Osteitis pubis is a condition in which there’s inflammation where the right and left pubic bones meet at the lower front part of the pelvis.
The pelvis is a set of bones that connect the legs to the upper body. It also supports the intestines, bladder, and internal sex organs.
The pubis, or pubic bone, is one of three bones that make up the hip. The joint where the pubic bones meet is called the pubic symphysis, which is made of cartilage. When it and the surrounding muscles become inflamed due to stress on the joint, the result is osteitis pubis.
Osteitis pubis doesn’t require a surgical procedure or prescription medications. The key to treating this condition is rest.
Osteitis pubis usually develops from overdoing a particular activity, such as running or jumping. So, it’s very important to refrain from exercises or activities that are painful. The more you engage in activities that cause pain or increase inflammation, the longer it will take for the joint to heal.
In addition to rest, treatment usually focuses on symptom relief. To ease pain, apply an ice pack or a package of frozen vegetables wrapped in a thin cloth to the joint. Do this for about 20 minutes every three to four hours.
For further pain relief, your doctor may recommend nonsteroidal anti-inflammatory medications (NSAIDs), such as ibuprofen (Advil) or naproxen (Aleve). NSAIDs may cause stomach irritation, especially in older adults.
Acetaminophen (Tylenol) may also relieve pain. In large doses, it can raise the risk of liver damage and other complications.
In some cases, a corticosteroid injection may reduce inflammation and ease symptoms.
The most obvious symptom of osteitis pubis is pain in the groin and lower belly. You may also feel pain or tenderness when pressure is applied to the area in front of your pubic bones.
The pain tends to start gradually, but it can eventually reach a point where it’s constant. It may even affect your ability to stand upright and walk easily.
Osteitis pubis tends to affect athletes and other people who are very physically active.
Repeating the same actions can stress the pubic symphysis. In addition to running and jumping, kicking, skating, and even sit-ups can put an unhealthy strain on the joint.
Osteitis pubis in women can also develop after childbirth. A prolonged labor that strains the muscles of the pelvis can cause inflammation, which will eventually subside.
Surgery or an injury to the pelvis may also result in osteitis pubis.
If you suspect that you have osteitis pubis, see your doctor to confirm a diagnosis. Your doctor will review your medical history and symptoms before performing a physical examination.
Some imaging tests may be recommended, including:
- CT scan
- bone scan
- blood and urine tests
Some of these tests are used to eliminate other possible causes of symptoms, such as a hernia or an injury to the joint.
Exercises to help strengthen the muscles around the pubic symphysis may help you recover and prevent recurring problems. These exercises shouldn’t be done if you’re still experiencing pain.
Transversus abdominis retraining
The transverse abdominal muscles are deep core muscles that wrap around your midsection. They play an important role in stabilizing the pelvis.
You can do the following transverse abdominal exercise while lying down or practice a version of it sitting or standing up.
- While lying on your back, contract your abdominal muscles as though you’re pulling your belly button back toward your spine.
- Hold this position for several seconds. Don’t lift your ribcage.
- Try to keep the rest of your body, other than your abdominal muscles, relaxed.
- Repeat this exercise three or four times per day.
The adductor muscles are located on the inside of your thigh.
To help improve the flexibility and strength of these muscles, which support the pubic bones, try the following stretch.
- Standing with your back straight and your legs wider than shoulder width, lunge to your left, while keeping your right leg straight. You should feel a stretch in your right leg.
- Hold for 10 to 15 seconds without straining or lunging too far.
- Slowly return to your starting position.
- Lunge to your right while keeping your left leg straight.
- Hold when you feel a stretch, then return to your original position.
Depending on the severity of your injury, it can take two or three months to fully recover and resume your physical activities.
While you recover, you may be able to find activities that don’t put too much pressure on the pubic symphysis. If you’re a runner, swimming may be a better alternative. Your doctor may recommend physical therapy, in which you’ll learn several stretching and strengthening exercises.
Once you return to physical activity, be sure to rest after rigorous exercise and allow recovery time, such as a day off in between workouts, to prevent future injury. Try to avoid exercising on hard or uneven surfaces, too.
You may also lower your risk of developing osteitis pubis after childbirth or surgery by carefully stretching and warming up your muscles before exercising.
Osteitis pubis can be a painful condition, but with rest and pain-relieving treatments, it shouldn’t keep you out of the action too long. Make sure you get a proper diagnosis, then follow the advice of your doctor and physical therapist.