What to Know About Osteitis Pubis

Written by Keri Wiginton
Medically Reviewed by Jabeen Begum, MD on June 24, 2025
8 min read

Osteitis pubis is a painful condition that causes inflammation around the center of the pelvis. This joint (called the pubic symphysis) connects the left and right sides of your pelvis and is surrounded by muscles such as your lower abs and hip muscles. 

This condition often comes from overuse or stress, especially from activities that involve running, kicking, or quick changes in direction. Osteitis pubis is more likely to affect people who play sports (such as soccer or hockey), but anyone can get it.

“It’s pretty common to see this in athletes or people that do repetitive exercises involving the lower extremities and the pelvis,” says Andrew Jimenez, MD, an orthopedic surgeon at Yale Medicine, who specializes in sports medicine and hip preservation. “But it can also be associated with other hip or pelvis conditions.” 

Osteitis pubis treatment usually involves rest and avoiding activities that make the pain and inflammation worse. While it can take a while to fully heal, most people recover without surgery. Learn more about osteitis pubis and how to treat and prevent it. 

The major symptom of osteitis pubis is pain. The inflammation in the joint and surrounding muscles may cause a constant, dull pain while sitting still. You might find that moving makes the pain worse. Putting pressure on the pelvic area will cause a sharp increase in pain.‌‌

“Sometimes that pain can radiate to the groin or the abdomen,” Jimenez says. 

This injury can be weakening, and it might limit movement. Because the pelvis is central in the body, many everyday movements will irritate the inflamed area and cause pain. 

Common osteitis pubis symptoms include:

  • Pain at the center of the pelvis that feels like it radiates outward
  • Lower abdominal pain that is centered in the pelvic area
  • Pain while running, kicking, or changing direction
  • Pain while walking, climbing stairs, coughing, or sneezing
  • Pain while lying on your side
  • A clicking or popping sensation when shifting positions

Because walking can be so painful, people with osteitis pubis may find that the way they walk changes. Your walk may become more of a waddle as you try to minimize the pain from moving.

The most common cause of osteitis pubis is repeated stress to the area. Athletes can get the condition due to repetitive motions that strain the joint, connective tissue, and muscles in the pelvic area. Sports such as soccer, hockey, tennis, football, and long-distance running can all lead to osteitis pubis.‌‌

Some research shows that you might get osteitis pubis after surgery in the pelvic area, but this is not common. People have also had symptoms of osteitis pubis after giving birth to a baby. This is also less common than cases related to sports injuries.  

“Diagnosis can be tricky,” Jimenez says. “And it’s something that can be present either by itself or with other conditions.” 

To find out what’s going on, your doctor will ask about your symptoms and how the pelvic bone pain began. They’ll rule out other medical problems, such as urinary tract infections, groin or abdominal muscle strain, sports hernia, or conditions that affect the bones in the hip joint.

Your doctor will also give you a physical exam. They’ll check your pelvis and lower belly to see if certain movements or pressure cause pain. 

They might test how your hip and leg muscles move using one or more of the following: 

Pubic spring test. Your doctor will gently press on the front of your pelvis, right over the pubic bone. If this causes sharp pain or pressure, it may be a sign of inflammation in that area. 

Lateral compression test. In this one, your doctor presses on the sides of your hips to squeeze the pelvis. Pain during this test can mean that the joint in the middle of your pelvis is irritated or unstable. 

FABER test. This stands for flexion, abduction, and external rotation. That’s a fancy way of saying your doctor will move your leg into a figure-four position. If this movement causes pain in the front of your pelvis, it could point to osteitis pubis. 

Adductor squeeze test. You’ll be asked to press your knees together against resistance. This activates the muscles attached to the pubic bone (sometimes called the pubis bone). If this hurts, it may mean those muscles and the joint they pull on are inflamed.

Osteitis pubis radiology

These are imaging tests that help your doctor see what’s going on inside your body. They can spot swelling or damage to the pubic joint. 

“X-rays can sometimes give diagnostic clues,” Jimenez says. “But the best way to diagnose this is going to be done on MRI, which gives the best evidence of inflammation.”

