What is osteitis pubis?

Osteitis pubis is pain and swelling in the area where the right and left pubic bones meet. Muscles from the lower belly, thigh, and groin attach to these pubic bones.

What is the cause?

When the muscles attached to the pubic bones are overused, they pull on the area where the pubic bones meet.

Doing the same kind of activity often and repeating the same movement over and over is the usual cause. This may happen with running, jumping, kicking, skating, or doing sit-ups. Osteitis pubis may also be caused by an injury, surgery, or childbirth.

What are the symptoms?

Symptoms may include:

• Pain when the area in front of your pubic bones is touched
• Pain in your lower belly
• Pain in your groin

The pain usually starts gradually, and you may notice just mild aching after activity. Over time, the pain may become constant and may affect the way that you walk and move.

How is it diagnosed?

Your healthcare provider will ask about your symptoms and medical history and examine you. Tests may include:

• X-rays
• CT scan, which uses X-rays and a computer to show detailed pictures of the bone
• MRI, which uses a strong magnetic field and radio waves to show detailed pictures of the bone
• Bone scan, which uses a radioactive chemical to look at your bone

How is it treated?

You will need to change or stop doing the activities that cause pain. If running causes pain, you should swim or bicycle instead. You may need to rest from all activities. If you try to keep doing activities that cause pain, it will take longer for the pain to go away. Sometimes it takes 2 to 3 months or longer for symptoms to go away. You can also:

• Put an ice pack, gel pack, or package of frozen vegetables, wrapped in a cloth on the area every 3 to 4 hours, for up to 20 minutes at a time.
• Take nonprescription pain medicine, such as acetaminophen, ibuprofen, or naproxen. Read the label and take as directed. Unless recommended by your healthcare provider, you should not take these medicines for more than 10 days.
  • Nonsteroidal anti-inflammatory medicines (NSAIDs), such as ibuprofen, naproxen, and aspirin, may cause stomach bleeding and other problems. These risks increase with age.
  • Acetaminophen may cause liver damage or other problems. Unless recommended by your provider, don’t take more than 3000 milligrams (mg) in 24 hours. To make sure you don’t take too much, check other medicines you take to see if they also contain acetaminophen. Ask your provider if you need to avoid drinking alcohol while taking this medicine.

Your healthcare provider may recommend stretching and strengthening exercises and other types of physical therapy to help you heal. Your provider may give you an injection of a corticosteroid medicine.

Follow your healthcare provider’s instructions, including any exercises recommended by your provider.

Ask your provider:

• How and when you will hear your test results
• How long it will take to recover
• If there are activities you should avoid and when you can return to your normal activities
• How to take care of yourself at home
• What symptoms or problems you should watch for and what to do if you have them

Make sure you know when you should come back for a checkup. Keep all appointments for provider visits or tests.

When can I return to my normal activities?

Everyone recovers from an injury at a different rate. Return to your activities depends on how soon you recover, not by how many days or weeks it has been since the pain started. The longer you have symptoms before you start treatment, the longer it will take to get better. If you return too soon you may worsen your injury, and it will take even longer to heal.

You may safely return to your activities when:

• You do not have any pain or tenderness over the pubic bone.
• You can walk straight ahead without pain or limping.