I've never experience this kind of pain before. Its definitely painful. Googled and I found this info on several sites:
OK, before that, let me summarise them for you, in case you've caught the lazy bug:
1. the usually hard joints of pubic ligaments are soften by a hormon called relaxin. Result - joints jiggle about leaving gaps in the pubic area (hence the pain!!!)
2. No identified causes, or reason, they just happen. Some pregnant woman got it, some don't feel the pain.
3. Usually happens in the middle of pregnancy. i.e. 2nd trimester. Can continue post partum.
4. The pain concentrates at the lower part of the body, the pubic area, thigh, lower back and hips
5. Pain occurs when the legs are spread apart, pressure on one leg or lower back.
6. Pain killer might help. As do phisiotherapy.
7. Self help: keep the knees together (in other words, close those legs dear... no kangkang please). Sit down when wearing pants/undies. Buttocks first then leg and vice versa going in and out of car.
8. During labour, don't open your legs too wide especially if u are under epidural.
9. and oh yeah.. cannot prevent this from happening again...
*****
What is Symphysis Pubis Dysfunction (SPD)
The two halves of your pelvis are connected at the front by a stiff joint called the symphysis pubis and strengthened by a dense network of ligaments. Normally, very little movement occurs. However, when pregnant, a hormone called relaxin is released , which softens the ligaments in your pelvis. As a result, these joints move more during and just after pregnancy.
Causes still unsure but current thinking indicates that if one side of the pelvis moves more than the other when you walk or move your legs, this can lead to pain and inflammation at the symphysis pubis. Many women with SPD experience significant pain without any great separation of the joint -- the amount of pain isn't related to the degree of separation.
When does it happen?
SPD normally happens from the second trimester of pregnancy onwards, but can occur at any stage in any pregnancy, even if you've never suffered before. Many women notice their symptoms for the first time around the middle of their pregnancy. If you experience SPD in one pregnancy, it is more likely that it will reoccur in your next pregnancy. The symptoms may also come on earlier and progress faster, so it is important to seek help as early as possible. It can help if you allow the symptoms from one pregnancy to settle before trying to conceive another child.
What are the symptoms?
Pain in the pubic area and groin are the most common symptoms. Also pain in the inside of your thighs and sometimes in your lower back and hips or hip pain. It is common to feel a grinding or clicking in your pubic area and the pain may travel down the inside of the thighs or between your legs. The pain is usually made worse by separating your legs, walking, going up or down stairs or moving around in bed. It is often much worse at night and can stop you getting much sleep. Getting up to go to the toilet in the middle of the night can be especially painful. Sometimes there can be a clicking during hip movement felt or even heard. A tendency to shuffle along or waddle may develop as women try to distribute their weight evenly.
Treating SPD
• The best person to treat SPD is an obstetric physiotherapist
• The physiotherapist can give you a pelvic support garment to wear such as a belt or Tubigrip bandage, and crutches if walking is difficult. You'll also be given gentle exercises to help strengthen the muscles supporting the joint and general advice about posture and activities to avoid.
• Your doctor can prescribe safe painkillers to take in pregnancy, usually paracetamol.
• The most effective alternative therapies, according to the British SPD Support Group, include chiropractic and osteopathy which help to relieve joint pain.
• In most cases you'll be fully recovered in six months after giving birth, but if the pain continues, surgery to fix the joints together may be considered.
Self-help tips
• Avoid pushing through any pain. If something hurts, if possible don't do it. If this type of pain is allowed to flare up, it can take a long time to settle back down again.
• Move little and often. You may not feel the effects of what you are doing until later in the day or after you have gone to bed.
• Rest regularly by sitting reasonably upright with your back well supported.
• Avoid heavy lifting or pushing (supermarket trolleys can be particularly painful).
• When dressing, sit down to put on clothing such as your knickers or trousers. Pull the clothing over your feet and then stand up to pull them up. Don't try to put your legs into trousers, skirts or knickers whilst standing up.
• When climbing stairs, go up them one step at a time. Step up onto one step with your best leg and then bring your other leg to meet it. Repeat with each step.
• Avoid separating your legs and making straddling movements. Getting into a car by sitting on the seat first, and then lifting your legs inside. Reverse this procedure for getting out.If you need to separate your legs, do so slowly and carefully and keep your back arched.
• Avoid swimming breaststroke if you can and take care with other strokes. Swimming can often feel like it is helping whilst you are in the water but cause an increase in pain when you get out.
• Always having the knees together firmly when turning over in bed.
• Rest as much as possible. Take the body’s weight off the pelvis when you can. Try to have some daily bed rest.
• Where possible, sit down to do daily tasks like food preparation.
• Try to avoid twisting the upper body. Think ahead, turn and face the thing you are doing.
• Avoid straddling positions e.g. sit on a bidet as you would on a toilet.
• Avoid sudden jerky movements.
