Constant pain in your groin area? Let's talk about Osteitis Pubis!

Do you sometimes feel a strange pain in your groin area or lower abdomen while running, climbing stairs, or even just standing? This experience is probably familiar to you, especially if you are an athlete. One possible cause of this pain is a condition called Osteitis Pubis. But don't worry, it is usually not serious. Let's talk about this in a simple way that everyone can understand.

What is Osteitis Pubis?

Simply put, Osteitis Pubis is an inflammation, that is, a swelling, of a joint in the middle of our pelvis. We medically call this joint the Pubic Symphysis . This is where the right and left sides of our pelvic floor are connected in the middle. Imagine, many things, such as our abdominal muscles and hip muscles, are connected around this joint. So, when this joint becomes inflamed, pain occurs.

This condition is most commonly caused by overuse/stress from repetitive motions. People who play sports that involve running, kicking, or sudden changes in direction (such as soccer or hockey) are more likely to develop this condition. However, it can also occur in non-athletes.

What are the symptoms?

The main and most obvious symptom of Osteitis Pubis is pain. This pain can be felt in different ways. Sometimes it feels like a dull ache even when just sitting. This pain increases when moving or exercising.

Let's take a closer look at what these symptoms are in the table below.

This pain is so severe that for some people, the way they walk changes. In an attempt to relieve the pain, walking may become a waddling gait .

What causes this?

The main reason for this is, as I mentioned before, the constant pressure on the pelvic area. This is especially common in athletes.

• Sports: This condition can occur due to the pressure placed on the pelvic joints, connective tissue, and muscles during sports such as football, hockey, tennis, and long-distance running.
• Surgery: Very rarely, these symptoms may occur after surgery in the pelvic area.
• Childbirth: Also, some women may develop this condition after giving birth. However, both of these cases are much less common than those related to sports.

How is the diagnosis made?

So when you see a doctor, he will first ask you about your symptoms and how the pain started. Then, he will try to rule out other medical conditions.

Next, a physical exam will be performed. This involves examining your pelvis and lower abdomen, applying certain movements and pressures to see if there is any pain. There are several special tests for this.

• Pubic Spring Test: The doctor will gently press on your pelvis from the front, just above the pubic bone. If there is any sharp pain, it could be a sign of this inflammation.
• Lateral Compression Test: This involves squeezing the hip bones from both sides. If there is pain, it means that the medial joint is unstable or inflamed.
• FABER Test: Here, your leg is bent into a figure '4' shape. If this movement causes pain in the front of the pelvis, it is also a sign of Osteitis Pubis.

Imaging Tests

After a physical examination, imaging tests are performed to confirm the diagnosis and accurately assess the internal condition.

• X-ray: This can look for things like changes in the bones, joint widening, and bone roughness.
• MRI (Magnetic Resonance Imaging): The best way to diagnose this condition is with an MRI scan. It can clearly see things that are not visible on an X-ray, such as early swelling of the bones and tissues, and fluid accumulation in the joint.
• CT (Computed Tomography) Scan: This helps to get a very detailed image of the bones. It is used if an MRI is difficult to perform or if more clarity is needed.
• Bone Scan: This test is very sensitive in detecting problems in the bones caused by conditions such as infection, injury, or cancer.

How is it treated?

The best news I can give you is that Osteitis Pubis can be completely cured with time and proper management.

A trained physical therapist can help you strengthen your muscles to prevent re-injury. Once your doctor and physical therapist give you the OK, you can resume your sports activities. This can take anywhere from a few weeks to 3-6 months.

The following are usually done for this:

• Alternate applying heat and ice to the painful area.
• Limiting physical activity.
• Rest completely from sports until the pain improves.
• Taking painkillers such as Ibuprofen, Naproxen, and Acetaminophen as directed by your doctor.

If these things don't help, your doctor may give you a steroid injection to reduce swelling. They may also recommend a non-invasive treatment called Extracorporeal Shock Wave Therapy (ESWT).

When is surgery necessary?

Although most people do not need surgery, surgery may be considered in the following cases:

• If the pain lasts more than 6 months.
• If the pain is too much to move.
• If you are unable to engage in sports activities.

Now, many doctors are performing this surgery minimally invasively . That is, instead of making a large incision, a thin tube with a camera (endoscope) is inserted through several small holes and the inflamed tissue is removed. This results in less healing time and less pain.

How to avoid this situation?

If you are at risk for this condition, you can take steps to prevent it. Strengthening the muscles in the pelvic area and increasing flexibility can reduce the risk of sports injuries.

Here are some exercises that will help with this:

• Strengthening the muscles of the hips and thighs (hip adductors).
• Strengthening the muscles of the lower back.
• Strengthening the abdominal muscles.
• Strengthening the hamstring and quadriceps muscles.
• Stretching.
• Swimming.

If you work with a trainer or physical therapist, you can get guidance on the correct exercises to prevent this condition.

Osteitis Pubis, groin pain, pubic symphysis, sports injury, physical therapy, pelvic pain