Priv.-Doz. Dr. Christopher Becker is a renowned specialist in orthopedics and trauma surgery who has been practicing at his own clinic, spectrum MED, in the heart of Munich since August 1, 2024. In addition to his private practice, he also serves as a senior physician specializing in spinal surgery at Artemed Klinikum München Süd. Dr. Becker specializes in minimally invasive pelvic ring and spinal surgery and enjoys an excellent reputation for his expertise in this field.
His clinical focus is particularly on the treatment of pelvic pain, which can be caused by various conditions such as pubic bone inflammation, symphysis pain, or pain in the sacroiliac joint. In addition, Dr. Becker is well-versed in the treatment of traumatic and degenerative spinal conditions, making him a key point of contact for patients suffering from complex pain syndromes. His in-depth knowledge of the anatomical and functional relationships in the pelvic region enables him to offer innovative and effective treatment options tailored to the individual needs of his patients.
The Artemed Klinikum München Süd, where Dr. Becker also practices, offers a modern medical infrastructure and places great emphasis on patient-centered care. There, patients benefit from a broad spectrum of surgical specialties, including orthopedics and trauma surgery. Minimally invasive techniques and a fast-track approach help ensure that patients can recover quickly and with minimal pain. The interdisciplinary collaboration at the hospital ensures comprehensive and continuous care, which is of great importance to Dr. Becker.
At his practice, spectrum MED, a holistic approach to treatment and rehabilitation is pursued. Dr. Becker and his highly qualified team offer modern pain management therapies and surgical treatments characterized by a gentle and precise approach. An important aspect of his work is post-injury and post-surgical care, aimed at ensuring the fastest and most complete recovery possible. In addition, the practice places great emphasis on preventive measures that help identify and treat health issues early on.
Priv.-Doz. Dr. Christopher Becker is not only a dedicated physician but also an empathetic caregiver who places great importance on understanding his patients’ individual concerns. Through his comprehensive expertise in orthopedics and his patient-centered care, he has earned the trust of many patients and is a valuable resource for anyone seeking help with spinal and pelvic pain.
The editorial team of the Leading Medicine Guide spoke with PD Dr. Becker to learn more about pelvic ring pain, pubic bone inflammation, and back pain.
Pelvic ring pain, pubic bone inflammation, and back pain are common conditions that affect many people and are often interrelated. These pains can cause significant limitations in daily life and severely impair quality of life. The causes are varied and range from injuries to degenerative changes to inflammatory conditions. An accurate diagnosis is crucial for developing appropriate treatment strategies and helping affected patients regain their mobility and zest for life.
Pelvic ring pain can be attributed to various specific causes that differ from other causes of back pain.
“Pain in the pelvic ring is often a mechanical pain triggered by specific events. Those affected include, for example, soccer players who perform repetitive movements, causing constant irritation due to muscle strain in that area. This then triggers pain or even bone marrow edema in the area of the anterior pelvic ring. The situation is similar for women after childbirth, where the birthing process itself is a mechanical trauma that can also lead to bone marrow edema in the area of the anterior pelvic ring, which causes pain. The pain occurs particularly when walking and is less pronounced when lying down. Pain is also noticeable when contracting the adductors (a group of muscles in the thigh). The pain is dull and pressing, rather than neuropathic. Neuropathic pain occurs when nerves are pinched. Generally speaking, there are also a wide variety of other causes in this area that can trigger what is known as “pelvic pain syndrome.” “Here in Munich, we specialize in traumatic and orthopedic causes,” explains Dr. Becker at the beginning of our conversation.
While back and leg pain are often accompanied by radicular symptoms such as numbness or weakness in the legs, pain in the anterior pelvic ring is more concentrated in the groin area and around the pubic bone, while pain in the posterior pelvic ring is centered on the sacroiliac joint, without affecting the nerve structures of the lumbar spine. These symptoms differ from other types of back pain because they are often exacerbated by activities such as walking or lifting objects and are typically related to posture. The diagnosis and treatment of pelvic ring pain require a differentiated assessment of the specific causes and their symptoms compared to conventional back pain. An accurate diagnosis is crucial for implementing appropriate therapeutic measures, which can range from conservative treatments to surgical interventions.
The biomechanical stability of the pelvis plays a central role in the development of pubic bone inflammation and back pain.
“The pelvis is a complex system consisting of several bones, joints, and soft tissues. It not only serves as a supporting structure for the upper body but also connects the legs to the spine. A stable pelvic structure is necessary to maintain proper movement mechanics and distribute the load evenly. Of course, there are also congenital misalignments in the pelvic region, but these do not affect the majority of patients. Several misalignments, including congenital ones, can occur in the posterior pelvic ring, such as Bertolotti syndrome—a transitional abnormality between the lumbar vertebrae and the coccyx—which frequently affects the sacroiliac joint and often causes pain that goes undetected for a long time,” explains Dr. Becker.
In addition, an unstable pelvic structure can lead to compensatory overload of the spine. This overload can manifest as back pain, which is often accompanied by movement or postural problems. To counteract these problems, targeted physical therapy is important, focusing on strengthening the stabilizing muscles and improving mobility. Restoring the biomechanical stability of the pelvis can both prevent and effectively treat pubic bone inflammation as well as back pain. Interdisciplinary approaches that combine orthopedics, physical therapy, and, if necessary, pain management are crucial for holistic treatment.
The treatment of pubic bone inflammation requires a comprehensive approach that includes both short-term and long-term strategies.
