Need follow up to problems with Symphysis Pubis Dysfunction

I am 53 yrs old. I knew after my first baby, 30 yrs ago that I just didn't come back together right. She was delivered by forceps. I had on and off pain all these years. It has significantly increased over the last 3 yrs. I could literally use a cane to get out of my chair after workout nag. I finally went to an ortho dr. He diagnosed pubic symphysis degeneration. He did say it gets worse with age. I just had a symphseal injection in my pubic bone April 8. The shot is not working. I'm at n so much pain it brings me to my knees. I am facing the surgery. Bone graft from my hip, alignment, plate, screws. I'm scared to death I st to be laid up. And one have a surgery experience to share? I'm hearing 3 weeks of n hospital and 3mo recovery time. Would love your comments. Thank you

i too had spd after 4 babies over 9lb between 1988 and 1997.suffered for 6 years badly from 2004 and got progressively worse. i seen 5 orthopaedic specialists had phsio, muscular skelital physio injections into pubic bone, every type of xray and scan available and the fifth specialist actually agreed to do my fixation( after informing me hed done it before) i was overwhelmed with joy i even gave him a hug and couldnt thank him enough for agreeing to do my op because every other surgeon refused. he seen how bad i was and how i couldnt do anything and lived in excruciating pain daily with bone wearing bone away on my pubic bone, which could be heard on movement might i add.
that was june 2010 my operation was jan 2011 i had to have damaged bone removed off pubic bone a transplant of bone from my hip to fill gap then 2 metal plates and 13 screws put on my pubic bone. to do all this all my muscles tendons and ligaments had to be removed from my pelvis to do plates and then stuck back.
i was in hospital for 3 weeks non weight baring for ten weeks then 2 steps daily with physio gradually a few more steps each day. i done everything i was told. then in june 2011 i got a bump below my scar which is on my hair line. i rang my consultant and made appointment he said oh its just fatty tissue, my gp said it was a hernia.i was referred to another surgeon who done numerous tests over 7 months and i have a massive hernia of my bladder which is so big it cant stretch no more it is hip to hip sticks right out in front and goes down below on both sides of my female parts, ive had this for 10 months now, tests show my bladder is right over my pubic bone and down the front also found this is because my muscles and main tendons and ligaments have ALL came off my pelvis and caused this hernia also 2 of my screws are very large and sticking into my bladder (not pierced thank god) but one false move and it will. i have been told my op should have been done different as muscle tendons and ligaments do not go back to bone once removed.. ive got to have my plates removed now so they can try to stick them back onto bone to repair the damage and my bladder. so my message is if you have spd or are having a large baby please have a c section and avoid all this.......

Hi, I am currently 32 weeks pregnant and suffering from severe SPD, I am on crutches which do not help and have a support band on the way to me after seeing a physio privately who specialises in hypermobile joints but she could offer no further help until after the birh. She also said I should have a caesarean and not risk a natural birth- for the exact reasons that happened to you!

I am in agony and can cont imagine the next 8 weeks in this much pain. My doctor was very nice but as you said more used to dealing with mild SPD and was unable to help me further.

I also live in Cambs and was wondering if you could let me know which pilates instructor you found as I am not finding it easy to find a specialist!

Many thanks for your article it made me feel I am not alone and I won't always feel like a 90 year old woman in urgent need of new hips and legs!
Thanks, Lora

I had symphysis pubis dysfunction with my pregnancy in 2004. I contacted the Pelvic Partnership Organisation in England. They recommended specialist physio to be started a.s.a.p. They said this was imperative to avoid long-term problems.

I was eventually referred to a specialist gynae physio at The Royal London Hospital where I was given a girdle and some crutches and told that my SPD was too severe for physio. She also told me to tie a bit of string around my knees when in labour to ensure that my legs were not opened to wide......By this time I could no longer get out of bed, get dressed, or wash without help. The girdle caused even more pain.

I finally contacted the London Osteopathic Centre for Children who also help pregnant women. They told me that the right hand pelvis had slipped above the left side so the girdle was keeping this incorrection in place causing the increased pain. I had osteopathic treatment from 6 months pregnant until my baby was 9 months old. It helped a bit.

