During pregnancy, the two most common problems I treat are low or mid-back pain and Symphysis Pubis Dysfunction or SPD. Others include heartburn and carpal tunnel syndrome.
Back Pain: The National Council for Osteopathic Research has reported evidence that pregnant patients who receive osteopathic care experienced a better outcome in labour and delivery than those who didn’t. Another study has shown that osteopathic mobilisation may help to stop the deterioration of back function in the third trimester. In the first trimester I do not use any thrust techniques, nor in the third, despite the fact that there is no evidence that these are unsafe. During the second these can be used to relieve back pain and I use a combination of techniques, including deep soft-tissue massage, stretching, mobilisation and trigger point therapy, give advice on exercises to assist maintaining a healthy posture relaxation and self-stretching at home or work.
Pubic Symphysis Dysfunction: Symphysis pubis dysfunction (SPD) is a problem with the pelvis. Your pelvis is mainly formed of two pubic bones that curve round to make a cradle shape. The pubic bones meet at the front of your pelvis, at a firm joint called the symphysis pubis. The joint's connection is made strong by a dense network of tough tissues (ligaments). During pregnancy, swelling and pain can make the symphysis pubis joint less stable, causing SPD. The symptoms include back pain, pain at the back of your pelvis or hip pain. You may sense a grinding or clicking sensation in your pubic area. Pain down the inside of your thighs or between your legs isn’t uncommon.
The pain will be felt as worse when parting your legs, walking, going up or down stairs or moving around in bed. It will probably be worse at night and getting up to go to the toilet in the middle of the night can be especially painful. Despite the fact that it is a hormone called relaxin that is the main culprit, the general functioning of the spine, pelvis and body as a whole is a factor in whether or not you develop SPD. Osteopathic care at this time can be especially important because of this.
Diastasis symphysis pubis (DSP) is another type of pelvic girdle pain, which is related to SPD. DSP happens when the gap in the symphysis pubis joint widens too far. DSP is rare, and can only be diagnosed by an x-ray, ultrasound scan or MRI scan.