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Osteitis Pubis

What Is Osteitis Pubis?

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Updated December 06, 2011

Osteitis pubis is an uncommon cause of pain in the groin and pelvis. Osteitis pubis occurs when there is inflammation of the pubic symphysis - the joint of the two major pelvic bones at the front of the pelvis.

The pubic symphysis is a thin joint that under normal circumstances has very minimal motion. The joint holds the two sides of the pelvis together in the front; they are connected at the sacrum in the back of the pelvis.

Causes of Osteitis Pubis

In some people, the pubic symphysis can become inflamed and irritated, causing the symptoms of osteitis pubis. Causes of osteitis pubis include:
  • Sports activities (soccer, hockey, and football are most common)
  • Pregnancy
  • Surgical procedures (gynecologic or abdominal)
  • Trauma/injury

The most common symptom of osteitis pubis is pain over the front of the pelvis. Often the diagnosis of osteitis pubis is confused with causes of groin pain or a groin strain. Usually the symptoms of osteitis pubis cause pain in the middle of the pelvis, although one side may be more uncomfortable. Other symptoms of osteitis pubis may include weakness or limping.

X-rays of patients with osteitis pubis typically show an irregular pubic symphysis with sclerotic (thick) bone edges and evidence of chronic inflammation. An MRI test is usually not needed, but will show inflammation of the joint and the surrounding bone. Tests may be done to ensure there is no infection of the bone that could cause similar symptoms. This is usually more of a concern in people who are prone to infections or have had recent surgery.

Treatment of Osteitis Pubis

The most important treatment for osteitis pubis is rest. Because inflammation is the problem that is occurring, the body needs the joint to rest in order to heal properly. Treatment of osteitis pubis consists of:
  • Rest
    The most important treatment for osteitis pubis is to allow the acute inflammation to subside. Often this is the only step needed to relieve the pain of osteitis pubis. If the symptoms are severe, crutches or a cane may be helpful as well.
  • Ice and Heat Application
    Ice packs and heat pads are among the most commonly used treatments for inflammation. So which one is the right one to use, ice or heat? And how long should the ice or heat treatments last? Read on for more information about ice and heat treatment.
  • Physical Therapy
    Physical therapy can be helpful in the treatment of osteitis pubis. Physical therapists use different modalities to increase strength, regain mobility, and help return patients to their pre-injury level of activity. While rest is needed for the inflammation to subside, physical therapy can help maintain strength and flexibility.
  • Anti-Inflammatory Medication
    Nonsteroidal anti-inflammatory medications, commonly referred to as NSAIDs, are some of the most frequently prescribed medications, especially for patients with hip pain caused by problems such as arthritis, bursitis, and tendonitis.
Treatment of osteitis pubis can take several months or longer to completely settle down. There have been attempts to treat osteitis pubis with cortisone injections, but this treatment has not been shown to be better than those listed above.

Sources:

Choi H, et al. "Treatment of Osteitis Pubis and Osteomyelitis of the Pubic Symphysis in Athletes: A Systematic Review" Br J Sports Med. 2008 Sep 30.

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