How Pelvic Floor Therapy Can Address Pubic Bone Pain

Pubic bone pain refers to pain or discomfort in the pubic bone (also called the pubis), which is the lower area of the hip bone located more towards the front of the body.

The pubic bone is actually split into left and right halves, connected by a slightly flexible joint known as the pubic symphysis. The pubic bone sits between the thighs and abdomen, and protects inner structures such as the urinary organs and internal sex organs.

The pubic bone plays an important role in supporting your body. It acts as a shock absorber during movement, and helps distribute weight to the legs. It provides balance and support to the upper body, and serves as an important attachment point for ligaments and tendons.

For pregnant individuals, the pubic bone accommodates the increase in weight and pressure, and also plays a role in childbirth (particularly the pubic symphysis, which can expand during labor).

Now that you understand more about where this bone is located and how it supports the body, you’ll be able to better understand the different factors that may create pain in the area—which we’ll discuss next!

Pubic bone pain can occur for a variety of reasons, but some common reasons include the following:

Pelvic Floor Dysfunction

Pubic bone pain can be caused by many different factors and conditions. One important thing to note is that many of those conditions (including the ones we’ll discuss below) can cause pelvic floor dysfunction. Vice versa, pelvic floor dysfunction can cause or worsen many of the symptoms experienced with those conditions, too. 

The pelvic floor is a group of muscles found within the pelvis that connects to pelvic bones such as the pubic bone, the sacrum, and the tailbone.

These muscles interconnect with and affect all areas of the pelvis—your hips, abdominals, bladder, bowels, genitals, anus, uterus, and more. They allow you to use the restroom, experience sexual function, have balance and stability, and much more. Unfortunately, the pelvic floor can experience problems.

Pelvic floor dysfunction is a condition where the pelvic floor is too tight, weak, inflexible, or uncoordinated. When this occurs, it can create a wide range of symptoms: constipation, urgency, incontinence, pelvic pain, sexual dysfunction, hip pain, lower back pain, and much more. 

Problems with the pelvic floor can cause pain in the pubis, and can worsen symptoms with a variety of conditions. Therefore, individuals who are experiencing pubic bone pain should consider pelvic floor physical therapy, especially if other treatments are not providing relief.

Pregnancy

Pregnancy is a very common cause of pubic bone pain and general pelvic pain. This is because the body experiences a lot of changes during pregnancy. Not only does your center of gravity shift and the pressure on your lower body increase, but your body will also release a hormone called relaxin.

Relaxin loosens your joints and ligaments so that your pelvis will widen in preparation for childbirth. As this happens, your pelvis and pubic bone will experience more strain and pressure, often causing pain and other symptoms.

Additionally, these bodily changes can cause pelvic floor dysfunction, which can worsen pubic bone pain as well as cause a variety of unwanted symptoms during pregnancy and postpartum. 

Pubic Symphysis Dysfunction

Pubic symphysis dysfunction is pain specifically in or near the pubic symphysis joint. As mentioned earlier, this joint connects the left and right halves of the pubic bone and is flexible during childbirth.

With this condition, pain is felt more towards the front of the pelvis where the joint is located—near the groin, inner thighs, and perineum. Individuals with pubic symphysis dysfunction may have difficulty walking or climbing, pain when lifting, and difficulty with using the restroom.

Pubic symphysis dysfunction is often referred to by other names. It may be called lightning crotch, symphysis pubis dysfunction (SPD), or osteitis pubis. Osteitis pubis is similar, but actually refers to inflammation of the joint from repeated stress.

Pelvic Girdle Pain (PGP)

Often confused with pubic symphysis dysfunction, pelvic girdle pain is a term that encapsulates pain felt in the general pelvic region. The pelvic girdle encapsulates more area as it contains the pubic bone (explored previously) as well as other parts of the hip bone called the ilium and ischium.

Pelvic girdle pain can refer to pain felt in the hips, perineum, lower back, joints, back or front of the pelvis, and other surrounding areas. 

Individuals with pelvic girdle pain may experience trouble with leg-swinging motions (such as getting out of the car, bed, or bath), have an irregular gait, struggle with standing or sitting for long periods, and may experience pain with sex.

Pelvic girdle pain is often associated with pregnancy and childbirth as these are the most common causes of PGP, but they are not the only causes. Injury, trauma, arthritis, pelvic floor dysfunction, or inflammation of the joints can also contribute to PGP.

Urinary Tract Infection (UTI)

The pubis protects your urinary organs. Therefore, conditions such as urinary tract infections can cause pain in the pubic area. This is more common with severe infections, as inflammation can affect nearby structures or tissues, especially near the pubic bone.

UTIs are a common infection, but leaving one untreated can sometimes worsen your situation. Urinary tract infections are caused by bacteria that has entered your system. This can happen due to sex or masturbation, poor restroom habits, medications, exams, surgeries, and more.

Unfortunately, some individuals are more prone to experiencing frequent UTIs. This is often due to pelvic floor dysfunction. This is because pelvic floor dysfunction can cause dysfunctional voiding, which makes it difficult to completely empty your bladder and leaves a higher likelihood of developing a UTI.

Pelvic floor dysfunction can also mimic symptoms of a urinary tract infection, even if there is no infection actually present. If you are struggling with pain from what you think is a UTI, but have negative test results, consider seeking a pelvic floor physical therapist.

Stress or Trauma

The pubic bone can be affected by different forms of trauma and stress, too. For example, repetitive use and movements during sports or similar activities can harm the pubic bone and surrounding structures. Trauma can also occur from sudden injuries to the pelvis, or in some cases because of surgeries performed in the area.

Pelvic floor physical therapy can significantly reduce the symptoms of a variety of conditions! Whether you are experiencing pregnancy-related pubic bone pain, pelvic girdle pain, UTI symptoms, or a pelvic injury, physical therapy offers immense benefits.

There is not a one-size-fits-all treatment plan when it comes to pubic bone pain or pelvic floor dysfunction. Each person’s situation and pelvic floor health will vary. This is why I always curate an individualized care plan for each of my patients! 

This care plan will look to reduce tension, regain flexibility, improve coordination, and build strength in your pelvic floor muscles. When the pelvic floor is unrestricted, strong, and able to work together with other structures as needed, your pain and other symptoms will be alleviated! 

Your care plan for pubic bone pain or the conditions associated with it can include a variety of treatments: hands-on manual therapies, behavioral modifications, neuromuscular re-education and biofeedback, exercises, stretching, education, and much more. 

All of these treatments are designed to help you better understand and gain control over your pelvic floor. When you have a clearer understanding of this group of muscles and how they contract or relax, you are better able to strengthen them and release muscle tension!

Pubic bone pain is no joke—it can be confusing at times, as pelvic pain can be attributed to many different conditions. Not to mention, receiving treatment for this area of your body can be intimidating.

Rest assured that my top priority is to make you feel safe and heard during treatment. I always request consent before any examination or treatment, and can work with your individual comfort level!

If you’d like to get started today on working towards a pain-free life, book an appointment. I offer both in-person and virtual sessions, and I accept patients of all ages and gender identities. If you still have other questions about treatments or appointments, consider a discovery call!