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What to Know About Osteitis Pubis

Reviewed by Dan Brennan, MD on April 27, 2021

Osteitis pubis is a painful condition that causes inflammation around the center of the pelvis. It usually occurs as a sports injury due to overuse of the hip and leg muscles. It’s particularly common in athletes who play sports like soccer or hockey that involve changing direction, kicking, or pivoting.  

Osteitis pubis can be treated, but recovery may take a long time. Learn more about osteitis pubis and how to treat and prevent it. 

What Is Osteitis Pubis?

‌‌Osteitis pubis is a painful inflammation of the bone and soft tissues of the pubic symphysis, which is the joint connecting the right and left halves of the pelvis. Several muscle groups connect to that area, including the lower abdominal muscles and the hip abductor muscles.‌‌

The inflammation is usually due to stress injuries and overuse of the muscles around the pubic symphysis. Treatment varies, but rest is usually the best way to heal osteitis pubis.  

Symptoms of Osteitis Pubis

The major symptom of osteitis pubis is pain. The inflammation in the joint and surrounding muscles may cause a constant, dull pain while sitting still. You might find that moving makes the pain worse. Putting pressure on the area will cause a sharp increase in pain.‌‌

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This injury can be debilitating, since it might limit movement. Because the pelvis is central in the body, many everyday movements will irritate the inflamed area and cause pain. Common osteitis pubis symptoms include: ‌‌

  • Pain at the center of the pelvis that feels like it radiates outward
  • Lower abdominal pain that is centered in the pelvic area
  • Pain while running, kicking, or changing direction
  • Pain while walking, climbing stairs, coughing, or sneezing
  • Pain while lying on your side
  • A clicking or popping sensation when shifting positions

Because walking can be so painful, people with osteitis pubis may find that their gait changes. Your walk may become more of a waddle as you try to minimize the pain from moving. 

Causes of Osteitis Pubis

The most common cause of osteitis pubis is repeated stress to the area. Athletes can get the condition due to repetitive motions that strain the joint, connective tissue, and muscles in the pelvic area. Sports like soccer, hockey, tennis, football, and long-distance running can all contribute to osteitis pubis.‌‌

Some research shows that you might get osteitis pubis after surgery in the pelvic area, but this is not common. People have also had symptoms of osteitis pubis after giving birth to a baby. This is also less common than cases related to sports injuries.  

Treatment of Osteitis Pubis

In general, osteitis pubis will get better with time and rest. Your doctor may suggest ways to manage the pain so that you feel more comfortable. Common ways to deal with osteitis pubis include:‌

  • Alternating heat and ice on the painful areas
  • Limiting physical activity
  • Taking time off from sports
  • Taking pain medicine‌

In severe cases where osteitis pubis doesn’t get better over time, your doctor may suggest surgery. Typically, surgery is not recommended.

Once you feel better and can start moving without pain, you may need physical therapy. A trained therapist can help you build your muscles back up without reinjuring the area. You can resume sports once your doctor and physical therapist say it’s safe to do so, which may be as long as 3 to 6 months.

Prevention of Osteitis Pubis

If you are at risk for osteitis pubis, you can take steps to prevent it. Building up strength and flexibility in your pelvic region can reduce the risk of sports injury. You may also want to focus on working both sides of your body so that you don’t use one side more than the other. Unequal strain has been shown to be a risk factor.

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Some training activities to help avoid osteitis pubis include:

  • Strengthening hip flexors and hip adductors 
  • Strengthening lower back muscles
  • Strengthening abdominal muscles
  • Strengthening hamstring and quadriceps
  • Stretching
  • Swimming 

If you work with a trainer or physical therapist, they can suggest more activities that may help you treat or prevent osteitis pubis.

WebMD Medical Reference

Sources

SOURCES:

International Journal of Women's Health and Wellness: “Osteitis Pubis in a 30-Year Old Postpartum Recreational Runner: A Case Report."

Reviews in Urology: “Osteitis pubis: A rare cause of suprapubic pain.”

Sports Medicine Today: “OSTEITIS PUBIS.”

StatPearls: “Osteitis Pubis.”

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