When it comes to persistent groin pain, there are a number of potential causes. But one of the most common – particularly among athletes – is a condition called osteitis pubis.

What is Osteitis Pubis?

It’s an inflammation of the pubic symphysis, which is the joint where the two halves of the pelvis meet in the front. Our previous blog post discussed anatomy of your groin. Your pubic symphysis acts as a shock absorber, so it takes a lot of wear and tear, particularly during activities that involve high impact or twisting motions – like running, soccer, hockey, and football.

What are the Symptoms of Osteitis Pubis?

Osteitis pubis usually develops slowly, over the course of several months. The first symptom is usually pain in the groin area, which can range from a dull ache to a sharp, stabbing pain. The pain is usually mild or moderate but can become a throbbing pain with aggravating activities. When it's aggravates your pain may even radiate down into your thigh or groin.

As the condition progresses, the pain may become more constant, and you may also experience swelling and warmth in the area. In some cases, the pain can be severe enough to interfere with your ability to walk or even stand.

What causes Osteitis Pubis

There are a number of factors that can contribute to the development of osteitis pubis, including:

- Repetitive stress on the joint: This is the most common cause, and is often seen in athletes who participate in high-impact sports.

- Trauma to the area: A direct blow to the pubic symphysis can cause osteitis pubis, as can surgery in the area.

- Infection: In rare cases, osteitis pubis can be caused by an infection in the joint.

Treatment for Osteitis Pubis

If you suspect you may have osteitis pubis, the first step is to see your physiotherapist. They will take a detailed history and conduct a physical examination. If your injury was related to trauma, they may refer you to your family doctor for imaging to rule out a fracture.

Once osteitis pubis is diagnosed, the goal of treatment is to reduce the pain and inflammation and allow the joint to heal. This can be done with a combination of:

- Rest: This is crucial, as osteitis pubis cannot heal properly if you continue to stress the joint.

- Ice: Apply ice to the area for 20 minutes, several times a day.

- Physical therapy: A physiotherapist can develop a customized rehabilitation program to help speed up the healing process. This may include exercises, manual therapy, and modalities like ultrasound or electrical stimulation. If clinical testing suggests a strain of your pubic joint is involved they may recommend the use of a brace.

If you have osteitis pubis, it’s important to be patient – it can take several weeks or even months to fully heal. But with the right treatment, you’ll be on your way to recovery in no time.

Do you think you may have osteitis pubis? Contact our team of physiotherapists today – we can help!

References:

Amer et al. "The challenges in diagnosis and management of osteitis pubis: An algorithm based on current evidence" BJUI Compass 3(4) July 2022