they might also suggest comfortable positions for labor and birth.
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TENS Therapy or Pain Medications - The doctors may suggest TENS therapy or pain medications for severe pain. Application of cold or heat to the area may reduce pain or swelling.
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Avoid Triggers - Avoid any triggers that may cause pain, such as avoiding heavy lifting and pushing.
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Apply an Ice Pack or Heating Pad - Applying heat or cold to the pelvic area relieves pain.While using a heating pad, do not leave it on for more than 10 minutes since long exposure to heat can raise the baby’s temperature and cause complications.
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Pelvic Support Belt - Wearing a pelvic support belt can help place the pelvic bones back during pregnancy.
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Kegels - Regular practice of Kegels exercise helps strengthen the muscles of the pelvis.
What Are the Complications of Symphysis Pubis Dysfunction During Pregnancy?
Pelvic pain and instability may affect other parts of the body, such as how a person walks and moves. This could, in turn, stress other body parts, such as the back or the hip. Severe pain can interfere with normal daily activities and mobility. Emotional problems may also develop due to SPD-related pain, and it can also lead to social isolation.
Conclusion:
Pelvic pain during pregnancy is not unusual. It is important to differentiate the pain type and cope with it. The good news is that the symptoms will likely go away after the delivery of the baby. However, there are many things to be done to control the pain. Consult with a healthcare provider about ways to manage discomfort and pain.
