Why is SPD Worse at Night: the Newest Answer in 2023

Why is SPD Worse at Night: the Newest Answer in 2023

One in five pregnant women experiences SPD. Frequently referred to as SPD (symphysis pubis dysfunction), this condition only affects the symphysis pubis. You may have either PGP or SPD, or in some cases, both.

It is important to remember that pelvic girdle pain is common and in most or some cases treatable. At any point during or after pregnancy, it may be safely treated. Therefore, if you experience pelvic pain during or after pregnancy, seek treatment.

The definition of SPD, its causes, and why SPD hurts more at night are all covered in the section that follows.

Definition: What is SPD?

The first thing to remind yourself of is that you are not alone. One in 300 women is thought to experience SPD to some extent. Despite the fact that not all women receive a formal diagnosis, many healthcare professionals believe the incidence is actually higher than this. Women commonly put their discomfort down to one of those things or general pregnancy discomfort when in fact, it is a condition that response very well to correct management.

Symphysis Pubis Dysfunction (SPD) is the umbrella term that describes pain in the joints of the pelvis, including:

  • The bones connect the sacrum, a triangular bone that sits behind your hip bones. The sacroiliac joints are the name of these joints.
  • The joint that connects the two halves of the front of your pelvis, is called the symphysis pubis joint. Pain brought on by issues with the symphysis pubis joint is referred to as symphysis pubis dysfunction (SPD).

Symptoms of SPD

  • A frontal pubic area pain that is acute and occasionally excruciating.
  • A challenge when walking, particularly after prolonged periods of inactivity.
  • The backs of the legs, the perineum, the hip bones, and the backs of the body can all experience this kind of stabbing, shooting, or burning pain.
  • A waddling walking gait.
  • When one leg is lifted in front of the other or when one is supported only by one leg, as in when climbing stairs, getting out of bed or twisting, the pain can be felt more acutely.
Why is SPD Worse at Night: the Newest Answer in 2023
  • Knee pain that may radiate down to the ankles and feet. This is generally a result of alignment problems further up in the pelvis.
  • The pain frequently gets worse at night when you’re lying on your back. The discomfort can get worse if you roll over in bed or lift your legs to get out of bed.
  • Urinary incontinence affects some females.
  • The area around the pubic bone may experience grating, clicking, or grinding sounds as well as physical sensations.

Why is SPD Worse at Night?

Pregnancy-related SPD (Symphysis Pubis Dysfunction) and lower back pain are frequently brought on by joint misalignment and additional strain on ligaments as a result of their weakened state as a result of the hormone relaxin’s release. Your muscles play an even more crucial role in stabilizing your spine and pelvis when your joints are in a more vulnerable state, especially as your pregnancy progresses. In the case of SPD, many women find it worse at night. This is frequently caused by your buttock muscles’ reduced activity at night because they are in a resting position. These muscles serve as your pelvis’ primary stabilizers. You have overdone it during the day without enough support around the pelvis. The joints may also be in a more vulnerable position depending on how you are sleeping.

Here are other reasons for increased SPD pain at night:

  • Excessive weight gain during pregnancy.
  • The stability of a woman’s pelvis also depends on how well her connective tissue is made.
  • Having multiple pregnancies or a large baby. Gestational diabetes can add to gestational weight gain and increase birth weight.
  • Exercises with repeated jarring motions, strenuous activity, poor posture, and past injuries all increase the risk of developing this condition.
  • Being overweight relative to basal metabolic rate.
  • Previous pelvic injury or fracture.
  • The way the baby is lying or in what position can affect the outcome.

What You Can Do to Relieve SPD?

Keep Your Knees in Line With Your Hips

You should try to keep your knees in line with your hips as much as possible, especially if you have Symphysis Pubis dysfunction (SPD). Your knees experience valgus (outward angulation) stress when they touch or droop in the middle. Your buttock muscles are also in their least active state when your knee is in this valgus position, which prevents them from supporting the joints in your pelvis. The weight of your body, your bump and gravity are then having a bigger impact on your joints because they are not being buffered by your buttock muscle strength. Therefore, placing a pillow between your knees when you’re on your side will help to keep you out of the valgus position and keep your knees in line with the middle of your hip, allowing your buttock muscle to be more active when you’re resting. During the day, if you are out shopping or walking for more than 20 minutes, where a recommended support belt to limit the build-up of strain, which will then present itself at night when you are trying to rest.

Relieve the Inflammation

You can also try applying ice to sore joints like your pubic bone or lower back to reduce swelling around those areas, as well as stretching before bed to help your muscles and joints feel more balanced. To release tension, try a few rounds of the cat-cow and child’s pose as well as some very gentle buttocks and abductor’s muscle stretches.

Why is SPD Worse at Night: the Newest Answer in 2023

Change Positions a Lot

Alternating positions frequently is another thing you can do to reduce nighttime SPD pain. In the later stages of pregnancy, it is advised to only lie on your left side because research indicates that doing so helps to increase blood flow to the uterus, which can be compromised by lying on your back or right side. According to research, lying on your front increases blood flow to your uterus more than lying on your left. The general recommendation is to lie on your left side because, prior to Belloost, there was no safe way to do this. Being on your right side or back for brief periods during the early stages of pregnancy won’t usually harm your unborn child, but be mindful to switch positions frequently.


After birth, SPD typically goes away in a few weeks or months. It lasts longer for about 1 in 13 women. If you had severe pelvic pain during your pregnancy, it is more likely to persist. You might experience a mild recurrence before your period, even though you are unlikely to experience pain all the time. These hormones may have similar effects to pregnancy hormones at this time.

Performing the exercises your physical therapist recommended to you while you were pregnant will aid in your recovery if your pain does continue. The core muscles can be strengthened and SPD nighttime pain can be avoided with the help of Pilates or yoga.


How is SPD Diagnosed?

It is possible to identify symphysis pubis dysfunction by thoroughly reviewing your medical history. The diagnosis may also benefit from ultrasounds. Pregnant women should not undergo X-rays unless absolutely necessary.

Are SPD Any Complications?

The pelvic joint may occasionally actually separate, producing more severe pain. The term “symphyseal separation” or “diastasis of the symphysis pubis” refers to this condition. This may cause excruciating pain. Bed rest and heat treatment are usually prescribed. Assessment and treatment of this condition require orthopedic and physiotherapy expertise. Some women need to use elbow crutches to walk in order to prevent further pain and are also advised to limit their weight-bearing activity.

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