Symphysis Pubis Dysfunction (SPD): Managing Female Upper Inner Thigh Pain During Pregnancy

Experiencing female upper inner thigh pain during pregnancy can be uncomfortable, confusing, and sometimes worrying. One common cause of this type of pain is Symphysis Pubis Dysfunction (SPD) — also known as Pelvic Girdle Pain (PGP).

SPD is not uncommon in pregnancy. In fact, studies suggest that up to 1 in 5 pregnant women experience some form of pelvic girdle pain. While it can range from mild discomfort to significant pain, the good news is that it is manageable with the right care.

Below, you'll find a clear explanation of what SPD is, why it happens, how it feels, and what you can do about it.

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What Is Symphysis Pubis Dysfunction (SPD)?

The pubic symphysis is a joint at the front of your pelvis where the two pubic bones meet. Normally, this joint moves very slightly. During pregnancy, hormonal changes (especially the hormone relaxin) cause the ligaments around the pelvis to soften and loosen to prepare for childbirth.

In some women, this loosening becomes excessive or uneven, leading to instability in the pelvic joint. This can result in:

• Pain at the front of the pelvis
• Female upper inner thigh pain
• Groin pain
• Lower back pain
• Difficulty walking or climbing stairs

SPD is mechanical in nature — meaning it relates to how the joints move — not an infection or disease.

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Why Does SPD Cause Upper Inner Thigh Pain?

The pubic symphysis connects directly to muscles of the inner thighs (adductor muscles). When the joint becomes unstable:

• The adductor muscles work harder to stabilize the pelvis.
• This strain can cause female upper inner thigh pain, especially when moving.
• Pain may radiate from the pubic area into the groin or down the inner thighs.

This explains why many women describe SPD as "groin pain" or "sharp pain between the legs."

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What Does SPD Feel Like?

Symptoms vary from mild to severe. Common signs include:

• Pain in the pubic bone area
• Female upper inner thigh pain
• Clicking or grinding in the pelvis
• Pain when:
  • Walking
  • Turning in bed
  • Getting out of a car
  • Standing on one leg
  • Climbing stairs
• Waddling gait
• Difficulty separating the legs

The pain is often worse with uneven weight-bearing movements — like lunging, stepping sideways, or putting on pants while standing.

While uncomfortable, SPD does not directly harm your baby. However, severe pain can impact mobility and quality of life.

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When Does SPD Start?

SPD can develop:

• As early as the first trimester
• More commonly in the second or third trimester
• Occasionally shortly after delivery

Risk factors include:

• Previous pelvic injury
• Prior SPD in earlier pregnancy
• Hypermobility
• Multiple pregnancy (twins or more)
• Physically demanding work

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How Is SPD Diagnosed?

SPD is usually diagnosed clinically by a healthcare provider based on symptoms and a physical exam. Imaging is rarely needed unless another condition is suspected.

If you're experiencing symptoms like pelvic pain, groin discomfort, or inner thigh pain and want to better understand what might be causing them, you can use a free symptom checker for Pubic Symphysis Dysfunction to help identify whether your symptoms align with SPD before your next doctor's appointment.

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Managing Female Upper Inner Thigh Pain from SPD

The goal of treatment is to reduce pain and stabilize the pelvis. Most cases improve with conservative care.

1. Physical Therapy (Highly Recommended)

A physical therapist trained in pelvic health can:

• Teach stabilization exercises
• Strengthen core and glute muscles
• Reduce strain on inner thigh muscles
• Improve posture and movement patterns

This is one of the most effective treatments available.

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2. Modify Daily Movements

Small changes can significantly reduce female upper inner thigh pain:

• Keep knees together when:
  • Getting out of bed
  • Exiting a car
  • Turning over
• Sit down to get dressed
• Avoid standing on one leg
• Take smaller steps when walking
• Avoid deep squats or lunges

Think "symmetry and stability" with all movements.

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3. Pelvic Support Belts

A maternity pelvic support belt can:

• Provide external stabilization
• Reduce strain on the pubic joint
• Ease upper inner thigh pain

These belts should be fitted properly and used under medical guidance.

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4. Sleep Adjustments

To reduce pain at night:

• Sleep on your side
• Place a pillow between your knees
• Keep hips and knees aligned
• Avoid twisting the pelvis when turning

Some women find that satin sheets or pajamas make turning in bed easier.

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5. Exercise — But Carefully

Gentle movement is important, but certain exercises should be avoided.

Helpful exercises may include:

• Pelvic tilts
• Gentle core activation
• Swimming (if comfortable)
• Stationary cycling (if pain-free)

Avoid:

• High-impact workouts
• Running (if painful)
• Wide-legged movements
• Heavy lifting

Always check with your provider before starting or continuing exercise.

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6. Pain Relief Options

Your doctor may suggest:

• Acetaminophen (considered generally safe in pregnancy when used appropriately)
• Heat or cold packs
• Manual therapy

Avoid taking any medication without speaking to your healthcare provider first.

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Will SPD Affect Labor or Delivery?

In most cases:

• SPD does not require a cesarean section.
• Vaginal delivery is still possible.
• Care teams can modify positions during labor to reduce strain.

Communicate your symptoms clearly with your obstetric provider so they can plan positioning carefully.

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Does SPD Go Away After Pregnancy?

For most women:

• Symptoms improve within weeks to months postpartum.
• Mild discomfort may persist temporarily.
• Severe untreated instability may take longer to recover.

Continuing pelvic physical therapy after birth can significantly speed recovery.

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When to Speak to a Doctor Urgently

While SPD is common and manageable, not all female upper inner thigh pain during pregnancy is SPD.

Seek immediate medical attention if you experience:

• Sudden severe swelling in one leg
• Redness or warmth in the calf
• Chest pain or shortness of breath
• Fever with pelvic pain
• Numbness or weakness
• Inability to bear weight at all

These symptoms could signal more serious conditions such as blood clots or infection.

If you're unsure whether your symptoms are normal pregnancy discomfort or something more serious, speak to a doctor promptly. It is always better to be evaluated than to ignore potentially dangerous symptoms.

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Key Takeaways

• Symphysis Pubis Dysfunction (SPD) is a common cause of female upper inner thigh pain during pregnancy.
• It occurs due to ligament loosening and pelvic instability.
• Pain is often triggered by uneven movements like climbing stairs or turning in bed.
• Physical therapy is one of the most effective treatments.
• Most cases improve after delivery.
• Severe or unusual symptoms should always be evaluated by a healthcare professional.

If you're experiencing pelvic pain or inner thigh discomfort and want to learn more about whether Pubic Symphysis Dysfunction might be the cause, a quick online symptom assessment can provide helpful insights to discuss with your healthcare provider.

Most importantly, if your pain is severe, worsening, or accompanied by concerning symptoms, speak to a doctor right away. Your safety — and your baby's — always comes first.