What You Should Know About Osteitis Pubis

woman with pelvic pain laying down
BSIP/Getty Images

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

Symptoms of Osteitis Pubis

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 pain in the middle of the pelvis, although one side may be more uncomfortable. Other symptoms of may include weakness or limping.

Osteitis pubis is sometimes confused with infection of the bone, a condition called osteomyelitis. On imaging studies, these conditions often have similar findings. However, infections will typically be accompanied by symptoms including fevers, chills, sweats. In addition, there are laboratory studies which can help distinguish osteomyelitis from a osteitis pubis.

Diagnosis of 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 placed 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 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. 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.
  • 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. Surgery is not a standard treatment, even for patients who take a long time to improve with the aforementioned treatments.

    A Word From Verywell

    Osteitis pubis is an uncommon condition that can cause groin and hip pain. This condition should be considered in people who have symptoms of groin pain that do not seem to be responding to typical treatments. 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?