Signs and symptoms
The symptoms of osteitis pubis can include loss of flexibility in the groin region, dull achingCauses
* Pregnancy/childbirth * Gynecologic surgery * Urologic surgery * Athletic activities (e.g. running, football, American football, ice hockey, tennis) * Major trauma * Repeated minor trauma * Rheumatological disorders * Unknown cause In the pre-antibiotic era, osteitis pubis was an occasional complication of pelvic surgery, and in particular, of retropubic prostatectomy.Overload or training errors
*Exercising on hard surfaces (like concrete) *Exercising on uneven ground *Beginning an exercise program after a long lay-off period *Increasing exercise intensity or duration too quickly *Exercising in worn out or ill-fitting shoesBiomechanical inefficiencies
*Faulty foot and body mechanics and gait disturbances *Poor running or walking mechanics *Tight, stiff muscles in the hips, groin, and buttocks *Muscular imbalances *Leg length differencesDiagnosis
Osteitis pubis may be diagnosed with anTreatment and prevention
Until recently, there was no specific treatment for osteitis pubis. To treat the pain and inflammation caused by osteitis pubis, antiinflammatory medication, stretching, and strengthening of the stabilizing muscles are often prescribed. In Argentina, Topol et al. have studied the use of glucose and lidocaine injections ("prolotherapy", or regenerative injection therapy) in an attempt to restart the healing process and generate new connective tissue in 72 athletes with chronic groin/abdominal pain who had failed a conservative treatment trial. The treatment consisted of monthly injections to ligament attachments on the pubis. Their pain had lasted an average of 11 months, ranging from 3–60 months. The average number of treatments received was 3, ranging from 1–6. Their pain improved by 82%. Six athletes did not improve, and the remaining 66 returned to unrestricted sport in an average of 3 months. Surgical intervention - such as wedge resection of the pubis symphysis - is sometimes attempted in severe cases, but its success rate is not high, and the surgery itself may lead to later pelvic problems. Recent advances in the field of hip arthroscopy have introduced endoscopic resection of the pubic symphysis which has a potentially higher success rate with less complications. TheEpidemiology
The incidence of osteitis pubis among Australian footballers has increased sharply over the past decade. There are believed to be three reasons for this: * The increasing physical demands of Australian rules football. As the game has become more professional, with players becoming full-time athletes, such factors as running speed, kicking length, jumping, and tackling have all increased, placing increasing stress on the pubic region. * The increasing hardness of the surfaces of football grounds. Grounds are better drained than in the past, and the game is increasingly played in roofed stadiums, in which the grounds receive no rain. Australian football evolved as a winter game played on soft, muddy grounds, and modern surfaces have made muscle and bone injuries more common. * The increasing demand for size and strength among footballers. This has led young players to concentrate on building muscle mass before their bodies are fully mature. The additional strain that highly developed abdominal muscles place on the pubic bone explains the higher prevalence of osteitis pubis in young players. Some develop the condition while still playing school-level football.Pregnancy
Damage can occur to the ligaments surrounding and bridging the pubic joint (symphysis) as a result of the hormone relaxin, which is secreted around the time of birth to soften the pelvic ligaments for labor. At this time repetitive stress or falling, tripping, and slipping can injure ligaments more easily. The hormone usually disappears after childbirth and the ligaments become strong again. In some women the weakness persists, and activities such as carrying their baby or stepping up even a small step can cause a slight but continuous separation or shearing in the ligaments of the symphysis where they attach to the joint surfaces, even causing lesions in the fibrocartilage and pubic bones. Symptoms include one or more of the following: pain in the pubic area, hips, lower back, and thighs. This can take months (or even years) to go away. X-rays taken during the early stages of osteitis pubis can be misleading - pain may be felt, but the damage doesn't appear on the films unless stork views (i.e. standing on one leg) are obtained. As the process continues and progresses, later pictures will show evidence of bony erosion in the pubic bones. Osteitis pubis can also be associated with pelvic girdle pain.References
External links
{{DEFAULTSORT:Osteitis Pubis Inflammations Injuries of abdomen, lower back, lumbar spine and pelvis