Symphysis Pubis Dysfunction (SPD) is most commonly associated with pregnancy and childbirth. It is a condition that causes excessive movement of the pubic symphysis, either anterior or lateral, as well as associated pain, possibly because of a misalignment of the pelvis. SPD is a dysfunction that is associated with pelvic girdle pain and the names are often used interchangeably. It is thought to affect up to one in four pregnant women to varying degrees, with 7% of sufferers continuing to experience serious symptoms postpartum.[1][2] Although the condition was recognised by Hippocrates, incidences of SPD appear to have increased in recent years; it is unclear whether this is because the average maternal age is increasing, or because the condition is being diagnosed more frequently.
The main symptom is usually pain or discomfort in the pelvic region. This will probably be centred on the joint at the front of the pelvis (the pubic symphysis). Some sufferers report being able to hear the lower back and hip joints, the sacroiliac, clicking or popping in and out as they walk or change position. Sufferers frequently also experience pain in the lower back, hips, groin, lower abdomen, and legs. The severity of the pain can range from mild discomfort to extreme and prolonged suffering.[3] There have been links between SPD and depression on account of the associated physical discomfort.[4][5][6][7] Sufferers may walk with a characteristic waddling gait and have difficulty climbing stairs, problems with leg abduction and adduction, pain when carrying out weight bearing activities, difficulties carrying out everyday activities, and difficulties standing.
Early diagnosis is crucial in order to minimize the medium to long term severity of the condition, which can be disabling in its extreme form. Unfortunately not all healthcare practitioners are sufficiently aware of the condition.[9][10] A diagnosis is usually made from the symptoms alone, although after pregnancy, MRI scans, x-rays and ultrasound scanning are sometimes used. Women initially report the condition to a midwife, obstetrician, general practitioner or physiotherapist. On seeing a health professional, women should expect to receive a thorough physical examination to rule out other lumbar spine problems, such as a prolapsed disc, urinary tract infections and Braxton Hicks contractions.
Birth planning
It is usually recommended that women with SPD give birth in an upright position, with knees slightly apart, and it is often suggested that a woman tie a ribbon to both legs to ensure that the gap never exceeds her maximum comfort zone. Practices such as placing the feet on the midwife's hips during delivery, stirrups, and interventions such as forceps should be avoided in the delivery room if at all possible, as they can strain ligaments further and cause long term problems. If stirrups must be used, for example during suturing, great care must be taken to move the legs in symmetry, manoeuvering them gently into position.Everyday living
Typical advice usually given to women includes avoiding strenuous exercise, prolonged standing, vacuum cleaning, stretching exercises and squatting. Women are also frequently advised to:- Brace the pelvic floor muscles before performing any activity which might cause pain
- Rest the pelvis
- Sit down for tasks where possible (e.g. preparing food, ironing, dressing)
- Avoid lifting and carrying.
- Avoid stepping over things.
- Avoid straddle movements especially when weight bearing.
- Bend the knees and keep the legs 'glued together' when turning in bed and getting in and out of bed.
- Place a pillow between the legs when in bed or resting.
- Avoid twisting movements of the body.
p/s Information retrieved from Wikipedia
Pain love,
Mysa
xoxox
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