The diagnosis of pelvic ring pain and pubic bone inflammation begins with a detailed medical history, during which the doctor asks about the symptoms, their duration, and intensity. It is particularly important to determine whether the pain is related to specific activities such as physical exertion, sports, or trauma. Patients often report pain in the pubic bone, groin, or lower abdomen, which may worsen with certain movements such as climbing stairs or lifting a leg. During the clinical examination, the doctor palpates the pelvic area to identify areas of tenderness or pain, particularly around the symphysis pubis and adjacent structures. In addition, functional tests are performed to assess the mobility and stability of the pelvis, which may also include specific tests of the adductor muscles or the thigh.
Imaging studies are then crucial for confirming the diagnosis and ruling out other possible causes. X-rays can reveal fractures or misalignments in the pelvic region and are particularly helpful when pubic symphysis inflammation or pelvic ring fractures are suspected. Ultrasound examinations are used to detect inflammation in the soft tissues of the pelvic region and can be useful in cases of pubic bone edema or muscle tension. Magnetic resonance imaging (MRI) provides detailed images of the soft tissues and is particularly important for diagnosing inflammation or injuries to muscles, ligaments, and joints. In rare cases, computed tomography (CT) is used to obtain detailed images of the pelvis, especially when fractures are suspected.
“To relieve the patient’s pain, we have established a step-by-step treatment plan and first exhaust all conservative measures. These include shockwave therapy, injections, and physical therapy or medical exercise therapy. With these measures, the majority of patients can be treated effectively. Surgery is only a last resort. Since we offer all services under one roof, this process is straightforward. All surgeries are performed using minimally invasive techniques, regardless of whether the condition involves pubic bone inflammation or instability. During pubic bone surgery, a small incision is made in the symphysis (the symphysis connects the two pubic bones in the pelvis) to remove the inflamed tissue from the symphysis. Sometimes a decompression drill hole is made in the pubic bone, and if instability is present, stabilization can be performed, for example, using artificial ligaments. Sometimes the adductors are also affected, which can be treated using various methods,” explains Dr. Becker regarding the treatment options.
The difference between physical therapy and medical exercise therapy lies in the treatment goals and approach. Physical therapy focuses on treating acute symptoms, pain, and functional limitations through manual techniques, exercises, and massage. Its goal is to improve mobility, relieve pain, and promote the body’s functionality. Medical exercise therapy, on the other hand, is an individualized, targeted training approach that is typically used for chronic conditions or for rehabilitation following injuries. It primarily uses targeted strength and endurance exercises to strengthen the muscles, improve coordination, and achieve long-term functional goals.
Preventing pelvic ring pain and pubic bone inflammation is an important aspect of maintaining quality of life.
“Most pelvic ring conditions stem from intense sports involving frequent changes in direction, such as soccer or handball. Effective prevention is achieved by maintaining excellent muscle condition, particularly with regard to the core muscles. It can be difficult to build up these muscles because some of these muscle structures are located very deep within the body and cannot be trained in isolation. Unfortunately, there is no such thing as 100% protection,” explains Dr. Becker. A healthy diet can help reduce excess weight, which in turn reduces the strain on the pelvis. Regular exercise, such as walking, cycling, or swimming, not only promotes overall fitness but also strengthens the muscles around the pelvis. Ergonomic adjustments in daily life, such as maintaining proper posture when sitting and lifting, are also important for avoiding unnecessary strain.
Psychosocial factors play a significant role in the perception and treatment of back pain, as they influence both the sensation of pain and the ability to cope with it.
Stress, anxiety, and depression can intensify the body’s physiological responses to pain, causing patients to experience their pain more intensely. Studies show that people with a pessimistic outlook or a belief that their pain is incurable often report more severe and longer-lasting pain. Social support is another important factor; people who feel isolated or alienated from their social circle often have poorer pain management. In contrast, a supportive environment in which friends, family, and healthcare professionals actively help can improve the chances of recovery. It is crucial to take these psychosocial aspects into account during treatment. Cognitive behavioral therapy, mindfulness training, and psychological support, when combined with physical therapy, can help optimize pain management.
“Unfortunately, it is often the case that patients with chronic back pain develop psychosomatic problems because the constant pain naturally takes a toll on their mental health, which in turn causes the pain to become chronic—it’s a vicious cycle. It works the other way around, too—people who primarily suffer from mental health issues often develop deep-seated back pain. This is because internal tension causes the muscles to tense up, including the deep pelvic muscles. A typical example here is tension in the hip flexors, which stiffen under severe stress—often on just one side—leading to a tilt in the pelvis. This tilt, in turn, can cause back or pelvic pain,” says Dr. Becker, who recommends:
“It’s always best to investigate such pain early on, using imaging if necessary, in order to initiate consistent treatment and prevent the condition from becoming chronic. It is essential that the sacroiliac joint be evaluated and treated as well. In many cases, the problem is not the lumbar spine at all, but rather the sacroiliac joint.”
The sacroiliac joint (SIJ) is the joint that connects the sacrum to the ilium (the flat part of the pelvis). It is located in the lower back, at the point where the spine meets the pelvis. The SIJ is a crucial joint for pelvic stability and allows for limited movement between the sacrum and the hip bones. It plays a vital role in transmitting forces between the upper body and the legs, particularly during movements such as walking, standing, or lifting. Problems or inflammation in this joint, such as sacroiliac joint dysfunction, can cause pain in the lower back and pelvic area.
One-stop care at the spectrum MED Practice for Orthopedics, Trauma Surgery, and Pain Management
“At my new practice, spectrum MED, we specialize in pelvic and back pain. We have years of expertise in this field, have conducted numerous studies at the university, and base our treatments on established guidelines. The clear advantage for patients is that we can offer everything under one roof, from diagnostics and conservative therapy to necessary surgeries. Thanks to our collaboration with radiologists and physical therapists, patients can also get appointments quickly,” says Dr. Becker about his new practice. This concludes our conversation.
Thank you very much, Dr. Becker, for this orthopedic insight!
