Table of ContentsView AllTable of ContentsSymptomsCausesDiagnosisTreatmentPrognosis
Table of ContentsView All
View All
Table of Contents
Symptoms
Causes
Diagnosis
Treatment
Prognosis
The pubic symphysis is a joint situated in front of and below thebladder. It holds the two sides of the pelvis together in the front. Under normal circumstances, the pubis symphysis has very little motion. But when abnormal, ongoing stress is placed on the joint, osteitis pubis can occur.
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This article describes the symptoms and causes of osteitis pubis. It also explains how this overuse injury is commonly diagnosed and treated.
Osteitis Pubis Symptoms
The most common symptom of osteitis pubis is pain over the front of the pelvis. While the pain is most often felt in the center of the pelvis, one side may be more painful than the other. The central pain typically radiates outward.
Other signs and symptoms of osteitis include:
Osteitis pubis is often confused with other injuries, including agroin strain(a “groin pull”), direct inguinal hernia, a pelvic stress fracture, or illoinguinal neuralgia.
Osteitis pubis typically occurs when the pubic symphysis joint is exposed to excessive, ongoing, directional stress.
Causes of osteitis pubis include:
Less commonly, pregnancy and childbirth can place stress on the pubic symphysis, leading to osteitis pubis. Certain injuries, such as a severe fall, can also cause the disorder.
Causes of Chronic Pelvic Pain
Osteitis pubis is diagnosed based on a physical examination and imaging tests. Other tests may be performed to rule out other possible causes.
The physical exam will involve the manipulations of the hip to place tension on therectus abdominismuscle of the trunk and adductor muscle groups of the thigh. Pain during the manipulation is a common sign of osteitis pubis.
You may also be asked to walk to check for irregularities in your gait or to see if pain occurs with certain movements.
X-rays will typically reveal joint irregularities as well assclerosis(thickening) of the pubic symphysis.Magnetic resonance imaging (MRI)—a type of test that is better at imaging soft tissues—may reveal inflammation of the joint and surrounding bone. Some cases will show no signs of injury on an X-ray or MRI.
Lab Tests for Osteitis PubisThere are no laboratory tests that can diagnose osteitis pubis. However, lab tests may be ordered to differentiate it from conditions likeosteomyelitis, a type of bone infection.
Lab Tests for Osteitis Pubis
There are no laboratory tests that can diagnose osteitis pubis. However, lab tests may be ordered to differentiate it from conditions likeosteomyelitis, a type of bone infection.
Groin Pain Causes and Treatment
Treatment of osteitis pubis can take several months or longer to be fully effective. Because inflammation is the underlying cause of your symptoms (rather than a break or tear), the treatment will often involve:
Can Cortisone Help?There have been attempts to treat osteitis pubis withcortisone injections, but the evidence supporting its use is weak.Surgery is also not a standard treatment, even for people who are taking a long time to recover.
Can Cortisone Help?
There have been attempts to treat osteitis pubis withcortisone injections, but the evidence supporting its use is weak.Surgery is also not a standard treatment, even for people who are taking a long time to recover.
By contrast,physical therapycan be extremely helpful in treating osteitis pubis. While rest is needed for the inflammation to subside, physical therapy can help regain strength and flexibility.
Pelvic Floor Therapy: What to Expect
If conservative treatment fails to provide relief after six months, surgery may be explored.
Summary
Osteitis pubis is the inflammation of the joint that connects the pelvic bones, called the pelvic symphysis. Symptoms include pain in the center of the pelvis. There may also be limping or popping or clicking sounds with movement. The pelvic pain can occur while walking, running, climbing stairs, laying on your side, shifting directions, or coughing or sneezing.
Osteitis pubis is mainly seen in athletes who participate in sports that require kicking, pivoting, or shifting directions. Hockey, football, and soccer players are commonly affected. Osteitis pubic may also occur as the result of an injury, pregnancy, or childbirth.
Osteitis pubis is diagnosed with a physical exam and imaging tests. Treatment typically involves rest, heat or ice applications, and over-the-counter pain killers. Physical therapy and assistive walking devices can also help.
Once diagnosed, the prognosis for osteitis pubis is good, although the recovery can be lengthy.
