What You Should Know About Osteitis Pubis

Table of Contents
View All
Table of Contents

Osteitis pubis is a cause of pain in the groin and pelvis, commonly diagnosed in athletes in particular sports. 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.

woman with pelvic pain laying down
 BSIP / Getty Images

Osteitis Pubis Symptoms

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 symptom is a pain in the center of the pelvis at the front, although one side may be more uncomfortable. Other symptoms may include weakness or limping.

Osteitis pubis is sometimes confused with infection of the bone, a condition called osteomyelitis. These conditions may sometimes have similar findings but can be differentiated by specific imaging or laboratory findings.


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


Laboratory studies can help distinguish osteomyelitis from osteitis pubis. Examination of an individual with osteitis pubis is typically characterized by tenderness directly over the front of the pubic bone.

Manipulations of the hip joint, specifically manipulations that place tension on the rectus muscle and abductor muscle groups will often cause discomfort. Many people who have more severe cases of osteitis pubis will have an abnormal gait pattern.

X-rays of people with osteitis pubis typically show an irregular pubic symphysis with sclerotic (thick) bone edges, particularly in chronic cases. A magnetic resonance imaging (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 can take several months or longer to be fully effective. There have been attempts to treat osteitis pubis with cortisone injections, but evidence showing effectiveness is limited. Surgery is not a standard treatment, even for patients who take a long time to improve with the below treatments.

The most important treatment for osteitis pubis is rest. Because inflammation is the problem, the body needs the joint to rest in order to heal properly.

Treatment for the inflammation may include:

  • Rest: Rest allows the acute inflammation of osteitis pubis to subside. Often this is the only step needed to relieve the pain. If the symptoms are severe, crutches or a cane may be helpful as well.
  • Ice and heat application: Ice packs and heat pads are commonly used to treat inflammation.
  • Anti-inflammatory medication: Nonsteroidal anti-inflammatory medications (NSAIDs) are some of the most frequently prescribed medications for pain in general, and for the pain of osteitis pubis.

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 regain and maintain strength and flexibility.

A Word From Verywell

Osteitis pubis is a condition that can cause groin and hip pain. Imaging findings are often subtle and should be carefully evaluated. The good news is that most people with osteitis pubis will find symptomatic relief with some simple treatment steps and time.

Was this page helpful?
3 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Gomella P, Mufarrij P. Osteitis pubis: A rare cause of suprapubic pain. Rev Urol. 2017;19(3):156–163. doi:10.3909/riu0767

  2. Beatty T. Osteitis pubis in athletes. Curr Sports Med Rep. 2012;11(2):96-8. doi:10.1249/JSR.0b013e318249c32b

  3. 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 literatureOpen Access J Sports Med. 2018;10:1–10. doi:10.2147/OAJSM.S155077

Additional Reading