What is SPD & Why is it Miserable? When Pregnancy Hurts


What is SPD? SPD stands for Symphysis Pubis Dysfunction. Most people have no clue what it is or that it exists. That is, until they experience it first-hand. Even then, many of us have no clue that there is a name for the excruciating and debilitating pain that is specific to SPD.

Never-ending pain: a story

My fourth pregnancy was the first time I felt it. At around 30 weeks, I began feeling a horrible sensation in my pelvis. I thought I was imagining it. How could anyone identify pain in their pelvis? I couldn't explain it, but I knew that I was experiencing agonizing sensations deep in my bones. My symptoms, besides pain, included throbbing in my legs, clicking near my tailbone when I walked, and eventual immobility. Thankfully, as soon as I gave birth, the pain subsided; however, it returned with the vengeance of The Punisher in subsequent pregnancies. And each time? It had grown smarter, more deft, and less forgiving.

By my sixth, and last pregnancy, I felt the burns and incessant discomfort as soon as a zygote was formed. And it was visible. Just as a model skeleton in the high school biology class sways without synchronized movement, so did I. The instability was perceptible even to the untrained eye. By the time I reached 20 weeks, I needed pain medication along with physical therapy. The hour-long sessions once a week were absolute paradise. I never would have thought that a machine that literally zaps your nerves would provide relief greater than air, but it did. I didn't make it to 40 weeks with that pregnancy. While I was scared when my water broke at 30 weeks, my chest went supernova with guilt. In that fraction of a second, I was grateful to soon be free of agony. Little did I know, I would feel the vestiges for what's most likely a lifetime.

What causes SPD?

Symphysis pubis dysfuntion is not caused by an over-abundance of "y's" but of an over-abundance of relaxin. Relaxin is a hormone the pregnant body produces in order to facilitate the birthing process. It is what allows the bones to separate and the body to become more relaxed for your baby's grand arrival. It's basically the couch potato of hormones. The symphysis pubis joint becomes increasingly looser and about as unstable as The Leaning Tower of Pisa or your couch-surfing college roommate. This misalignment is the source of pain and the perpetual expletives. There are other factors too that have been posited, such as connective tissue disorders, weakened transverse abdominals, and prior injuries.


What are the symptoms and treatments of SPD?

The symptoms are so fairly obvious that it's a shame so many people live with this disorder without ever being diagnosed. The actual numbers are most likely higher than the publicized quote of 1 in 300. That said, it's easier than pie for many people to discredit themselves and chalk SPD up to normal pregnancy discomfort. Here's what to look for:

  • Extreme pain between your legs when you are <em>not</em> giving birth

  • Clicking in and around the tailbone when you walk or move

  • Burning and throbbing sensations in your lower back, abdomen, and legs

  • Inability to step forward, lift, or push things

  • Sharp pain when walking or moving legs outward (abduction)

  • Difficulty getting out of bed ,chair, or car

  • Sciatic pain

  • Complete immobility

Unfortunately there is no cure for SPD during pregnancy. And getting your body back to the singular is no guarantee you won't have lasting consequences. Treatments are helpful, and include physical therapy, modified exercise, rest, and lifestyle changes in addition to pain medication. You need to avoid pushing a shopping cart, vacuuming, and splaying the legs apart (I know, I know). Turn your entire torso when you exit the car. Be mindful with your movements. Enjoy baths and your recliner.

SPD is probably one of the most excruciating conditions of pregnancy, and yet, nobody really talks about it. It is important that you share with your care provider how you are feeling, moving, and coping so that you can get appropriate treatment ASAP. You don't to suffer in silence while your body wails in despair.