A Word From Verywell
Patience is required if you have been diagnosed with osteitis pubis. As much as you may want to return to activitynow, doing so prematurely may only lead to the worsening of your condition and a longer recovery time.
By taking time off to rest, you’ll be able to start physical therapy sooner. This, in turn, can ensure that you return to your pre-injury levels of activity faster.
4 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Gomella P, Mufarrij P.Osteitis pubis: a rare cause of suprapubic pain.Rev Urol. 2017;19(3):156–163. doi:10.3909/riu0767Beatty T.Osteitis pubis in athletes.Curr Sports Med Rep. 2012;11(2):96-8. doi:10.1249/JSR.0b013e318249c32bVia AG, Frizziero A, Finotti P, Oliva F, Randelli F, Maffulli N.Management of osteitis pubis in athletes: rehabilitation and return to training - a review of the most recent literature.Open Access J Sports Med. 2018;10:1–10. doi:10.2147/OAJSM.S155077Dirkx M, Vitale C.Osteitis pubis. In:StatPearls [Internet].Treasure Island, FL: StatPearls Publishing; 2021.Additional ReadingChoi H, Mccartney M, Best TM.Treatment of osteitis pubis and osteomyelitis of the pubic symphysis in athletes: a systematic review.Br J Sports Med. 2011;45(1):57-64. doi:10.1136/bjsm.2008.050989
4 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Gomella P, Mufarrij P.Osteitis pubis: a rare cause of suprapubic pain.Rev Urol. 2017;19(3):156–163. doi:10.3909/riu0767Beatty T.Osteitis pubis in athletes.Curr Sports Med Rep. 2012;11(2):96-8. doi:10.1249/JSR.0b013e318249c32bVia AG, Frizziero A, Finotti P, Oliva F, Randelli F, Maffulli N.Management of osteitis pubis in athletes: rehabilitation and return to training - a review of the most recent literature.Open Access J Sports Med. 2018;10:1–10. doi:10.2147/OAJSM.S155077Dirkx M, Vitale C.Osteitis pubis. In:StatPearls [Internet].Treasure Island, FL: StatPearls Publishing; 2021.Additional ReadingChoi H, Mccartney M, Best TM.Treatment of osteitis pubis and osteomyelitis of the pubic symphysis in athletes: a systematic review.Br J Sports Med. 2011;45(1):57-64. doi:10.1136/bjsm.2008.050989
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Gomella P, Mufarrij P.Osteitis pubis: a rare cause of suprapubic pain.Rev Urol. 2017;19(3):156–163. doi:10.3909/riu0767Beatty T.Osteitis pubis in athletes.Curr Sports Med Rep. 2012;11(2):96-8. doi:10.1249/JSR.0b013e318249c32bVia AG, Frizziero A, Finotti P, Oliva F, Randelli F, Maffulli N.Management of osteitis pubis in athletes: rehabilitation and return to training - a review of the most recent literature.Open Access J Sports Med. 2018;10:1–10. doi:10.2147/OAJSM.S155077Dirkx M, Vitale C.Osteitis pubis. In:StatPearls [Internet].Treasure Island, FL: StatPearls Publishing; 2021.
Gomella P, Mufarrij P.Osteitis pubis: a rare cause of suprapubic pain.Rev Urol. 2017;19(3):156–163. doi:10.3909/riu0767
Beatty T.Osteitis pubis in athletes.Curr Sports Med Rep. 2012;11(2):96-8. doi:10.1249/JSR.0b013e318249c32b
Via AG, Frizziero A, Finotti P, Oliva F, Randelli F, Maffulli N.Management of osteitis pubis in athletes: rehabilitation and return to training - a review of the most recent literature.Open Access J Sports Med. 2018;10:1–10. doi:10.2147/OAJSM.S155077
Dirkx M, Vitale C.Osteitis pubis. In:StatPearls [Internet].Treasure Island, FL: StatPearls Publishing; 2021.
Choi H, Mccartney M, Best TM.Treatment of osteitis pubis and osteomyelitis of the pubic symphysis in athletes: a systematic review.Br J Sports Med. 2011;45(1):57-64. doi:10.1136/bjsm.2008.050989
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