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Ketoprofen (Oruvail) can be used to treat osteitis pubis. Osteitis pubis is a medical condition which is prevalent among footballers, runners and other athletes. Ostietis Pubis if not treated early and correctly can more often than not end a sporting individuals career or give them an uncertain playing future.
Presentation
Osteitis pubis, first described in 1924, is characterised by inflammation of the pubic symphysis, which is the joint at the front of the pelvis between the two ends of the pubic bone. This inflammation leads to sclerosis and bony changes of the pubis symphysis, causing both acute and chronic groin pain. The condition can render sufferers incapable of sustained physical activity. There is no specific treatment for the condition and it can seriously affect the careers of footballers affected by it.
Causes
The cause of osteitis pubis is excessive physical strain on the pubic bone, usually caused by the increasing rigorous demands of competitive sport, particularly soccer and football. In such sports, actions such as running, jumping, kicking and rapid changes of direction cause the abdominal and groin muscles to exercise a pulling or traction force on the pubic bone, which in some cases can result in excessive stress and inflammation.
Symptoms
The symptoms of osteitis pubis can include loss of flexibility in the groin region, a dull aching pain in the groin, or in more severe cases a sharp stabbing pain when running, kicking, changing directions, or even during routine activities such as standing up or getting out of a car.
Treatment and prevention
Until recently there was no specific treatment for osteitis pubis. As it frequently causes long-term problems, medication, stretching and strengthening of the stabilising muscles are usually used.
The acute phase of rehabilitation for osteitis pubis is sometimes a misnomer. During the acute phase, that is, when the patient presents to the physician, the symptoms may actually be acute or chronic at this point. Either way, the patient should be treated as if the onset of symptoms is acute. This is a time to help alleviate the patient's pain and to start correcting the mechanical problems that precipitated the injury. The athlete is pulled from all sporting activities during this phase.
Surgery is rarely warranted, if ever, for osteitis pubis and should not be a consideration during the acute phase.
During the acute phase, nonsteroidal anti-inflammatory drugs (NSAIDs) are administered for pain and inflammation therapy. In rare cases, usually when the symptoms have been present for more than 4-6 weeks, oral corticosteroids are prescribed.
The use of steroid injections is often necessary to speed recovery in athletes with osteitis pubis, but this therapy should be used with caution. If the athlete can take the time to progress without an injection, this therapy may not be warranted. Osteitis pubis often resolves without the use of corticosteroid injections. Though, as shown in a study by Holt et al, it is believed that early corticosteroid injection can be beneficial.
The aim of medical intervention for osteitis pubis is toward the joint goals of decreasing inflammation and controlling pain. The major concern with all the drugs that are used is their effect on the GI tract with long-term use, including the monitoring of renal function with long-term NSAID use.
NSAIDs are used to help reduce inflammation and pain. Multiple drugs are in this class, and every physician should be aware of the drugs in each subclass because some patients respond better to one subclass than another. A few NSAIDs are named below in order to not to belabor the wide variety of choices that are available.
Ketoprofen (Oruvail)
Has good anti-inflammatory properties and exceptional analgesic properties. First-line medication because of daily dosing, which helps with compliance.
Naproxen or naproxen sodium (Naprosyn)
For relief of mild to moderate pain and inflammation. Available in many dosages and delivery systems. Fairly inexpensive and has a similar therapeutic profile to other NSAIDs. An oral suspension (125 mg/mL) is available.
Corticosteroids
Corticosteroids are some of the strongest anti-inflammatory agents available. The injectable preparations make it possible to deliver the drug directly to the affected joint in a concentrated dose, while greatly decreasing the systemic effects.
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