Osteitis pubis is a painful condition caused by inflammation and degenerative changes in the bone and adjacent joint (sympysis pubis) located at the front of the pelvis in the midline. Osteitis pubis is a chronic condition (long standing) which progresses slowly. The symptoms fluctuate with activity levels. Osteitis pubis is more commonly seen in AFL & soccer players, patients with other injuries about the pelvic/ hip region & in association with pregnancy.
Adductor tendonitis is inflammation of a tendon where it attaches onto the pelvic bone close to the sympysis pubis. The symptoms may be very similar to osteitis pubis & the condition may also be seen in association with inflammation of the pelvic bone similar to osteitis pubis.
Osteitis pubis is a difficult condition to treat. The mainstay of treatment is effective and sustained physiotherapy. Often a prolonged period of activity modification is required, as the condition has the tendancy to relapse. For patients with adductor tendonitis, a short course of anti-inflammatory tablets and intermittent cortico-steroid injections may assist in recovery. Osteitis pubis associated with pregnancy usually (but not always) resolves within a few months of delivery. It is always important to exclude and treat other identified causes of groin pain which may mimic osteitis pubis (eg. sports hernia).
Surgery is only considered if symptoms persist after a suitable trial of non-operative management. Adductor tendonitis can be reliably and safely treated with key-hole partial release of the effected tendon (percutaneous adductor tenotomy). For problematic ostitis pubis which has been proven unresponsive to other forms of treatment, stabilisation of the joint at the front of the pelvis is often effective (pubic symphysis arthrodesis).
This information has been written by Dr Patrick Weinrauch for the purposes of patient education. The details provided are of general nature only and do not substitute for professional recommendations based an individual clinical assessment.