Osteitis Pubis & Tendonitis

Osteitis pubis is characterised by inflammation of the pubic symphysis, which is the joint at the front of the pelvis between the two ends of the pubic bone. This inflammation leads to sclerosis and bony changes of the pubis symphysis, causing both acute and chronic groin pain. Symptoms fluctuate with activity levels but can render sufferers incapable of sustained physical activity.

It is prevalent in footballers, runners and other athletes, particularly players of Australian rules football. It is also seen in patients with other injuries about the pelvic/ hip region & in association with pregnancy.

Adductor tendonitis is characterized by tissue damage and inflammation to the adductor tendon at its attachment to the pelvis resulting in groin pain. The symptoms may be very similar to osteitis pubis.

Osteitis pubis is difficult to treat. Physiotherapy is the main treatment. A prolonged period of activity modification may be required as the condition has the tendency 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

Surgery is only considered if a suitable trial of non-operative management has failed. Osteitis pubis may respond to pubic symphysis arthrodesis which involves stabilisation of the joint at the front of the pelvis. Adductor tendonitis can treated with key-hole partial release of the affected tendon (percutaneous adductor tenotomy).