Targeted Injection can Improve Groin Pain Management in Osteitis Pubis: A Narrative Review

Introduction. The strategy of choice for the treatment of groin osteitis pubis is conser­vative treatment, and the treatment effectiveness increases when it relies on an individ­ualized multimodal rehabilitative management. Osteitis pubis is a very common occur­rence among athletes: it makes up 5-13% of injuries in male soccer players and 4-5% in female athletes, and it is frequently hard to locate and diagnose. Methods. A literature review using online databases was carried out regarding the use of steroid injections for groin pain and sport related pubalgia. Articles were extract­ed from PubMed, Google Scholar, Medline, UpToDate, Embase and Web of Science, combining the terms "groin pain", "pubalgia", "injection in groin pain", "adductor pain", "adductor rectus syndrome" and "injections in pubalgia" as keywords for the research. Results. The search yielded numerous papers, and 21 full-text articles were consid­ered useful and screened. The review included trials and systemic or narrative reviews, recent guidelines and any report thought of with good methodological quality. Discussion. The use of corticosteroid injections in the treatment of athletes with other myo-aponeurotic injuries has been reported to reduce pain and return an athlete to preinjury activity. Guided peritendinous infiltrations was already proposed as a valid minimally invasive option for fastening recovering from GPS during the conserva­tive treatment of osteitis pubis and should be considered before approaching the area surgically. Conclusions. Given the elevate occurrence of osteitis on groin pain imaging of chronic painful pubis, patients who present this inflammatory condition may benefit from the creation of tailored protocols of muscle strengthening exercises and early mini-inva­sive procedures, as per common clinical practice evidence and US guided injections performed in early stages could faster recovery and rehabilitation outcomes.