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Do you have Symphysis Pubis Dysfunction (SPD)?

Updated: Nov 1, 2023


Symphysis Pubis Dysfunction (SPD) – also known as Pubic Symphysis Dysfunction – is pelvic pain that happens as the ligaments surrounding your pelvic joints become more flexible in preparation for delivery.


SPD is a common complaint during pregnancy and even postpartum.


SPD can be uncomfortable or extremely painful, particularly when you're climbing stairs or getting out of a car. The condition isn’t harmful to your baby, but it could be extremely painful for you. In some, the pain may be so severe that it affects mobility. The good news is that there are ways to ease the pelvic pain!



So what is SPD?

Symphysis Pubis Dysfunction can happen during pregnancy when the joint called the pubic symphysis that connects the two halves of your pelvic bone moves too much. This joint is normally very stiff and doesn’t move much at all, but during pregnancy, a hormone called relaxin is released in your body to help relax the muscles and joints as your body prepares for giving birth. As part of this, the symphysis pubis joint is also loosened.


During pregnancy the ligaments in the pelvis became more relaxed to allow for the changes of a growing baby. Sometimes with the combination of relaxation of ligaments, changes in biomechanics and increased fluid can cause instability in the pubic bone joint. Once the joint is loosened and inflamed, the simplest of movements can cause more stress, discomfort and inflammation. So its important to be aware of what movements to avoid, what exercises and at home care might be helpful and how to avoid further irritation. Let's learn more!


What does SPD feel like?

SPD is often describes as a sharp, wrenching pain in the pubic area. Some might describe the pain as a tearing feeling. The pain can radiate form the pubic bone, to the thighs and pelvic floor. This pain is often felt with activities such as walking, climbing stairs, getting dressed, rolling over in bed and getting out of the car.


It’s important to remember these movements can be modified to help better support our changing bodies and keep the pelvis balanced. While putting pants, shoes and socks on try taking a seat to avoid putting weight on one foot at a time and sheering the pubic joint. Also when rolling in bed avoid dropping one knee then the other, try to scoot and move your knees together while using you arms for added support. When getting out of the car be mindful not to swing one leg then the other, but instead scoot your legs together. These movements might seem simple but they can put a lot of extra stress on the pelvic joints.


What are the symptoms of Symphysis Pubis Dysfunction?

  • Shooting pain in the lower pelvis area

  • Lower back pain that radiates into the abdomen, groin area, thigh, and/or leg

  • Pain when you make certain movements like putting weight on one leg or when spreading your legs apart

  • Pain with regular daily movements like walking, rolling over in bed, going up or down stairs, bending forward, or getting up from a seated position

  • Hearing or feeling a snapping, clicking, or grinding in the lower pelvis area

  • Pain during sex

  • Fatigue


How common is SPD?

SPD is very common. About one third of pregnant women have reported symphysis pubis dysfunction. As it becomes increasingly recognized, the documented numbers are increasing.



What if the area is already inflamed and irritated?

There are some great therapeutic options for reducing inflammation and helping restore balance to the pelvis. First along with being conscious of everyday movements and making modifications, ice can be helpful to decrease inflammation. Also finding a Webster certified chiropractor near you (ICPA4kids.com) to help promote pelvic alignment and pay special attention to the pubic bone. Chiropractic care can help support your body while its changing for baby.


Pelvic floor PT can be extremely beneficial. When sleeping at night having a pillow or support between the knees can help prevent torsion on the symphysis pubis. Many patients also feel relief and added support from compression of a belly band, there are many brands available we have a few listed in our Amazon store here www.amazon.com/shop/anhwellness



How can I prepare for delivery with SPD?

Talk with your caregiver about your pain so that you can be prepared for any difficulties that arise during labor and delivery. You may want to experiment with different labor and birth positions that provide more support for your pelvis, for example. And if you choose to have an epidural or spinal anesthesia, you'll want to be careful not to overstretch your ligaments while you're numb. Spreading your thighs widely during pushing, and/or grabbing your legs behind your knees and pulling back, is often recommended by labor and delivery nurses but would not be a good idea, especially if you have an epidural and can’t feel the strain on your joints and ligaments.



What's the outlook on having Symphysis Pubis Dysfunction?

SPD can be happen during pregnancy but also felt during postpartum. Many mothers notice after a strenuous labor, or where their knees were held and perhaps hyper extended while pushing feel increased pelvic pain. Give these suggestions a try and find a provider near you that can help diagnose and treat your discomfort related to SPD. We also have at home programs available with supportive exercises and educational information to help rehab pelvic dysfunction related to enact trimester of pregnancy and also postpartum.

Don’t forget to follow along and subscribe to stay up to date on all things ANH Wellness to help support mom, babies and growing families. SPD doesn’t directly affect your baby, but it may lead to a more difficult pregnancy due to reduced mobility.


Some women may also have difficulty having a vaginal delivery. Symptoms of SPD often reduce after giving birth. Talk to your doctor if your symptoms still don’t improve. They can check if they may be the result of another underlying condition.



By: Dr. Alyssa Hickey

Owner and Chiropractor at ANH Wellness


Disclaimer: "The information including but not limited to text, graphics, images, and other material contained on this website is for informational purposes only. No material on this site is intended to be a substitute for professional medical advice, diagnosis, or treatment."

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