Aches and pains are an unfortunate, but normal part of most pregnancies. During pregnancy the hormone, relaxin, is created in large quantities and released in the body. Relaxin relaxes joints, muscles, and ligaments in the body, which is particularly helpful in the pelvis. When the pelvis relaxes, there is more room for your baby to pass through the birth canal during delivery. Up to 80% of pregnant women may experience Pelvic Girdle Pain, a generalized discomfort of the pelvic region that can range from mild to severe.
In some cases, extreme localized pelvic pain may actually be a condition called Symphysis Pubis Dysfunction (SPD). In SPD, there is too much movement of the pelvic joints, specifically the symphysis pubis, which is the joint in the front center of the pelvis. This condition affects approximately one out of four pregnant women, though only 7% of these cases are considered severe where the joint can actually separate or dislocate, referred to as Diastasis Symphysis Pubis.
Symptoms of SPD
(Note: these may occur during pregnancy or post-partum)
- A specific area in the pelvis that may be tender to the touch
- Difficulty standing, walking, or climbing stairs
- Pain while walking, rolling over in bed, or changing positions
- Pain that radiates to the hips, inner thighs, groin, or lower abdomen
- A “click” sound from your hips or pelvis
If you have some of these symptoms, discuss them with your provider. Links have been made between SPD and depression because the pain can be so debilitating for some women that if can affect their quality of life. You may also need to discuss birthing positions with your provider, since some positions may be more or less favorable to minimize your pelvic discomfort during labor.
Though SPD cannot be cured, the pain can be managed through various non-pharmacologic and pharmacologic interventions. For most women, once the pregnancy is complete and the body heals in the weeks after delivery, the levels of relaxin decrease and the pain subsides.
- Daily Kegal and Pelvic Tilt exercises that strengthen the pelvis and body’s core
- Yoga (click here for poses specifically for SPD)
- Water Aerobics
- Wear a pelvic support belt (click here to read a study about the effectiveness of these belts in combination with exercise)
- Physical therapy
- Chiropractic care
- Homeopathic remedies and herbs, such as Arnica or Comfrey
- Lifestyle modifications:
- Sit instead of stand when cooking or getting dressed
- Avoid stepping over things
- Avoid squatting
- Avoid lifting or carrying heavy objects
- Sleep with pillows between your legs, enough to keep legs more parallel
- Avoid excessive movement of the pelvis (i.e. move slowly, roll your body as if your knees are glued together when changing positions in bed, avoid twisting the pelvis)
- Use a lumbar pillow for support when sitting
- Use crutches, walkers, or other walking aids in severe cases
- Anti-inflammatory medications
- Pain medications
If you think you may have SPD, talk to your provider and be sure to discuss any treatment options with him/her prior to actually starting them, or ask them for referrals. For more information on SPD, please refer to the links below:
- Pelvic Pain (Symphysis Pubis Dysfunction) – includes firsthand accounts of women who have experienced SPD and how they have managed the discomfort
- Symphysis Pubis Dysfunction on Wikipedia – general information about the condition
- Symphysis Pubis Dysfunction on Whattoexpect.com – general information and tips