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A Retrospective Study on the Efficacy of Pubic Symphysis Corticosteroid Injections in the Treatment of Pubic Symphysis Pain


Colleen M. Fitzgerald, MD, MS, Physical Medicine and Rehabilitation, Rehabilitation Institute of Chicago, 345 E. Superior St., #1134, Chicago, IL 60625, USA. Tel: 312-238-1395; Fax: 312-238-2512; E-mail:


Objective.  To report immediate and follow-up pain intensity outcomes of fluoroscopically guided contrast- enhanced pubic symphysis corticosteroid injections for patients with pubic symphysis pain (PSP).

Design.  Retrospective medical record review.

Setting.  Outpatient rehabilitation clinic.

Subjects.  Patients with PSP who underwent pubic symphysis corticosteroid injection (PSI).

Intervention.  Pubic symphysis corticosteroid injection.

Outcome Measures.  Pain intensity as measured by numeric rating scale (NRS).

Results.  Fourteen patients (4 men and 10 women) underwent PSI. Five patients had PSP for less than 6 months, nine had chronic pain (>than 6 months). In 7 of the 10 women the pain was pregnancy related. All patients received other treatments prior to injection. Pubic symphysis tenderness was the most common physical examination finding (13/14 patients). Follow-up pain intensity (PI)-NRS improvement of greater than 2 points was considered clinically significant. At follow-up, improvement was not statistically significant (Wilcoxon signed-rank test, z = 1.62 P = 0.10). Patients with pain <6 months did not have a greater likelihood of benefit at follow-up compared with those with pain for >6 months (Fisher's exact test, P = 0.775).

Conclusions.  PSIs do not provide clinically or statistically significant relief at follow-up in patients with PSP.