Osteitis Pubis Syndrome

Osteoitis pubis is an overuse injury characterized by tissue damage and pelvic inflammation at the junction of the two pubic bones (symphless pubis), causing groin pain. It is usually caused by repetitive or prolonged activities that put tension on the symphsiz pubis. This usually consists of repetitive running, kicking, or movements that cause varying direction activities. It is often seen in sports such as football, tennis, and track and field (especially marathon runners).

           One of the main causes is instability of the pelvic bones, especially the symphsiz pubis. The imbalance is exacerbated when asymmetrical loads are placed on the pelvis, such as when running or kicking. Patients may also develop pubis osteitis after inadequate rehabilitation of other injuries, such as over-tightening of the abdominal muscles or adductor tendinopathy.

                                         Symptoms

         Osteitis pubis symptoms may be mild at first, but can get worse with activity. If you have pubic osteitis, you may experience a combination of:

• Extreme tenderness and pain in the groin area

• Pain when coughing, sneezing or using the abductor muscles.

• Clicking sound when getting up from sitting position or walking

• Decreased mobility and loss of flexibility

   In the later stages of pubis osteitis, an irregular gait pattern (posture disorder) may develop. A correct diagnosis is difficult to come by, as many of these symptoms also mimic a hernia or lower back pain.

                                                       Reasons

      Osteitis pubis is usually caused by one of the following:

 • Surgery: Osteitis pubis is a well-known complication of some gynecological surgeries.

• Sports injury: Overuse and excessive tension during activity can lead to pubic osteitis.

• Pregnancy: Because of the hormones that change between the pelvic bones to accommodate childbirth, women can develop pubis osteitis during pregnancy or after childbirth.

• Trauma or accident: Injury to the pelvic area can cause inflammation and bone stress present in the osteitis pubis.

• Rheumatological disorders: Conditions that cause inflammation in the body can cause pubis osteitis.

                                          Diagnosis and tests

     In order to determine osteitis pubis, a physical examination should first be performed and your personal characteristics and medical history should be questioned. Some of the following tests may be done to need more information to make a diagnosis.

• Blood or urine tests

• X-ray

• Ultrasound

• MR and CT

• Bone scan

Some of these tests may be done to rule out other causes of your pelvic pain, such as a hernia or other joint dysfunction or injury.

                                             Treatments

     Osteitis pubis treatment may involve one of two different approaches: non-surgical or surgical. Nonsurgical treatment may include a combination of:

• Heat and ice therapy

• To relax

• Physiotherapy

• Anti-inflammatory pain relievers

• Surgical treatment is recommended only in severe cases that do not respond to other treatments. This surgery involves surgical fusion and can have a long recovery time of up to a year.