The scary thing was that even the midwives and doctors seemed at a loss with how to deal with the condition. They had information for mild SPD but not for more severe SPD. Various midwives in fact, informed me, that the baby would practically walk out as the pelvis was so open. Even the most cursory research shows this to be untrue. It was very frightening to know that I had to inform myself and try and inform my own health care providers about the condition.

The Pelvic Partnership recommended a water birth as this supports the body more. They felt that a C-Section would cause more pain in that area. My birth plan was that if the water birth did not progress that I would then be sent to the hospital for a section.

By the time my labour started the SPD was so severe that 3 people had to lift me into a birthing pool. After 3 hours in the pool the baby had descended which caused my hips to completely lock. I could not kneel, sit, or stand, never mind open my legs - and had to lie on my elbows trying to keep my head out of water : - ) It was hell. After pushing for 4 hours I was lifted out of the water whereupon the midwives yanked me onto a birthing stool. This was excruciating as my hips and pelvis felt like they were breaking. Eventually they transferred me to the hospital where nobody read my birth plan or my notes. They put me in stirrups despite my partner telling them about the SPD. I was requesting a section at this point as I was fearful of the baby being caused distress by the protracted pushing time, and of my pelvis being further damaged by the stirrups. At this time they gave me an epidural. I could no longer feel the contractions but the symphysis pubis felt as if a knife was cutting into it. After a few more hours they performed a failed ventouse and the baby was finally delivered by forceps. She had to be resuscitated and I began to hemorrhage. They insisted on keeping my legs in stirrups for another couple of hours after the baby was born as they dealt with the bleed and then stitched me up. The pain of the SPD was indescribable despite the epidural which masked all other pain.

So, after 3 days of labour and the use of stirrups despite this being a complete no no with SPD I ended up in a wheelchair for 4 weeks being totally unable to stand or walk. I still on crutches when she was 6 months old and asked for a referral to a specialist at St Thomas's. He scanned the area, told me it was 3mm wide and that this may or may not have been how my pelvis was pre-pregnancy. He said there were many problems with the surgery and did not recommend it. (He also told me that SPD 'was very fashionable at the moment') I remember crying and saying that there must be something available. 'No'.

I was at the time receiving 30 minutes a week of NHS physio which involved balancing on a ball in a swimming pool.

When the baby was 10 months old we moved to Cambridge. I started talking to a woman at a baby group who had a 2 week old baby. She told me that her SPD with the first had been so bad that she had been in a wheelchair. She had been recommended a one to one Pilates specialist. This specialist had worked on specific areas of her body for some months before the second pregnancy and worked wonders. She continued to see her throughout the pregnancy and had requested a C-section. She said the experience was positive and that she had felt in control, not reliant on the various mis-informed professionals that had surrounded her giving conflicting information with the first pregnancy.

As she said, the C-section causes discomfort for 6 weeks but after the pain of SPD it is nothing. She did not have a long distressing labour and her baby, the second time round did not have to be resuscitated.

I began to work with this pilates therapist who just works on a one to one basis very gently correcting the muscles which hold the pelvis in place. Within 6 weeks 80% of the pain had receded. If I forget to do my exercises for a week then the pain starts again. I shall always have discomfort on the right hand side of my pelvis and I am left with a prolapsed uterus and bladder and am waiting for an operation on a rectocele. All caused by the forced delivery of my baby through a severely malfunctioning pelvis.

I would recommend to anyone with this problem to have a c-section and to start one to one pilates during the pregnancy. You must take control of your body with this complaint as nobody else will be informed enough to help you. Even a gynae physiotherapist.

Hi, Anon,

So sorry to hear that your friend has not had any improvement in her symphysis pubis dysfunction. In addition to the harness, was she sent to physical therapy and/or given exercises to do?

Has her doctor referred her to an orthopedic surgeon?

You might be interested in reading on this site:

http://www.pelvicinstability.org.uk/faq.asp

There's also good information here:

http://pelvicgirdlepain.com/pelvic-girdle-pain.htm

Two sites I found said that surgical repair of spd was not particularly effective. Is your friend's doctor very optimistic that this is the proper solution? Has she had a second opinion?

We would love to have her share her story. No doubt she would be a help to any woman going through this.