My Journey with SPD – Part I

My midwife has yet to make the formal diagnosis that I am suffering with Symphis Pubis Dysfunction (commonly known as SPD), but I can tell you from my own web-based self diagnosis that this is my unfortunate fate. The physiotherapist described it to her intern as distasis of the symphsis pubis: a condition prevalent in perhaps 1 of 10 (the web will tell you upwards of 1 in 5_ pregnant women.

How did it start?

Who really knows? When I was 12 weeks pregnant and galavanting around Europe in January with my husband, I slipped and fell outside St. Nicolas Church in Old Town Prague. I took a good fall on my right hip onto the icey cobble stone sidewalk. I got right back up, and proceeded with our trip.

Not even a week after our return, I started to experience severe and debilitating hip pain in the hip I fell on. I saw the acupuncturist, chiropractor, midwife and even the doctor to see what was the matter and to try and get some relief.

• The doctor told me it was just my fall, rest up.
• The acupuncturist was amazing and the inflamed hip was no more… but then it slowly came back, this time I felt it in my entire pelvis. I returned twice more in the second trimester, but never got as much relief, and stopped going until the beginning of my third trimester.
• The midwife suggested that because my body was starting to produce a hormone called relaxin my pelvis was beginning to relax and this caused pain. She suggested I see chiropractor or massage therapist. She also said it can get worse during pregnancy, but the other midwife also said it could ease up.
• The chiropractor said “oh my, your pelvis is out wack!” He adjusted it back in place, and I saw him twice a week for about three weeks. Each time immediate relief, and eventually the pain slowly faded into the background. The midwife was right! The pain would disappear.
• I returned to see my physiotherapist around this time too. I was originally going to her for my pelvic floor muscles because I previously struggled with Vulvodynia and was experiencing a resurgence of unprovoked pain in my vulva. She took the time to show me some strengthening exercise for my hips and often rotated my hips back into place for me.

From mid February onwards the pain faded into the background, and I began to enjoy my pregnancy! This is what people were talking about! The glow, the excitement as my bump grew and we felt our first kicks! We soon learned we were having a Baby Boy and he was growing right on schedule. It couldn’t get worse than this. The nassau and fatigue of the first trimester were behind us! It was all good from here.

At some point late in the second trimester, I began to notice some general discomfort in my hips again. The stairs were becoming more difficult, but the pain was not unbearable. Perhaps this would just be the general discomfort of being pregnant! When I was 27 weeks, I attended a PEO Convention Weekend in Vancouver. During this week, my belly got bigger, and sitting in chairs all day caused havoc on my mid-upper back. Upon returning home, I immediately sought relief from a massage therapist. However, as he massaged out the pain and tightness in my low back the discomfort returned to my hips, and my pelvis began to scream in agony.

I returned to the chiropractor for yet another set of adjustments. This time he reminded me about the scar tissue I’m carrying on the left side of my lower back. Apparently, according to him, there is some gnarly scar tissue build up in my low back. This scar tissue prevents my hips from relaxing evenly, and thus the need constant readjustments every week. He figures the scar tissue is a couple years old from something I did sometime ago. Don’t ask, I have yet to figure out from what. He suggested massage therapy to work out the scar tissue.  BTW, massage therapists won’t work out scar tissue when your pregnant. Too risky or something… So I’m stuck with this scar tissue till after my pregnancy. And as such, I’m stuck with a hip that won’t relax evenly. 

Where are we today?

Today, I’m almost 37 weeks pregnant. My pelvis has only gotten worse with each passing week. This week, I struggle to walk to the bathroom or kitchen without wanting to hold my pelvis and scream with pain. Each step there are sharp shooting pains in my Symphis Pubis, and with each step, the pain begins to exhaust me.  I have given up on a few care providers, while sticking it thru with others. Currently I see an acupuncturist and a physiotherapist, alongside my midwife.

