Symphysis pubis dysfunction, or SPD, can become really painful and seriously curtail mobility. It’s really important to limit movements that can aggravate the pain.

SPD cannot be cured but has to be managed during your pregnancy. You may be referred to your local physiotherapy department; some hospitals run SPD clinics for pregnant women.

• Try some core strength exercises that focus on your pelvic floor muscles and abdominal muscles. These are small movement exercises that tighten and stabilise the area to give extra support to your pelvis and spine. Don’t do any sit ups.
• Wear a support bandage around the pelvis when you are walking. This straps the joint to give it extra stability and support during exercise.
• Exercise in water can help but avoid lots of swimming, especially no breaststroke as the leg kick can really aggravate SPD.
• Obstetric physio referral should be made – can be done by midwife or GP.

You should also be given advice on how to make daily activities less painful. Avoid cycling, limit walking, get in and out of bed without spreading your legs each time and keep a pillow between your legs as your sleep. It’s really worth making the effort to protect the joints even though it can be very frustrating, especially if you are used to getting lots of exercises.

• Avoid movements and positions that will inflame the area such as crossing your legs, pushing heavy items like vacuum cleaners or shopping trolleys, twisting and lifting shopping in the supermarket. Ask someone help you pack your shopping and take it to the car for you, or try on-line grocery deliveries instead.
• If you have severe SPD mention it in your birth plan as birth positions where your legs are very wide apart may be too painful. Discuss active birth positions that don’t aggravate it.
• Some women try alternative therapies such as osteopathy and acupuncture. There are no good studies of the effectiveness of these treatments. Osteopathy is not offered on the NHS so make sure any practitioner is qualified to treat pregnant women.