You may need more than one imaging test. Here’s how each one works: 

X-ray. This shows bone changes or irregularities around the pubic joint. It may find: 

  • Widening of the pubic symphysis joint space
  • Uneven or rough bone edges (osteophytes)
  • Extra bone growth (sclerosis) 

MRI. This is best for spotting bone changes and inflammation early, before changes show up on an X-ray. It can spot: 

  • Swelling in the bone marrow or around a joint
  • Fluid in the joint
  • Soft tissue changes
  • Bone loss in certain spots (resorption)
  • Bone spurs or abnormal growth
  • Abnormal tunnel above the pubic bone (suprapubic fistula) 

CT. This scan gives a very detailed look at your bones. Your doctor may use it if they need a clearer image of the joint or MRI isn’t available. 

Bone scans (called scintigraphy). This test uses a small amount of special dye that shows up on a camera to check how your bones are working. It’s very good at finding bone problems caused by things such as infection, injury, or cancer. 

Symphysography. Rarely, your doctor may inject dye into the pubic joint before taking an X-ray. It helps doctors see if the joint is unstable or damaged, but it’s not used as often as other tests. 

In general, osteitis pubis will get better with time and reduced activity. Your doctor may suggest ways to manage the pain so you feel more comfortable. 

“There’s rarely a need for surgery,” Jimenez says. “The classic, standard approach to recovery is rest and physical therapy.”

A trained physical therapist can help you build your muscles back up without reinjuring the area. You can resume sports once your doctor and physical therapist say it’s safe to do so, which may be after many weeks or as long as three to six months.

Osteitis pubis self-treatment 

Common ways to deal with osteitis pubis include:‌

If self-care isn’t enough, your doctor might give you a steroid shot to reduce inflammation. They might also suggest extracorporeal shock wave therapy (ESWT). That’s a type of noninvasive treatment that uses high-energy sound waves to ease pain and promote healing. 

Osteitis pubis surgery

Most people get better without surgery. But your doctor may suggest it if your pain:  

  • Lasts longer than six months
  • Keeps you from moving well 
  • Stops you from playing sports

Surgery to remove part of the pubic symphysis (called a wedge resection) is an option, but it is used less often today. That’s because it may lead to complications, such as pelvic instability.

The more common procedure now is pubic symphysis curettage. Instead of removing part of the bone, the surgeon clears out the inflamed or damaged tissue inside the joint. The option works best when the back of the pelvis (the sacroiliac joints) is still stable. 

If you need osteitis pubis surgery, many doctors now use a minimally invasive approach. Rather than making a large cut in your lower belly, they use a few small incisions to access the joint. They’ll use special tools, including a thin tube with a camera (called an endoscope), to clean out the inflamed tissue. 

This type of surgery causes less damage to the muscles and skin, which may help you heal faster and with less pain compared to traditional open surgery. 

If you are at risk for osteitis pubis, you can take steps to prevent it. Building up strength and flexibility in your pelvic region can reduce the risk of sports injury. You may also want to focus on working both sides of your body so you don’t use one side more than the other. Unequal strain has been shown to be a risk factor.

Some training activities to help avoid osteitis pubis include:

  • Strengthening hip flexors and hip adductors 
  • Strengthening lower back muscles
  • Strengthening abdominal muscles
  • Strengthening hamstring and quadriceps
  • Stretching
  • Swimming 

If you work with a trainer or physical therapist, they can suggest more activities that may help you treat or prevent osteitis pubis.

Osteitis pubis is an inflammation in the joint where the two sides of the pelvis meet. It causes groin or lower belly pain that gets worse with movement. Doctors diagnose it with a physical exam and imaging tests such as X-rays or MRI.

Treatment usually includes rest, physical therapy, and anti-inflammatory medication. Full recovery can take many weeks or months. Surgery is rarely needed, but it may be done in special cases. 

How to fix pubic bone pain?

If you have osteitis pubis, you’ll need to rest and avoid any movement that makes the pain worse. Ice and heat may ease swelling and tension. Over-the-counter meds such as ibuprofen can help with pain and inflammation. If that’s not enough, your doctor may suggest physical therapy or a steroid shot. Surgery is an option, but it’s rarely needed. 

What happens if osteitis pubis is left untreated?

The inflammation and pain will likely get worse and last longer. You may have trouble walking, running, or playing sports. If you think you have osteitis pubis but don’t get checked by a doctor, you may miss finding other health conditions that have similar symptoms but need a different treatment. 

How long does osteitis pubis take to fully heal?

It depends. Most people get better within several weeks or a few months. If you’re hurt really badly or need surgery, recovery may take longer.