Symphysis Pubis Dysfunction (SPD) / Pelvic Girdle Pain (PGP): Causes and Risk Factors

Symphysis Pubis Dysfunction (SPD) / Pelvic Girdle Pain (PGP): Causes & Risk Factors

This is the third instalment on Symphysis Pubis Dysfunction (SPD) / Pelvic Girdle Pain (PGP). We already looked at exercises to alleviate SPD & how to minimise discomfort during everyday activity. So now you’re (a little) more comfortable, we’ll go to part 3 of 3 of these posts, & have a look at what is, why have you got it.

The sacrum is at the base of your spine, above your coccyx, & fits between the two halves of the pelvis. These pelvic bones are called the iliac bones. This is where the sacroiliac joints are formed (the 2 dimples in the small of your back). These three bones of the pelvis -the sacrum and the two iliac bones – form a ring.

The iliac bones meet at the front of the pelvis, forming a joint called the symphysis pubis. This joint is extremely vulnerable during pregnancy. Both raised levels of the hormone relaxin, & pressure from your baby, cause the joint to become more elastic & to widen in preparation for birth. This makes the whole pelvic joint less stable. The pain of SPD is not necessarily related to the degree of separation, but owes more to the instability of the whole pelvis.

Symphysis Pubis Dysfunction, now know as Pelvic Girdle Pain, refers to pregnancy-induced instability, pain & dysfunction of the symphysis pubis joint and/or the sacro iliac joint.

Some pain in the area is felt by 50-70% of pregnant women. 14-22% of women have serous PGP, with 5-8% having severe pain or disability.*

There are no clear causes or risk factors for SPD / PGP, however the pain experienced is associated with a misalignment of the pelvis (at any of the joints) & may be (less so) related to hormone levels.

If you have suffered from SPD / PGP in previous pregnancies; have been subject to pelvic injury or any misalignment to the spine or pelvis (including due to poor ergonomic working positions or heavy workloads); if your joints were particularly mobile pre-pregnancy or if you were very overweight – you may be more susceptible.

If you are suffering from SPD /PGP, then get referred to a physiotherapist as soon as possible, as discussed in the previous posts. As well as following the advice he/she gives you, activation & strengthening of the transverse abdominus muscles & pelvic floor is vital to assist stabilisation of the pelvis.

I do hope these 3 posts have been helpful! Please leave a comment to let me know your experiences, what has worked & what hasn’t, & to ask any further questions!

Did you know that the techniques of MuTu Core Phase 1 & MuTu Breathe in the MuTu System online program are gentle, safe & entirely appropriate for pregnancy & immediately after giving birth?

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* Association of Chartered Physiotherapists in Women’s Health

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Glen Daniels

Indeed raising awareness about SPD and the difficulties women have with this often debilitating problem is very important. I’ve been trying to promote the good work that Osteopaths can do to help women in pain with this condition. We often have pregnant ladies turn up to our clinics that have been told by their GP’s and physiotherapist that nothing can be done.

This is simply incorrect and osteopaths have been successfully treated this conditon for many years. My wife suffered from severe SPD during our last pregnancy, the symptoms carried on long after birth. After just a single treatment with an osteopath 95% of this had gone (this is one of the reasons I chose osteopathy as my career). There is really no need sit around In pain, give osteopathy a try and if/when it works, inform other of your success.

Glen from The Osteopathic Health Centre Buckhurst Hill