Week 13: Pelvic Bone pain/dreams/sleeping

Sorry - I have been taking forever to write this... I'm just not feeling very verbal right now :) So, here are some random thoughts that I have been having:

PELVIC BONE
For some reason, my pelvic bone is not happy :( I basically feel like I have a sore butt... I never bruised my tailbone, but at this rate I may know how that feels soon!!!!

Has anyone else had their butt hurt during pregnancy? Especially this early? It seems early to have something like this bugging me.

Most of the time, it's just sore, but twice I had two sharp pains (on the toilet, I think it was the position and hard bowl). Thanks for those who have tweeted about what it could be - I think you are right and it did make me feel better. That is, stretching and that sort of thing.

SLEEPING
I also now wake up around 3 am each morning. I don't necessarily have to pee, but I still wake up. I also wake up around 6 am or so. I wake up for real at 7 am, but it takes me awhile to get going. I really don't know if I will have that much energy going into the 2nd trimester - I do feel a bit less tired, but I still know that I'm tired by 10 pm and like the wake up around 9 pm... I think it's more about knowing your schedule and not trying to make the old one fit.

DREAMS
I have been having interesting dreams recently and apparently that's because I'm not sleeping as well and so have more REM sleep. :) (nice to have a scientific reason for it) I'm actually a bit tired to remember them right now, but I keep looking up through google every morning for the 'meanings' behind them. :) I usually like dreams, but these are just odd at times. Last night, I was in this old Victorian house and my family was there. I had two kids (boys) and we just brought them home, although they were pretty big babies. I was taking care of both and things were fine, but one of the babies seemed to be having some difficulties with something, I don't know what and so I was spending a lot more time with him. Interesting stuff....

Anyways - today I am done with 13 weeks and so I am officially into my second trimester!!! Yay!

Understanding Pelvic Pain in Pregnancy

One problem that many pregnant women complain about is pubic pain. Yet doctors and midwives often dismiss this pain as either 'inconsequential', 'unfixable', or 'just one of those pregnancy discomforts that have to be endured'. Occasionally, some uninformed doctors have even erroneously told women that such pubic pain means that they would need an elective cesarean section in order not to permanently damage that area during birth, or as a result of prior damage to the area.

Yet none of this is true. Pubic pain in pregnancy is certainly not 'inconsequential'; Although many doctors and midwives do not know what causes it or how to fix it, many women are able to get improvement or relief with chiropractic treatment or osteopathic manipulation. It is not something that you 'just have to live with'. And although extra care should be taken during labor and birth in order to prevent trauma, it absolutely does NOT mean that you 'have' to have a cesarean!

Although not every provider has a name for this condition, it is most commonly called Symphysis Pubis Dysfunction (or SPD), especially in Britain. Other names for it include: pubic shear (osteopathic term), symphyseal separation, pubic symphysis separation, separated symphysis, pelvic girdle relaxation of pregnancy, pelvic joint syndrome.

The symptoms of SPD vary from person to person, but almost all women who have it experience substantial pubic pain. Tenderness and pain down low in the front is common, but often this pain feels as if it's inside. The pubic area is generally very tender to the touch; many moms find it painful when the doctor or midwife pushes down on the pubic bone while measuring the uterus (fundal height).

Any activity that involves lifting one leg at a time or parting the legs tends to be particularly painful. Lifting the leg to put on clothes, getting out of a car, bending over, sitting down or getting up, walking up stairs, standing on one leg, lifting heavy objects, and walking in general tend to be difficult at times. Many women report that moving or turning over in bed is especially excruciating.

Many movements become difficult when the pubic symphysis area is affected. Although the greatest pain is associated with movements of lifting one leg or parting the legs, some women experience a 'freezing', where they get up out of bed and find it hard to get their bodies moving right away--the hip bone seems stuck in place and won't move at first. Or they describe having to wait for it to 'pop into place' before being able to walk. The range of hip movement is usually affected, and abduction of the hips especially painful. Many women also report sciatica when pubic pain is present. SPD can also also be associated with bladder dysfunction, especially when going from lying down (or squatting) to a standing position. Some women also feel a 'clicking' when they walk or shift just 'so', or lots of pressure down low near the pubic area.

Many women with SPED also report very strong round ligament pain (pulling or tearing feelings in the abdomen when rolling over, moving suddenly, sneezing, coughing, getting up, etc.). Some chiropractors feel that round ligament pain can be an early symptom of SPED problems, and indicate the need for adjustments. Other providers consider round ligament pain normal, part of the body adjusting to the growing uterus. If experienced with pubic and/or low back pain, it probably is associated with the SPED.

Indeed, although pubic pain often does go away after pregnancy, many women find that it sticks around afterward, usually diminished but still present. If treatment to resolve any underlying causes is not done, long-term pain usually sticks around. Anecdotally, this often seems to be associated with long-term low back pain or reduced flexibility in the hips. Even worse, if the mother is mishandled during the birth, the pubic symphysis can separate even more or be permanently damaged. This is called Diastasis Symphysis Pubis.

Although the best idea may be to resolve chronic SPD pain through realigning the pelvis girdle and soft tissues, most women have some residual pubic and low back discomfort sticking around during pregnancy and the early postpartum weeks because of hormones. Therefore, tips for coping with pubic pain tend to be a focus of many SPD websites.

Many of the suggestions include:

Use a pillow between your legs when sleeping; body pillows are a great investment!

Use a pillow under your 'bump' (pregnancy tummy) when sleeping

Keep your legs and hips as parallel/symmetrical as possible when moving or turning in bed

Some women also find it helpful to have their partners stabilize their hips and hold them 'together' when rolling over in bed or otherwise adjusting position

Some women report a waterbed mattress to be helpful

Swimming may help relieve pressure on the joint

Keep your legs close together and move symmetrically

When standing, stand symmetrically, with your weight evenly distributed through both legs

Sit down to get dressed, especially when putting on underwear or pants

Avoid 'straddle' movements

Swing your legs together as a unit when getting in and out of cars; use plastics or something smooth and slippery (like a garbage bag) on the car seat to help you enter car backwards and then turn your legs as a unit

An ice pack may feel soothing and help reduce inflammation in the pubic area

Move slowly and without sudden movements

Visit a chiropractor who has experience treating pregnant women.

taken from Symphysis Pubis Dysfunction
by Pamela Vireday
ICPA Newsletter Jan-Feb 2003