Pubic bone pain

Pubic bone pain is a common complaint heard in the DC's clinic.

Upper thigh and groin discomfort can be very disconcerting, often waking patients at night and disturbing sleep. More usually it is a femoral-nerve condition which radiates down the lower limb from the mid to upper lumbar spine.

One of these conditions is called Maigne's syndrome; another meralgia-paresthetica.

This page was last updated by Bernard Preston on 21st October, 2023.

Then there are a host of hip-joint problems that cause pain in and around the area.

One not to be forgotten is a radiation from the pubic bones and the muscles that attach to them; and the organs that are located close by.

This pain may be of a temporary nature but sometimes continues long after childbirth, referring down the inner thighs and making walking painful. Opening the legs during intercourse may also be very difficult.

However anyone can get pubic bone pain, not only in pregnancy. Men can experience it too. It may radiate into the groin; and commonly down the inner thigh.

The bones of the pelvis are the origin and insertion of a great many important muscles.

Some of them remain in and around the pelvis and are vital for such functions as stabilising the sacroiliac-joint, in urinating and defecating; in childbirth and orgasm too.

Others attach to the femur, enabling us to flex and particularly adduct the leg; as in riding a horse.

There are two pubic rami on each side; one superior and the other inferior. Their names are not important but their location is. They sit right adjacent to the bladder and the uterus and are recipients of referred-pain, often in pregnancy; do you see the blue stippling in the picture below?

There are two ilia, plural of ilium, in the pelvis. The sacrum makes up the third of the ring of three bones.

The pubes, as we call them are part of the large structure called an ilium that makes up much of the pelvis; and provides the sockets for the hips.

Pubic bone pain

Pubic bone pain is frequent in the aftermath of childbirth but is certainly not restricted to the circumstances surrounding pregnancy; anyone can experience it.

• Sacrum
• Ilium
  
• Acetabulum or hip socket
• Pubic bones

Deep pelvic muscles

In Dutch the pubes are known as the embarrassment bones; the "schaambeen."

And the sacrum is called the holy-bone or "heiligbeen." Are they not nice earthy names? The deep pelvic muscles of the pelvic floor are the "bekken-bodem spieren."

Bekken-bodem spieren

In Dutch these muscles are known as the bekken-bodem spieren; weakness causes a host of bladder and uterine problems.

Others stretch down the thigh enabling you to flex, rotate and extend your hips, and more movements that we shall for simplicity ignore; in this case they are not important.

For example there are three adductor muscles that attach to the pubes and are vital in squeezing the thighs against each other and stabilising the legs during running and jumping.

It is these adductors that can become extremely painful in association with pubic bone pain.

TREATMENT of Pubic bone pain

Chiropractic management of pubic bone pain would include the following:

• Correction of any subluxations. Sacroiliac joint treatment.
• Cross friction of the muscles and their insertion to the pubes (may be extremely painful).
• Stretching of the muscles.
• Strengthening of the core muscles of the pelvis. Kegel exercises.
  
• Alternating ice and heat; and other physiotherapeutic modalities.

IT WORKS - TRY US!

Anti-inflammatory foods

There is no substitute in my book for daily enjoyment of anti-inflammatory foods. Many of them have the same action as those drugs that block the COX enzymes that cause so much pain; but without the serious side effects that the medication has.

They are more sensible way to actually prevent pubic bone pain; and the rest. 

Many of the best medicinal herbs have this anti-inflammatory effect; add to that the proven action of oleocanthal found only in extra virgin olive oil. And that of omega 3 fatty acids found in fish and freshly ground flax seed.

I personally find it not the slightest bit onerous to make sure that I am enjoying some herbs and spices like ginger, chillies or sweet basil daily; and in any case olive oil is the norm in our household.

And in any case, if you are enjoying your minimum of eight to ten coloured foods daily you will be getting plenty of these anti-inflammatory compounds regularly in your diet.

My wife has over the years developed quite swollen and stiff fingers with all the signs of rheumatoid arthritis but she has almost no pain; she credits the anti-inflammatory foods we enjoy daily. They would contribute to pubic bone pain too.

From the coalface

Miss van Jaarsveldt, a slightly obese 30 year old woman began a course of medical treatment for acne some nine months ago. According to her doctor the medication is known to have muscular and joint side-effects though he omitted to warn her at the time. Within weeks she began to experience low back, sacral and coccyx pain and could not sit without extreme discomfort.

A short of course of treatment from an acupuncturist and a coccyx pillow relieved the coccyx pain; but the ache in the sacro-iliac joints,spreading down the front of her thighs rapidly worsened, even after she stopped the medication.