• Performing regular pelvic floor exercises (also called Kegel exercises) and lower abdominal exercises can help to reduce the strain of the pregnancy on your pelvis.
To perform a safe and easy lower abdominal exercise, get down onto your hands and knees and level your back so that it is roughly flat. Breathe in and then as you breathe out, perform a pelvic floor exercise and at the same time pull your belly button in and up. Hold this contraction for 5-10 seconds without holding your breath and without moving your back. Relax the muscles slowly at the end of the exercise.
How will it affect my labour?
• Make sure anyone attending you is aware that you have SPD. Your midwife should measure how far you can comfortably widen your legs at the onset of labour and ensure that you don't exceed this.
• If you have an epidural or spinal block injection, it's particularly important to ensure you don't exceed the comfortable gap as you won't be able to feel any damage you do.
• In very severe cases, an elective caesarean may be considered.
• Make sure you're in a comfortable position before any internal examinations are performed.
• Experiment with different positions for giving birth - kneeling on all fours, Lying on your side with the upper leg supported by someone, kneeling position with your torso fairly upright over several pillows, beanbags or such.
• Squatting positions are best avoided, and the lithotomy position (the on your back, knees bent and raised above the hips, thighs apart position often involving stirrups) can exacerbate pelvic pain. It is known to, among other things, put pressure on the coccyx, and is thought to be a potential cause of pelvic pain that presents itself postnatally. There are similar issues regarding the use of stirrups if any post partum stitching is required.
• Assisted delivery. You could specify a ventouse delivery (uses a suction cap on the baby’s head) instead of forceps, as this can be performed laterally.
• Some women feel that they cannot face the idea of adding to their pelvic pain by having a vaginal birth, and wish to opt for a caesarean. This should be very carefully discussed with health care professionals, as it is a major operation with its own drawbacks and issues.
The condition of SPD does no harm to the baby itself. It is purely a matter of the mother’s pelvic pain.
How soon will I recover from my SPD symptoms after the birth?
A recent study showed that around 60% of women with SPD still experienced some symptoms after delivery. Most women find that their symptoms improve after the birth of their baby although a small percentage still have pain when their babies are a year old. You should continue with physiotherapy after the birth and get help with looking after your baby during the early weeks if you can. Some ex-sufferers find they experience pain every month just before their period is due, which is caused by hormones which have a similar effect to the pregnancy hormone relaxin.
Can I avoid it happening again?
Unfortunately, there's no way of predicting whether you'll suffer in subsequent pregnancies, and if you do whether it'll be more or less severe than your first experience of SPD. However, if you have experienced it in one pregnancy, be aware of any signs of pain from the start of a subsequent pregnancy and see your midwife. Being referred to a physiotherapist early on and receiving treatment can help to reduce the pain as much as possible. "However, it's best to avoid a subsequent pregnancy until your baby is walking independently, as lifting your child will be especially difficult if you suffer SPD again.
*****
I guess, I just have to bear with the pain for a little while... in the meantime, I will reserve my right to complain at any time i like :)
What is Symphysis Pubis Dysfunction (SPD)
The two halves of your pelvis are connected at the front by a stiff joint called the symphysis pubis and strengthened by a dense network of ligaments. Normally, very little movement occurs. However, when pregnant, a hormone called relaxin is released , which softens the ligaments in your pelvis. As a result, these joints move more during and just after pregnancy.
Causes still unsure but current thinking indicates that if one side of the pelvis moves more than the other when you walk or move your legs, this can lead to pain and inflammation at the symphysis pubis. Many women with SPD experience significant pain without any great separation of the joint -- the amount of pain isn't related to the degree of separation.
When does it happen?
SPD normally happens from the second trimester of pregnancy onwards, but can occur at any stage in any pregnancy, even if you've never suffered before. Many women notice their symptoms for the first time around the middle of their pregnancy. If you experience SPD in one pregnancy, it is more likely that it will reoccur in your next pregnancy. The symptoms may also come on earlier and progress faster, so it is important to seek help as early as possible. It can help if you allow the symptoms from one pregnancy to settle before trying to conceive another child.
What are the symptoms?
Pain in the pubic area and groin are the most common symptoms. Also pain in the inside of your thighs and sometimes in your lower back and hips or hip pain. It is common to feel a grinding or clicking in your pubic area and the pain may travel down the inside of the thighs or between your legs. The pain is usually made worse by separating your legs, walking, going up or down stairs or moving around in bed. It is often much worse at night and can stop you getting much sleep. Getting up to go to the toilet in the middle of the night can be especially painful. Sometimes there can be a clicking during hip movement felt or even heard. A tendency to shuffle along or waddle may develop as women try to distribute their weight evenly.
Treating SPD
• The best person to treat SPD is an obstetric physiotherapist
• The physiotherapist can give you a pelvic support garment to wear such as a belt or Tubigrip bandage, and crutches if walking is difficult. You'll also be given gentle exercises to help strengthen the muscles supporting the joint and general advice about posture and activities to avoid.
