In professional circles, inflammation of the pubic bone is also known as osteitis pubis. The term “inflammation” is misleading insofar as the symptoms are not caused by infections. It is much more likely that they are caused by repeated trauma to the affected areas due to incorrect or excessive stress.
What is pubic osteitis?
The pubic bones, the pubic symphysis (symphysis) and the structures around it are primarily affected by an inflammation of the pubic bone. Inflammation of the pubic bone is also known as symphyseal osteitis or pubalgia. The pubic bone forms part of the hip bone. The other two parts are the ischium and ilium. Everyone has two hip bones and one sacrum, which in turn form the pelvis. See deluxesurveillance for Bacterial Vaginosis Guide.
The so-called pubic symphysis is a connection of fibers and cartilage that connects the two pubic bones. So they are mobile to a certain extent. Relaxin is released in pregnant women. This hormone provides extra mobility in the pubic symphysis to facilitate childbirth and minimize fractures.
Athletes are particularly affected by pubic bone infections. Up to seven percent of athletes develop the inflammation every year. The rate is highest for footballers, tennis players and basketball players. The average age for men is 30 years. On average, women are only affected at the age of 35. Depending on the severity of the disease, the affected person has to do without sport for a longer period of time and can only slowly get back into training.
The main cause of pubic osteitis is overloading and excessive stress on the pubic symphysis. This can cause scar tissue to form, which can lead to bone loss. This breakdown triggers cysts in adjacent areas . Stress fractures can also occur. This is what stress-related fractures are called.
Sports with many changes of direction, sprints or shot elements are particularly often affected, as strong tensile forces act on the pubic symphysis. In addition to the sports mentioned above, running sports and American football are also included. Athletes are therefore a special risk group.
But pregnant women are also affected. Pregnancy and childbirth can also cause inflammation of the pubic bone. According to studies, bleeding in the symphysis can occur after birth. In some cases, the adjacent bone is also affected. Cracks in the cartilage are not uncommon.
An operation in the pelvic area can also be the cause of pubic inflammation. This is where inflammation occurs as a complication. Examples of this are prostate surgery or the insertion of a catheter for the bladder. This type of urinary catheter runs past the pubic bone and can also lead to osteitis pubis.
Symptoms, Ailments & Signs
Various symptoms can indicate pubic inflammation. The swellings in the area of the symphysis are noticeable. It is often sensitive and responds to pressure associated with pain. Pain in the pubic rami and pubic symphysis is the main symptom of the disease.
Sometimes this pain is very distressing. Depending on the case, sporting activities can no longer be carried out because the inflammation leads to massive restrictions. In addition, pain can spread to the hip or groin. Inflammation of the pubic bone is often associated with pain in the lower abdomen or the pelvic floor.
Pain when standing up after sitting for a long time is also typical. This “ start -up pain ” usually subsides with uniform movements. Climbing stairs or jerky movements, on the other hand, often causes pain for those affected.
Diagnosis & course of disease
The diagnosis is not easy. Many sports injuries are accompanied by similar symptoms. The disease is often confused with groin problems such as strains. Overloading some tendons can also cause similar pain.
Inflammation of the pubic bone must be differentiated from avulsion fractures, inflammation of the bone marrow, rheumatic diseases and hernias. Adductor strains or diseases in the urinary and genital tract can also lead to similar symptoms.
To make a diagnosis, the doctor will first ask about the symptoms and medical history. Only then will he lead various physical examinations. Imaging methods can be used to diagnose pubic arthritis. Similar to a blood test, a distinction must be made between inflammatory diseases.
Depending on the infection, the diseases are not always easy to distinguish. In the case of pubic bone inflammation, however, the inflammatory parameters in the blood are not increased. X-rays and MRI can also be used for differentiation.
Inflammation of the pubic bone usually heals without complications. However, as the disease progresses, the pain can spread and radiate to the hips, groin, lower abdomen, and pelvic floor. In the case of long-term illnesses, the pain can lead to malpositions and occasionally to subsequent psychological problems. Typical of chronic diseases are, for example, depressive moods, which can develop into severe depression if the course is severe.
Surgical treatment can be associated with bleeding and wound healing disorders. Very rarely, nerve injuries occur that require further surgery. Prescribed medicines can result in side effects and interactions such as headaches, gastrointestinal complaints, oedema, reddening of the skin and temporary visual and hearing disorders. Allergic reactions and intolerances cannot be ruled out either.