Prolonged sitting and walking became increasingly painful. Intercourse was excruciating because she could not open her thighs.

Her doctor referred her for chiropractic care of her pubic bone pain.

On examination, extension of the sacro-iliac joints was limited and painful; and the adductor muscles of the thigh were extremely tender on palpation.

She consulted me again yesterday. The good news is that the pain in her thighs and the attendant difficulties with intimacy passed over very quickly after the first few treatments.

The bad news is that the medication has made her pelvic joints very unstable, so that about once a week she suddenly gets sharp stabs of pain. But she can now sit and walk mostly without pain; and the serious discomfort lasts only a few hours.

With these sorts of nasty conditions, our chiropractic experience is that patients who come in for a regular, occasional treatment and do their exercises faithfully, find that when they get pain, it usually passes over of itself. She is 90% better but the last ten percent is proving nuggety. Part of the problem is that she is seriously overweight.

A life without medication is only for those who take their lifestyle seriously. If you eat crap, and refuse to consume the good stuff because it's too sour, slimy and not sweet enough then expect to have these pain syndromes.

Chiropractic First

Whether or not the medication was the cause of Mrs van Jaarsveldt's pubic bone pain, and its attendant difficulties, is really from our perspective irrelevant. It is now up to the chiropractor to once again show that we can treat these sorts of conditions more cheaply, faster and more safely than medicine; put our mouths where our money is, so to speak.

In Mrs van J's case it has not been cheap. She has had 15 treatments, stretching over three months, and still needs to come in every three weeks. Not ideal, but she is 90% better. Dangerous drugs caused her problem; and Medicine had nothing successful to offer to then fix it.

We suggest you put your money there too before trying dangerous drugs and surgery. If Chiropractic does not help your condition, you can always resort to the more drastic measures. But if you turn first to Medicine, undoing the side-effects of drugs and surgery can be a nightmare.

Do you know what Iatrogenic Disease is? According to Wikipedia it is the third leading cause of death in the USA; doctor-caused illness.

Chiropractic also has a part in Iatrogenic Disease but we are many-fold safer than medical treatment; just compare our insurance premiums. 

In all honesty any and all forms of treatment, including chiropractic,can aggravate your condition. It does make sense though to start with conservative care, not so?

Just this morning I had a new patient who confessed she suffered from incontinence; yes, she admitted to being on hormone replacement therapy for years. It's one of the most pernicious side-effects and doctors rarely warn you when prescribing it.

The Kegel exercises would help; find them using the Site Search function in the index above.

Lower Back Exercises

Keeping the sacroiliac joint mobilised is vital if you are experiencing low back or pubic bone pain. Watch this video

Hip arthritis

Discomfort in the groin, easily confused with pubic bone pain, is one of the first signs of hip arthritis.

Lying on your back, pull your knee to the chest and then gently rotate your upper leg in the hip joint. Is it particularly stiff or painful in the groin?

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Hip arthritis is readily treatable with chiropractic if it is caught in its early stages, which is rare unless you have been examined by an astute practitioner who is looking for it; the telltale signs are well documented.

Has granny had a hip replacement? Does your grandfather walk with a pronounced limp? It is a familial disease.

Prevention is definitely better than a cure. If you have a sense that all is not well in your hip then it is best to have an opinion from your chiropractor; and perhaps your medical doctor too.

The Kellgran Lawrence grading system will give you some ideas about hip arthritis, how to assess it; and how to avoid the disability, pain and expense associated with advanced degenerative disease. 

Maigne's syndrome

The upper lumbar area, via the superior cluneal nerves may also cause groin area discomfort, easily confused with pubic bone pain. They also supply the skin overlying the buttocks.

A combination of buttock, groin and upper thigh pain suggests that the upper lumbars should be carefully examined.

• Maigne's syndrome can be found using the Site Search function above.
  

A different kind of pubic bone pain. The kind that nutcases go in search of. Just for the LOL. Read more about Bernard Preston's gliding …

Bernard Preston potboiler

Take a tour with me through the polders of Holland in my seven sojourn amongst these lovely people. Meet Gert whose ringing in the ears was so bad that he had to wear a hearing aid. Fixing his TMJ worked a miracle. I'm not sure if there's a pubic bone pain case, but if you enjoyed this page you'll love my books. 

• Perhaps DD did it after all ...
• Stones in my Clog ...

Now at 68 I spend my time with other more mundane but also fascinating matters such as rainbow worm farm experiments.

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