Introduction
The pubic bone is part of the hip bone and delimits the groin region as well as the region of the genitals. Pain in the pubic bone (Os pubis) often affects athletes, but can also occur during pregnancy or in everyday life.
Causes
The causes of pain in the pubic bone are varied and can be very gender-specific. In athletes, inflammation of the pubic bone can occur. This inflammation causes severe pain in the pubic bone and can occur in many different ways.
On the one hand, micro fractures of the pubic bone (os pubis) can occur when the pubic bone is subjected to heavy strain, for example during soccer or sprinting. These small cracks (also called fatigue fractures) do not cause instability of the entire hip, but they do cause severe pain in the pubic bone. In addition, new bone is formed to compensate for the small micro lesions.
This can lead to a painful but not infectious inflammation. It is important not to continue exercising in such pain, as the inflammation can spread to the inner thigh muscles (the so-called adductors) or even to the abdominal muscles, where it causes even more pain. Another cause of inflammation of the pubic bone and thus pain in the pubic bone can be a disbalance in the pubic symphysis (pubic symphysis), which consists of fibrous cartilage.
Numerous muscles attach to the pubic symphysis, especially the inner thigh muscles (the adductor group). If an incorrect load is applied to people who are very active in sports, the pubic symphysis can become irritated. This causes pain and inflammation in the surrounding pubic bone.
Often this pain in the pubic bone is only diagnosed when the thigh or abdominal muscles are also affected. There is also gender-specific pain in the pubic bone. In men, an inflammation of the prostate (prostatitis) can lead to pain in the pubic bone, among other things.
Prostatitis is usually caused by gram negative bacteria or Escheria coli (E. coli), which cause painful inflammation. The pain occurs mainly after urination or after an orgasm. Often the pain is limited to the groin area, but can penetrate to the pubic bone.
Since the prostate is very close to the anus, there is also a lot of pain during defecation. Another gender-specific cause of pain in the pubic bone is pregnancy. The paired pubic bones surround the cartilaginous pubic symphysis and thus represent the foremost and lowest border of the pelvis.
During a pregnancy, the pubic symphysis is stretched further and further. However, since it consists of quite taut fibrous cartilage, the surrounding pubic bone or the two paired pubic bones (Os pubis) are quickly stretched. However, it is also possible that the pubic symphysis is loosened too much due to the hormones that are released during pregnancy.
This is caused by the two hormones progesterone and relaxin. Both occur more frequently during pregnancy and ensure that the cartilage of the pubic symphysis is more easily stretched to make childbirth as easy as possible. However, it is possible that the pubic symphysis is loosened too much.
This can cause the pubic bone to slip easily. This pain in and around the pubic bone can radiate into the back or thigh muscles and is especially noticeable when climbing stairs.
- Bone skin inflammation at the coccyx
- Pubic bone branchial fracture
- Pain during bowel movement
Tendonitis of the adductors occurs when the adductors, i.e. the muscles on the inner side of the thigh, are subjected to excessive strain.
This is more often the case during sports, for example when playing soccer. This leads to typical pain in the inner thigh, which can radiate to the groin and pubic bone. They occur mainly during physical activity.
If the pain in the groin is also severe, a possible inguinal hernia should be clarified. The tendon inflammation of the adductors can be treated with drugs that inhibit the inflammation and physiotherapy. Inflammation of the inguinal ligaments typically leads to pain in the groin and pubic bone.
The inguinal ligament represents the connection between the ilium and the pubic bone and can be affected by various causes.Often, the inguinal ligament is overstretched due to incorrect loading. Pain occurs, which can radiate into different areas depending on the severity of the inflammation and is intensified by pressure. If the inguinal ligament is overstretched, the therapy consists of physical rest and, if necessary, physiotherapy.
An inflammation of the periosteum can rarely also affect the pubic bone. The reason for this is usually overloading or incorrect strain on surrounding muscles, for example, an incorrect sitting position, which can lead to periosteitis. This usually causes very severe pain.
These are typically localized exactly, i.e. they occur specifically at a certain point. They also get worse when pressure is applied. The pain usually occurs only when a specific movement is performed and can last for several months, but can be reduced by various medications.
Inflammation of the symphysis affects the pubic symphysis and can lead to severe pain in the pubic area and the surrounding area. The causes are very diverse and include incorrect exercise during certain sports, as well as fractures or the formation of cysts, i.e. tissue pockets. This leads to pain that increases with pressure and is often accompanied by swelling.
If a fever also occurs, an infection may be present, which must be treated as soon as possible. Otherwise, therapy consists of the administration of anti-inflammatory drugs and physiotherapy. A rarer cause of pain in the area of the pubic bone is rheumatism.
The so-called rheumatoid arthritis typically affects the hip joint, among other things. More rarely, an inflammation occurs in the area of the symphysis connecting the two pubic bones. In the case of a pronounced rheumatoid inflammation of the hip joint, however, pain can also occur during prolonged sitting, which can accordingly occur in the area of the pubic bone.
A hernia can lead to pain in the pubic bone. This is usually due to the radiation of the pain, although a hernia is often not accompanied by severe pain. Occasionally there is a strain on the inguinal ligament, which pulls up to the pubic bone.
The pain usually occurs mainly when there is a heavy load or pressure in the groin region. Depending on the type and severity of the inguinal hernia, it does not always require surgery, but should be treated by a doctor in all cases. These topics may be of interest to you:
- Pain with a hernia
- Symptoms of inguinal hernia
As a cartilaginous connection of the bony, anterior pelvic ring, the pubic symphysis is exposed to enormous stress during pregnancy.
The increasing body weight of the still unborn child causes ever greater pressure in the abdominal and pelvic area. The hormonal changes in the structure of the cartilage joint during pregnancy are essential for the process of the approaching birth. Due to the rising estrogen level in the blood, the fibrous cartilage loosens and softens during pregnancy, which makes the pelvic ring more flexible and wider during birth and facilitates the passage of the child.
A further hormone (Relaxin) also ensures increased elasticity in the otherwise very taut ligaments, which strengthen and secure the pubic symphysis. However, it can happen that this relaxation process leads to pain in the pubic bone area, which increases especially when walking, climbing stairs and lying on the side. This symptomatology is observed in 50% of all pregnant women.
Possible risk factors that favour painful joint loosening are back problems, joint diseases (arthrosis/arthritis) and injuries to the hip, which are suspected to exist even before pregnancy. A pubic bone fracture occurs rather rarely and is usually the result of a serious injury, for example in a car accident. The fracture leads to a great loss of pelvic stability and is associated with very severe pain. Since a pubic bone fracture often involves an injury to the internal organs in the area of the pelvis, it must be treated immediately in a hospital. Depending on the extent of the fracture, it may take some time for the pubic bone to recover from the fracture and the pain to pass.
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