Osteitis pubis is an acute or chronic injury to the small joint in the middle of the pelvis, known as the pubic symphysis. The condition is seen most often in athletes who play contact sports, although it can also affect pregnant women and older people with weakened joints. An inflamed pubic symphysis is likely to cause local tenderness and aching pain that radiates throughout the groin and abdominal region. In most cases, pubic osteitis can be overcome in about three months with rest, anti-inflammatory medications, and follow-up physical therapy. Serious injuries may require surgery to repair severely damaged joints.
The pubic symphysis is a narrow, cartilage-filled joint that helps stabilize the pelvis during activity. The joint may become acutely inflamed if the pelvis is hit directly, or it may gradually deteriorate as a result of frequent overuse. Soccer, hockey, and rugby players are especially prone to direct injuries from tackles and high-impact falls. Athletes who play sports in which intense running, jumping, kicking, and stopping are common have the highest risk of developing chronic osteitis.
Common symptoms of osteitis pubis include swelling and tenderness in the groin region. Sharp, shooting pains and dull aches envelop the abdomen, groin, and genitals. An athlete who is developing a chronic condition is likely to notice worsening pain during and after physical activity. In severe cases, the symptoms can be severe enough that it is very uncomfortable or impossible to walk. Even minor pain should be reported to a doctor or trainer so that a proper diagnosis can be made.
A doctor who suspects osteitis pubis can perform a series of imaging tests to check for signs of inflammation of the symphysis pubis. MRIs and CT scans are also used to make sure bones, ligaments, and pieces of cartilage tissue are not damaged. Blood tests may be done to rule out viral infections and other possible causes of inflammation.
Mild cases of pubic osteitis can usually be relieved by avoiding physical activity for several days, freezing the joint regularly, and taking anti-inflammatory medications. A doctor can inject a corticosteroid solution directly into the pubic symphysis if the pain is debilitating. Once the joint begins to feel better, a patient can perform stretching and strengthening exercises to complete the recovery phase. Surgery is reserved for recurrent or especially severe cases of pubic osteitis. A patient undergoing surgery can expect to spend several months in physical therapy before he can return to normal activity.