• Your doctor can prescribe safe painkillers to take in pregnancy, usually paracetamol.
• The most effective alternative therapies, according to the British SPD Support Group, include chiropractic and osteopathy which help to relieve joint pain.
• In most cases you'll be fully recovered in six months after giving birth, but if the pain continues, surgery to fix the joints together may be considered.
Self-help tips
• Avoid pushing through any pain. If something hurts, if possible don't do it. If this type of pain is allowed to flare up, it can take a long time to settle back down again.
• Move little and often. You may not feel the effects of what you are doing until later in the day or after you have gone to bed.
• Rest regularly by sitting reasonably upright with your back well supported.
• Avoid heavy lifting or pushing (supermarket trolleys can be particularly painful).
• When dressing, sit down to put on clothing such as your knickers or trousers. Pull the clothing over your feet and then stand up to pull them up. Don't try to put your legs into trousers, skirts or knickers whilst standing up.
• When climbing stairs, go up them one step at a time. Step up onto one step with your best leg and then bring your other leg to meet it. Repeat with each step.
• Avoid separating your legs and making straddling movements. Getting into a car by sitting on the seat first, and then lifting your legs inside. Reverse this procedure for getting out.If you need to separate your legs, do so slowly and carefully and keep your back arched.
• Avoid swimming breaststroke if you can and take care with other strokes. Swimming can often feel like it is helping whilst you are in the water but cause an increase in pain when you get out.
• Always having the knees together firmly when turning over in bed.
• Rest as much as possible. Take the body’s weight off the pelvis when you can. Try to have some daily bed rest.
• Where possible, sit down to do daily tasks like food preparation.
• Try to avoid twisting the upper body. Think ahead, turn and face the thing you are doing.
• Avoid straddling positions e.g. sit on a bidet as you would on a toilet.
• Avoid sudden jerky movements.
• Performing regular pelvic floor exercises (also called Kegel exercises) and lower abdominal exercises can help to reduce the strain of the pregnancy on your pelvis.
To perform a safe and easy lower abdominal exercise, get down onto your hands and knees and level your back so that it is roughly flat. Breathe in and then as you breathe out, perform a pelvic floor exercise and at the same time pull your belly button in and up. Hold this contraction for 5-10 seconds without holding your breath and without moving your back. Relax the muscles slowly at the end of the exercise.
How will it affect my labour?
• Make sure anyone attending you is aware that you have SPD. Your midwife should measure how far you can comfortably widen your legs at the onset of labour and ensure that you don't exceed this.
• If you have an epidural or spinal block injection, it's particularly important to ensure you don't exceed the comfortable gap as you won't be able to feel any damage you do.
• In very severe cases, an elective caesarean may be considered.
• Make sure you're in a comfortable position before any internal examinations are performed.
• Experiment with different positions for giving birth - kneeling on all fours, Lying on your side with the upper leg supported by someone, kneeling position with your torso fairly upright over several pillows, beanbags or such.
• Squatting positions are best avoided, and the lithotomy position (the on your back, knees bent and raised above the hips, thighs apart position often involving stirrups) can exacerbate pelvic pain. It is known to, among other things, put pressure on the coccyx, and is thought to be a potential cause of pelvic pain that presents itself postnatally. There are similar issues regarding the use of stirrups if any post partum stitching is required.
• Assisted delivery. You could specify a ventouse delivery (uses a suction cap on the baby’s head) instead of forceps, as this can be performed laterally.
• Some women feel that they cannot face the idea of adding to their pelvic pain by having a vaginal birth, and wish to opt for a caesarean. This should be very carefully discussed with health care professionals, as it is a major operation with its own drawbacks and issues.
The condition of SPD does no harm to the baby itself. It is purely a matter of the mother’s pelvic pain.
How soon will I recover from my SPD symptoms after the birth?
A recent study showed that around 60% of women with SPD still experienced some symptoms after delivery. Most women find that their symptoms improve after the birth of their baby although a small percentage still have pain when their babies are a year old. You should continue with physiotherapy after the birth and get help with looking after your baby during the early weeks if you can. Some ex-sufferers find they experience pain every month just before their period is due, which is caused by hormones which have a similar effect to the pregnancy hormone relaxin.
Can I avoid it happening again?
Unfortunately, there's no way of predicting whether you'll suffer in subsequent pregnancies, and if you do whether it'll be more or less severe than your first experience of SPD. However, if you have experienced it in one pregnancy, be aware of any signs of pain from the start of a subsequent pregnancy and see your midwife. Being referred to a physiotherapist early on and receiving treatment can help to reduce the pain as much as possible. "However, it's best to avoid a subsequent pregnancy until your baby is walking independently, as lifting your child will be especially difficult if you suffer SPD again.
*****
I guess, I just have to bear with the pain for a little while... in the meantime, I will reserve my right to complain at any time i like :)
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