Hip Pain at Night: Causes and Treatment

You roll onto your side, the hip starts throbbing, and you’re awake again at 3 a.m. Hip pain at night makes it hard to fall asleep, wakes you up over and over, and drains your energy for the next day.

Hip pain at night can be caused by multiple things, from uncomfortable positions to bad mattresses to various illnesses. It may be hard to find relief for hip pain at night, but figuring out what is causing it is the first step to fixing it.

Simple changes help some people. If the pain keeps coming back, a physical therapist can find the cause and build a hip pain treatment plan around it.

Most Common Causes of Hip Pain at Night

Hip pain during the day is generally caused by bearing weight on the joint, too much pressure, or movement. At night, the trigger is often pressure from lying on the sore side, or inflammation that settles in when you stop moving. Bursitis and tendonitis usually hurt on the outside of the hip. Arthritis more often shows up in the groin.

To find the right treatment for hip pain while sleeping, get a proper diagnosis early.

Postponing the visit to the doctor when you experience hip pain lying down or waiting for things to "sort themselves out" can worsen the condition.

The most common causes of hip pain at night are:

• Bursitis

• Osteoarthritis & arthritis

• Tendonitis

• Sciatica and piriformis syndrome

• Sleeping position

• Uncomfortable mattress

• Pregnancy

• Lower back pain

Bursitis

Bursitis is when the bursae, small fluid-filled sacs that cushion the bones and tendons around the hip, become inflamed. The main symptom is pain on the outside of your hip and upper thigh.

The pain often starts sharp and turns into a dull ache, and the outer hip feels tender to the touch.

You may also experience pain when standing up, climbing stairs, taking long walks, squatting as well as pain during the night when putting pressure.

Actually, pain may worsen during the night when lying on the hip.

Osteoarthritis & Arthritis

Osteoarthritis and arthritis are pretty common hip conditions; these include rheumatoid arthritis, psoriatic arthritis, and septic arthritis.

These cause pain in the groin, thighs, knees, buttocks, and hips that can keep you up at night. Many people notice it more with weather changes, after sitting a long time, or as stiffness first thing in the morning.

Tendonitis

Tendonitis affects the tendons that attach muscles to bone and enable movement. Hip tendonitis is an inflammation that causes pain in the groin and buttocks that can be intensified by climbing the stairs or similar activities. The continuation of that pain may last well into the evening or even the night.

Sciatica and piriformis syndrome

Sciatica happens when the sciatic nerve gets irritated. Sometimes the cause is a tight piriformis muscle deep in the buttock. It can cause numbness and tingling in the lower back, buttocks, hip, legs, and feet.

The Sciatica and piriformis syndrome may not only cause discomfort or pain in the hip but also a burning sensation or throbbing pain in your calf and foot. Many people wake up multiple times at night.

Pregnancy

During pregnancy, the hormone relaxin loosens the ligaments around the pelvis. Later in the pregnancy, the extra weight adds more pressure on the spine and hips and may lead to pain in the hip during the night.

Stretching, sleeping on your side with a pregnancy pillow between your knees, and adjusting sleeping positions can ease the pain.

Lower Back Pain

Problems in the lower spine, like a herniated disc or arthritis in the spinal joints, can send pain into the hip and buttock. The hip itself may be fine. If your hip pain comes with back stiffness or pain that travels down the leg, the source may be your spine. Our low back pain treatment targets exactly that.

Why is There Hip Pain From Sleeping On The Side

Lying on your side puts your full body weight on the bony point of the outer hip, right where the bursa and tendons sit. An incorrect sleeping position or a too soft or too hard mattress may trigger pressure points and leave your hips sore in the morning.

Side sleeping is a common trigger for hip bursitis. If it’s your default, try switching sides, sleeping on your back, or putting a pillow between your knees to keep the hips aligned.

The conditions we've discussed above can also be causes of your hip pain when sleeping on the side.

How to Relieve Hip Pain While Sleeping

Some fixes work tonight. Others take a few weeks. Here’s both.

Immediate pain relief

When pain wakes you up, try these first:

• Change your sleeping position. Try a few sleeping positions to find the one that bothers you the least. Sleeping on your back usually takes the most pressure off the hips.

