Symphysis Pubis Dysfunction (SPD)

Symphysis Pubis Dysfunction (SPD) happens when the ligaments that
keep your pubic bone and pelvis stable become overstretched and
no longer stabilize your pelvis. Essentially, a structure that is
designed to move very little begins to move a lot, and it can be
very painful and difficult to move with ease. SPD is a condition
that sometimes arises during pregnancy, though it can also first
occur during labor and birth or in the postpartum period. Pelvic
girdle pain in general is quite common during pregnancy—between
48% and 71% of women report feeling significant pelvic
discomfort. About 30% of women report that the area of the pubic
symphysis is painful. While SPD does involve the pelvis and the
integrity of the pelvic floor muscles, a general pelvic floor
dysfunction treatment like kegels is often not the answer to
symphysis pubis dysfunction.


Where is the Symphysis Pubis Located?


The pubic symphysis is a cartilage joint that resides in between
the pubic bones: above the genitals and in front of the bladder.
In most cases, the joint can rotate and move a few millimeters
without causing any issues. 


What are the Symptoms of Symphysis Pubis?


The symptoms of SPD can vary for different people, both in terms
of severity and presentation. The most commonly experienced
symptoms are:


The symptoms will vary from person to person – both in severity
and in presentation. However, if you’re concerned that you have
pubic symphysis dysfunction, these symptoms may be present:


Pain in the pelvis in general, and specifically in the groin
and inner thighs; pain moving around into the buttocks

Clicking sounds in the pelvis

Pain while sleeping

Activities like getting out of bed, in and out of cars,
stepping up and down from steep stairs, really, any position that
widens the legs can be very painful



What Causes Symphysis Pubis Dysfunction


Symphysis pubis dysfunction is most often pregnancy related.
However, the factors that predispose people to SPD are quite
varied. The medical literature on symphysis pubis pain seems to
agree that the hormone relaxin is not entirely to blame. Factors
as different as hypermobility, bearing twins or other multiples,
and a history of back pain can play a role in pubic symphysis
pain during pregnancy. SPD usually resolves for most pregnant
people after delivery, with most returning to normal function by
6-12 months postpartum. Rarely, some people find that SPD becomes
a longer-term problem. Most people are able to have a vaginal
birth even with symphysis pubis dysfunction—finding pain-free
ranges of hip movement prior to labor can be helpful if such a
delivery is in your birth plan.


What Causes Symphysis Pubis Pain?


Symphysis pubis dysfunction (SPD) and pelvic girdle pain occurs
when the ligaments and joints that help support and align your
pelvic bone become overly stretched or relaxed. This often leaves
the pelvic joint unstable and can lead to various painful
sensations, including pelvic pain. During pregnancy, it is common
for these joints and ligaments to become stretched, especially as
you are nearing the time for delivery. When the pubis symphysis
becomes too loose too early in your pregnancy, you may begin to
notice more pain in your pubic region.


Although the most common cause of symphysis pubis dysfunction is
pregnancy, SPD is not entirely pregnancy related. In some cases,
the cause of SPD is unknown.


It may be common to experience pain during pregnancy or
postpartum in these areas:


hips

stomach

pelvic floor

pelvis



What Does Pubic Symphysis Pain Feel Like?


Discomfort and pelvic pain are usually the most common symptoms
of symphysis pubis dysfunction. The pain is generally located in
the front of the pelvis, above the genitals and pubic bone. In
some cases, people report feeling a clicking or popping sensation
as they walk or shift their weight. It is common for many men and
women to experience the pain in their lower back, lower abdomen,
hips, groin, and legs.