• Acupuncture provides mild relief. In the beginning it was about 12 hours of immediate relief, and it slowly increased. This past week, there was some relief, but the pain is just atrocious overall. It kind of helps, and for that I keep going. Right now, I’m focused on getting her to prep my body for labor because I want this baby out sooner than later.  She has suggested many alternative therapies over the course of her visits, a one of which I can afford and have found helpful.
  • For general inflammation she has suggested Arnica Gel and Tablets. I found the tablets do help keep the inflammation down and the pain down. The Arnica Gel I also apply to my hips and bikini region. It does provide a moderate amount of relief.
• Physiotherapy has provided me with the most relief, especially since introducing the TENS machine about 3 or 4 weeks ago. At physiotherapy she manipulates my SI joint in place, and has given me some exercise to do at home. I must admit I’m terrible at remembering to do them…
  • TENS Machine: The tens machine was originally placed just on my low back for 20 minutes, but then she also put little pads on my pubic region (I had to go get a wax for that, since I can’t see under my big pregnant belly). She puts the two pads along the panty line where it hurts the most. For 20 minutes, the little zaps come and go. Surprisingly, since starting this, I have found the most relief. Enough that I should have considered purchasing my own TENS machine for relief at home. I’m also now considering using the TENS machine in labor.
  • Heat: While I do my TENS I also lay on a heat pack for 20 minutes. This has brought an awareness of the power of heat. I relax in an epson salt bath almost every other night, and when the hip pain gets bad, I also pack myself up with heat packs at home. I find immediate temporary relief from heat. And I love it.
  • SI Belt: At one of our first appointments she set me up with an SI Belt used to hold the SI joint in place. At first I didn’t take this very seriously, but as the pain worsen, the more seriously I took this. Seriously, invest in an SI belt (it’s cheaper than a maternity belt – don’t get me started on that – and it actually does something). I wear it whenever I move around the house, and I wear it when I go out. WEAR IT ALL THE TIME.
  • Taping: The past two appointments, she heard my complaints about how much I hate wearing my SI belt, and the physiotherapist taped up my back. However, I seem to be reacting to the tape. It either itches or leaves a not so pleasant red mark on my back. The taping of my low back was also another god send that I wish I could continue. The tape help stablise my low back and thus made getting out of bed or off the couch when I wasn’t wearing my SI belt much more bearable. I wish I could continue to tape. ASK ABOUT IT!
• Midwife: My midwife seems pretty apathetic about the whole issue. She see’s that I’m in excruating pain, but doesn’t have much to offer. She knows that I have proactively sought out help through various care providers and hasn’t had much more to offer.
  • Japanese Mint Oil: This was an amazing suggestion she made early on, which I love and don’t use enough. I only use it on my hip and low back when the pain starts to both me and I want to be mobile or I want some relief. I don’t know how it works, but I think it brings blood flow to the region and distracts from the pain. Anyways, I use it occasionally, and when I do I remember how much I enjoy it. I usually get 30-60 minutes of relief, I’ll take it. Makes you sane again. Plus I love the smell.
  • Swimming & Hot Tubs: I hate swimming, and with this big belly I had to get a new swim suit top (which is totally cute). But I find time at the pool is helpful on giving me time to relax without pain as I float around the waveless wave pool. In the past couple of weeks I got relief, this week, I felt worse afterwards, but the pain has been rough.  My midwife also encouraged me to check out the hot tub. She said it was all cool until I noticed my body temperature increasing. As soon as I got too hot or uncomfortable to get out. I can usually do about 4-5 minutes at a time. My routine is to go swimming (lets call it bobbing around) for 15 minutes. Then I slowly make my way to the hot tub for a dip lasting about 5 minutes, I get out and cool off for a bit, take another 4 minute dip and then go back to bobbing around in the pool. 15 minutes later, I repeat in the hot tub, and then shower off and go home. I usually find it works best at night because it makes you tired and ready for sleeping! However, I hate the waves and the children at the pool, so the morning is a nicer and calmer time to go! I am grateful there are no stairs, but just a ramp into both the hot tub and the pool, this makes it very easy. I prefer going with my husband, then he can help me get changed and get into the pool. But he’s not always around to help.

Aside from my weekly appointments, I spend my day at home resting. Earlier on I could do more, now not so much. The doorbell just rang, and it was Purolator. I, unfortunately, live upstairs, and the jaunt down the stairs nearly just killed me. I try my best to avoid the stairs at all cost. Once I’m down, I’m down. If I have an hour or two to kill between appointments, I try to do other things besides coming back home upstairs. We have a bed downstairs, so I’ll sometimes crash down there.  Avoiding the stairs is seriously the best. I’ve noticed a trend in that the days I’ve don the stairs more than I should have, are my bad days. The days where I haven’t had to do any stairs, now those are my good days. I once stayed upstairs for two full days, no stairs at all. AWESOME DAYS. However, not a reality for me. A girl gets cabin fever stuck upstairs, plus the laundry machine is downstairs, the lawn has to get watered, and packages come to the door.

My doula, acupuncturist and physiotherapist are rooting for me. We are all hoping we can have an early delivery, fewer weeks of pain. I’ve done 6 bad weeks of pain already, another 5 will probably kill me (or so it feels like). I’m hoping acupuncture can encourage our baby boy to come early. I’m drinking my raspberry leaf tea, I bounce around on my ball, and I really just try to channel positive thoughts to baby!

I’ll try to keep you posted, and post my birth experience with SPD. Right now, I’m thinking lots of time on my ball, maybe some water birthing time, and I’m aiming for a medication free birth (because this mom wants to feel her hips and pelvis. She doesn’t want to do anything that might hurt her, wether that’s pushing too hard, or not adjusting to find a good spot).