• Use a pillow. A pillow can help with hip pain or hip impingement while sleeping. Place it between the legs to keep the hips in a neutral position and reduce stress and pain. You can also get a wedge-shaped pillow or fold a blanket to put under the hips and relieve pressure. If you have the sciatic-piriformis syndrome, place a pillow under the knees.

• Take painkillers. Over-the-counter non-steroidal anti-inflammatories such as ibuprofen and naproxen can help relieve pain and allow you to sleep. Check with your doctor or pharmacist first, especially if you take blood thinners or have stomach, kidney, or heart problems.

• Use ice or heat. Ice works best for fresh pain and swelling. Heat is better for stiff, achy joints and tight muscles. Wrap the ice pack or heating pad in a thin towel and use it for 15 to 20 minutes at a time.

Long-term pain relief

Quick fixes get you through the night. If hip pain while lying down keeps coming back, you need hip pain treatment that goes after the cause.

First of all, you may want to change your mattress or add a pad to even out the weight distribution. The most reliable long-term fix is physical therapy. A therapist strengthens the glutes and hip muscles that take load off the joint and shows you which movements to change.

Doing some low-impact exercise like swimming, yoga, or easy hikes can also benefit you and reduce the pain.

Make sure you also stretch before bed and during the day to gain flexibility and improve your circulation. You can even do it during the workday by getting up and doing a few simple stretching exercises.

One of the easiest ones is the butterfly stretch. Sit on the ground, bend your legs, bring the soles of your feet together, and let your knees fall out to the sides. Hold for 20 to 30 seconds without forcing it.

Other therapies

If stretches and sleep changes aren’t enough, treatment usually starts with physical therapy. Injections or surgery come later, for cases that don’t respond.

These treatments include:

• Physical therapy built around targeted exercise, with massage, ultrasound, or electrical stimulation as extras.

• Hip resurfacing, which caps the damaged ball of the hip joint instead of replacing it.

• Total hip replacement surgery (arthroplasty). Recovery depends on physical therapy after hip replacement and knowing what not to do after hip replacement surgery.

• Removing fluid from the bursa.

• Arthroscopic surgery to remove the bursa.

• Corticosteroid or hyaluronic acid injections.

• Various arthritis medicines.

• Arthroscopy to remove loose pieces of cartilage or bone spurs.

Sleep Hygiene and Self-Care

When talking about how to ease hip pain while sleeping, it's essential to address self-care and proper sleep hygiene.

• Eat a healthy diet, do not sit too much, do at least minimal exercise daily and reduce or eliminate consumption of alcohol and caffeine.

• Have a sleep schedule and get up and go to bed at the same time every day.

• Air out your room and adjust the temperature to cooler for better sleep quality.

• Minimize sleeping distractions like TVs, phones, computers, and sounds from outside.

• Take a warm bath a couple of hours before bed to relax your muscles and nerves and soothe you.

• Wind down with something calm, like herbal tea or reading.

When You Should See a Doctor

While many of these therapies and strategies may help you reduce your hip pain when sleeping and improve the quality of your sleep, if the pain hasn’t improved after a week or two, book a visit with your doctor or a physical therapist.

Get seen right away if you can’t move your leg, can’t put weight on it, have severe pain or swelling after a fall, or have a fever with a hot, red joint. That last one can signal a joint infection (septic arthritis), which needs urgent care.

Your doctor will do a proper examination, assess your range of motion, and look for signs of arthritis, bursitis, or nerve problems, sometimes with an X-ray or MRI.

Final Thoughts

Hip pain at night is more than annoying. Weeks of broken sleep wear down your mood and energy, and an untreated hip problem tends to get worse, not better.

If you're not getting enough sleep, you should consult with your doctor or physical therapist and get diagnosed. Once you have your diagnosis, a proper treatment plan and lifestyle adjustments can make a huge difference.

Treatments may include surgery, injections, different physical therapy modalities, and medicine, but you should also focus on exercise, a healthy diet, a proper sleeping routine, and a comfortable mattress.

Don’t wait for it to sort itself out. Our physical therapists will find what’s behind your night pain and build a treatment plan that fits you. Book a visit at one of our Miracle Rehab Clinic locations and start sleeping through the night again.