Complications such as cardiovascular problems, increased susceptibility to infections and weight gain are possible with cortisone treatment. Water retention in the tissue can also occur. Cortisone also promotes the development of osteoporosis. Skin damage, circulatory disorders, cardiac arrhythmia, sensitivity disorders and other complications can occur as part of electrotherapy. If you start exercising again too soon after the treatment, the pubic osteitis is likely to recur.
When should you go to the doctor?
If acute pain occurs again and again while jogging or doing sit-up exercises, it may be due to pubic osteitis. A doctor’s visit is indicated if the symptoms recur and make it difficult to exercise. The symptoms usually develop insidiously and should be clarified at an early stage. It mostly affects people who are active in sports and often go cycling, jogging or horseback riding. Anyone who lifts heavy for work-related reasons is just as at risk as pregnant women, rheumatism patients and people with a tilted pelvis. If you belong to one of these risk groups, it is best to see a doctor if the symptoms mentioned appear.
Affected people consult their family doctor or an orthopedist. Other contact points are sports physicians and pain therapists. In general, pubic arthritis can be treated well if it is detected at an early stage. However, osteitis pubis is often based on another condition that must be identified in the context of intensive examinations. In addition to symptomatic treatment, further visits to specialists should therefore take place. The doctor must be informed of an increase in symptoms and any side effects of the prescribed painkillers.
Treatment & Therapy
As a rule, an inflammation of the pubic bone heals on its own. If this is not the case, injection therapy or surgery can be considered. In principle, however, the inflammation is primarily treated conservatively. It can sometimes take several months for the disease to heal completely. Pain-inducing movements and sports should ideally not be carried out during the healing phase.
Patience is essential during therapy, otherwise relapses may occur. One treatment option is physiotherapy. Anti- inflammatories such as ibuprofen can also help against the pain and provide short-term relief. Cortisone treatment is also possible. Other options include electrotherapy and ultrasound treatments. After the inflammation has healed, it is important to slowly get back into training. Heavy loads on the pelvic girdle should be avoided.
As a preventative measure, it is important to warm up before training in order to avoid overloading as much as possible. Stretching the adductors and targeted training of the trunk and abdominal muscles reduce the risk. Any malformations in the arch of the foot can be adjusted with insoles. This prevents incorrect appearance and minimizes the risk of pubic bone inflammation due to incorrect strain.
If the pubic inflammation has been cured well, a one-time follow-up examination is sufficient. The doctor must clarify whether the patient still has symptoms. Prescribed medications must be gradually discontinued after recovery. Depending on whether anti-inflammatories or stronger drugs were prescribed, tapering off must be monitored by a doctor. After cryotherapy or electrotherapy, psychological care can sometimes be useful for the patient.
The doctor will usually recommend a break from exercise. After an inflammation of the pubic bone, intensive physical exercise should be avoided for at least one to two weeks. After an operation, follow-up care takes place in the hospital. If curettage has been used, the surgical wound must be carefully observed.
Competitive athletes need intensive follow-up care after an inflammation of the pubic bone. Otherwise, the symptoms can reoccur and significantly limit performance. On the one hand, repeated illnesses can be avoided by early therapy. On the other hand, comprehensive aftercare is necessary.
The orthopedist or the general practitioner takes care of aftercare for pubic bone inflammation. In the case of intense pain that radiates into the lower abdomen and pelvic floor, further treatment by a pain therapist is usually necessary. If necessary, the physiotherapist is also involved in the aftercare.
You can do that yourself
The pubic symphysis is a neuralgic point of the human body, something that competitive athletes in particular have to notice regularly. Inflammation of the pubic bone or the pubic symphysis results almost exclusively from continued overload. The best self-help measure is therefore not to constantly overtax the body, but to adapt the training to your own condition and physical capabilities. In particular, short, fast movements, hitting hooks or sprints with abrupt stops put excessive strain on the pubic bone. If such behavior cannot be avoided, which is likely to be the case only with professional athletes, countermeasures must be taken on a regular basis.
Physiotherapeutic measures can help to strengthen and relieve the stressed body region. Very often, however, it is necessary for those affected to maintain a longer rest phase in which they do no or only light endurance sports. Anyone who lifts heavy work may have to take a long break or pursue another activity. Those affected should definitely follow the instructions of their treating doctor, otherwise pubic bone infections can be very stubborn or even become chronic. The pain associated with the inflammation can usually be treated well with over-the-counter anti-inflammatories such as ibuprofen.