Symphysis Pubis Dysfunction (SPD)
Symphysis pubis dysfunction is pain at the pubic joint at the front of the pelvis, where the two halves of the pelvis meet. At Modern Physio we focus on understanding the root-cause of your problem & personalizing your treatment for lasting results.
Understanding Symphysis Pubis Dysfunction (SPD)
Symphysis pubis dysfunction is pain at the pubic joint at the front of the pelvis, where the two halves of the pelvis meet. It is a specific presentation within the broader picture of pelvic girdle pain, and it has a characteristic feel: a sharp, sometimes grinding pain low at the front, worst when the legs move apart — turning in bed, getting out of a car, walking up stairs, standing on one leg. It can be severe enough to limit walking distance considerably. It is not dangerous, and it responds to the same principles as pelvic girdle pain, with particular attention to keeping the legs working symmetrically.
Common Symptoms
- Sharp pain low at the front of the pelvis, over the pubic bone
- Pain that increases when the legs move apart
- A clicking or grinding sensation at the front of the pelvis
- Pain turning in bed, often the most disruptive symptom because it wakes you
- Difficulty walking, sometimes with a waddling gait
- Pain radiating into the groin or inner thigh
- Pain when standing on one leg to dress
How Common Is It?
Pubic joint pain is a recognised and reasonably common presentation in pregnancy, ranging from mild discomfort to pain that limits walking. It usually settles after delivery, though it can persist and should be treated if it does.
Causes & Risk Factors
- Increased ligament laxity in pregnancy allowing more movement at the pubic joint
- Asymmetric loading through the pelvis
- Reduced control from the deep abdominal, gluteal and pelvic floor muscles
- The weight and position of the growing baby
- A previous episode in an earlier pregnancy
Our Diagnosis Process
- History focused on the location and the specific movements that provoke pain
- Screening for the obstetric red flags below
- Assessment of pelvic joint movement, gait and single-leg control
- Assessment of the muscles controlling the pelvis
- A trial of external support to see whether it changes your symptoms
Our Treatment Approach
- Symmetrical-movement strategy: keeping the knees together for turning, transfers and dressing
- A pelvic support belt where the trial shows benefit
- Strengthening the gluteal, deep abdominal and pelvic floor muscles
- Gentle manual therapy in positions comfortable in pregnancy
- Walking-distance and activity pacing to stay within a manageable daily load
- Planning labour positions that avoid excessive separation of the legs, discussed with your obstetric team
Recovery & Prevention Tips
- Keep your knees together for every transfer — bed, car, chair. A plastic bag on a car seat genuinely helps you swivel
- Sit to put on clothing rather than balancing on one leg
- Take stairs one step at a time
- Place a pillow between your knees when sleeping on your side
- Note your comfortable walking distance and stay just inside it rather than pushing through
Products That Can Help
Supports and equipment we fit at the clinic that patients with this condition commonly use alongside treatment — never instead of it.
Evidence & Sources
Pubic and pelvic pain in pregnancy is common, is not harmful to the baby, and is managed with physiotherapy advice, support and modified movement.
NHS — Pelvic pain in pregnancyFrequently Asked Questions
Will I be able to have a normal delivery?
That decision belongs to your obstetric team, and SPD alone does not usually determine it. What physiotherapy can contribute is advice on labour positions that avoid excessive separation of the legs — worth discussing with your team in advance.
Why does it hurt most at night?
Turning in bed moves the legs asymmetrically, which is exactly the movement the pubic joint objects to. A pillow between the knees and a deliberate log-roll technique often make a noticeable difference.
Is the grinding sensation damaging?
It is uncomfortable and alarming, but it reflects movement at the joint rather than damage being done. It usually settles after delivery as ligament laxity reduces.
Can I still exercise?
Usually yes, with modification. Symmetrical, supported activities are generally better tolerated than anything on one leg. The programme is built around what you can do without provoking pain.
How soon will treatment help?
Movement strategy and a well-fitted belt often help within days, because they reduce the provoking load immediately. Strength changes take longer. You will be told what to expect and when.
Medically Reviewed
This content was reviewed for medical accuracy by Dr. Surabhi Bansal, BPT, MPT (Ortho) with 14+ years of clinical experience.
At Modern Physio, all medical content undergoes a thorough review process to ensure accuracy and alignment with current physiotherapy standards. Our content is created to educate and should not replace professional medical advice. Learn more about our review process.
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