Symphyseal and sacroiliac joint pain associated with pubic symphysis instability

Fifty patients presenting with lumbosacral and inguinal pain were examined by routine clinical radiographic and electromyographic evaluations. All were without antecedent history of major pelvic trauma or spinal surgery but demonstrated evidence of pubic symphysis instability. Slip between the pubic rami in excess of 2 mm could be demonstrated in each with alternate leg weight bearing. Asymmetry of hip mobility on the symptomatic side with a reduction in abduction and external rotation was present in 20 patients. An approach to treatment of pain associated with pubic symphyseal and associated sacroiliac joint instability is described, combining both intraarticular steroids, lumbosacral supports and physical therapy modalities.