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  • June 2013
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Beautiful pregnant woman doing exercises.

Symphysis Pubis Dysfunction – Managing SPD During Pregnancy

Symphysis Pubis Dysfunction (SPD) occurs as a result of a hormone called relaxin (which also makes your feet bigger in pregnancy).  This hormone allows the usually taut ligaments that connect the three bones of your pelvis, to relax and make way for baby. While this added flexibility is useful during birthing, it can cause pain during pregnancy in the form of SPD.

Symptoms include pains or aches in the pelvic area that radiates to the lower back, hips, buttocks and down the legs.  You may also experience pain with movements  such as getting out of bed or a car and other positions where one leg drops down in a scissor-like movement. Walking and other weight-bearing activities can increase pain.

Self-Help Tips

Daily movement:

  • Stand symmetrically, with your weight evenly distributed through both legs.
  • Sit down to get dressed, especially when putting on underwear or trousers.
  • Keep your legs close together and move symmetrically and slowly.   Avoid “straddle” movements.
  • Swing your legs together as a unit when getting in and out of cars.  Use something slippery on the car seat e.g. bin liner,  to help you enter car backwards and then turn your legs as a unit.
  • Avoid heavy lifting or pushing.
  • When climbing stairs, step up with your best leg and then bring your other leg to meet it.


  • Acupuncture may reduce pain levels.
  • Movement and strengthening therapies like the Alexander Technique and Pilates may help. The Alexander Technique helps retrain more efficient and better muscle usage. Pilates works on strengthening the core muscle areas e.g. abs, back, etc.
  • Physiotherapy, osteopathy and chiropractic may help.


  • Use a pillow between your legs when sleeping and/or use a pillow under baby.
  • Keep your legs and hips as symmetrical as possible when moving in bed.  You may find it helpful to have your partner stabilize your hips when adjusting position.
  • Silk/satin sheets and nighties may make it easier to turn over in bed.


  • Performing regular pelvic floor exercises and lower abdominal exercises can help to reduce pelvic strain. To perform a lower abdominal exercise, get down onto your hands and knees and level your back so that it is roughly flat. Breathe in and as you breathe out, perform a pelvic floor exercise and at the same time pull your belly button in and up. Hold this for 5-10 seconds without holding your breath and without moving your back. Relax the muscles slowly at the end of the exercise.
  • Back pain can be helped by resting backwards over a birth ball.
  • Water aerobics may be helpful.


Finally some general advice which might help.  Ask a partner to massage your lower back.  If their hands get tired, they could use a rolling pin or tennis ball.  If you prefer hard pressure on this area, get on your hands and knees and arch your back a bit, then have your partner put their elbow against the area and rub in small circles.

A chilled wheat bag may feel soothing and help reduce inflammation in the pubic area. Wheat bags warmed in the microwave before using, feel really nice on the back!

Young woman slicing pomegranate

Natural Anti-Inflammatories


The following can aggravate inflammation, so avoid or limit:

  • Sugar and caffeine.
  • Known allergens such as wheat, gluten, yeast, eggs, dairy, soy and nuts.  To help you identify sensitivities that could be causing you problems, follow an elimination diet avoiding a substance for two weeks, and then introducing it for a day or two.
  • Saturated fats found in meats, dairy products and eggs.  An important source of minerals and vitamins, these foods also contain arachidonic acid, which although essential for health, too much in the diet can make inflammation worse. Choose low fat milk and cheese and lean cuts of meat, which will not promote inflammation.
  • The nightshade family of plants such as tomatoes, aubergines, red and green bell peppers and chili and paprika may increase pain from inflammation.

To decrease inflammation, include:

  • Raw nuts especially walnuts and freshly ground flaxseeds to provide you with nutrients that balance blood sugar and provide the amino acids that muscles need for good health.
  • Foods rich in antioxidants such as spinach, strawberries, carrots, red grapes, kale, apples and dark chocolate to repair cell damage and help you feel better.
  • Ginger which is a potent anti-inflammatory and antioxidant. Grate some into juice or tea.
  • Enzymes which contain bromelain. The most effective enzymes are ones that break down proteins and are found in several fruits such as kiwi, pineapple (especially the stem) and green papaya. When consumed raw, a portion of these enzymes are absorbed into the blood stream where they break down inflammatory complexes.
  • Olives and extra virgin olive oil which are packed with anti-inflammatory polyphenols. However, these important phytochemicals are not present in refined oil, so use the extra virgin, cold-pressed oil or the whole olives.
  • Generous portions of brightly-coloured vegetables for their fibre and natural anti-inflammatory compounds.
  • A daily intake of honey which is a natural anti-inflammatory and cleanser, both outside and inside the body.
  • Peppermint, spearmint, and Earl Grey (contains bergamot) teas to help reduce inflammation and fight uric acid levels (main contributor to inflammation).

 Further Steps to Reduce Causes Of Inflammation

  • Substances like alcohol, caffeine and nicotine place a burden on your system, so eliminate or moderate your intake.
  • Use natural cleaning products and detergents. Test your air and water and, if necessary, get high-quality filters. Bring in lots of houseplants to help filter the air.
  • It’s impossible to completely eliminate your exposure to environmental toxins, so it’s a good idea to periodically detoxify.

Investigate alternative therapies to deal with pain management:  Use anti-inflammatory drugs for short periods during acute crises. If you still notice symptoms of inflammation, you may want to try some form of adjunctive therapy such as acupuncture, massage or water therapy that reduces pain and inflammation naturally.  An easy self-help tip to reduce inflammation is the topical application of a frozen wheat bag used as a cold compress. To prevent frostbite, let the area warm completely before repeating.