By Dr Karnika Tiwari
During pregnancy, a woman’s body undergoes a number of physical changes, several of them accompanied by uncomfortable symptoms. One of the most under-recognised conditions to affect women during pregnancy is Symphysis Pubis Dysfunction, commonly known as SPD. In SPD, misalignment of the pelvis may occur in pregnancy owing to loosening of the muscles in the pelvic region. Let us look into the causes and symptoms associated with SPD and the correct course of treatment.
Causes of SPD
The primary cause of SPD is said to be pregnancy itself, with reports suggesting that the symptoms manifest in one out of five pregnant women. With progress in the pregnancy, the relaxin hormone makes the ligaments holding the symphysis pubis joint (the joint holding the pubic bones together) lax in order to accommodate the growing foetus in the womb. In SPD, the irregular movement of the symphysis pubis joint causes the joint to become imbalanced, leading to extreme pain and discomfort.
The unbalanced movement of the joint can be due to weakening of the muscles surrounding it, which can be a closed pelvis during a woman’s development, which expands irregularly during pregnancy due to lack of exercise. Another cause for SPD is a pelvic injury or fracture experienced prior to the pregnancy.
Symptoms of SPD
The manifestation of SPD is usually in the form of sharp and shooting pains in pregnant women. However, for different women experiencing SPD, the severity and intensity of the pain may vary. Generally, prolonged and persistent pain in the front centre of the pubic bone, in the lower back, and in the perineum (the region between the vagina and anus) is a symptom of SPD. This pain may be experienced when the woman is walking, climbing the stairs, lifting heavy objects of exercising. If you have difficulty in carrying out even the routine activities of your day due to the extreme pain, you should see a doctor to diagnose SPD.
Often, in India, women and doctors tend to ignore symptoms of SPD by labelling the shooting pain accompanying the syndrome as a ‘normal’ occurrence. However, ignoring the severe pain can cause stress and depression, in turn affecting the growth of the foetus. Hence, to rule out SPD, it is advisable that you see your doctor if the pain persists in the pelvic region during your pregnancy.
If diagnosed on time, treatment for SPD can make the condition easily manageable. The following actions may be taken for the treatment:
· Physiotherapy is the general form of treatment as it can help manage the symptoms and relieve the pain. Physiotherapy for the treatment of SPD is done in order to improve muscle function in the affected area of the body as well as to improve the flexibility and position of the symphysis pubis joint. Both manual physiotherapy and hydrotherapy have been found effective in relieving the pain in patients with SPD.
· Wearing a pelvic brace or a support to keep the pelvic bones from moving too much during your daily routine can help avoid discomfort and pain in SPD during pregnancy.
· Undertake light exercise at home to strengthen the muscles of your pelvis if you have SPD during pregnancy. However, practice only under the guidance of an expert for the best results and to avoid mishap.
· If the pain in SPD is extreme, the physician may also prescribe a course of pain medication to the patient.
On the whole, SPD is not life-threatening either for you or for your unborn child, but timely diagnosis can help prevent difficulties in managing your everyday life during pregnancy. The condition usually reverses itself after delivery of the baby, so care must be taken during the pregnancy itself for complete care of the mother and the unborn child.
(The writer is Consultant-Obstetrician & Gynecologist, Motherland Hospital, Noida.)
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