How to Deal with Hip Pain While Sleeping

Do you suffer from hip pain that keeps you awake? If hip pain wakes you up at night, you are not alone.

As a licensed physical therapist, I can verify that hip pain is a common complaint among older adults. It can affect sleep quality as well as overall health. But what causes hip pain while sleeping, and how can you deal with it?  

This article will explore some possible causes of hip pain at night. We will also share some strategies to help you relieve hip pain while sleeping, such as changing your sleeping position, using a pillow for hip pain, stretching before bed, trying medication, and, if necessary, seeking medical help.  

By following these tips, you can sleep better with less pain and improve your quality of life. Read on to learn more about nighttime hip pain so you can find relief and get a good night’s sleep.

Hip Pain Causes: Why Your Hips Hurt at Night 

There are a variety of different factors that might influence hip pain while lying down. Many people experience nighttime hip pain due to factors like body position or the quality of their sleeping surface. 

Here are some of the most common causes of hip pain while sleeping.

Sleeping position

Your posture can affect the alignment and pressure on your hip joints, even while you sleep. For example, sleeping on your side can cause your hips to rotate inward or outward, which can strain your muscles, tendons, and ligaments.

Similarly, sleeping on your back can cause your lower back to arch, which can compress your nerves and cause hip pain. 

Mattress quality

Your mattress can influence your hips’ comfort and support at night. A bed that is too firm or soft can cause uneven pressure on your hips, leading to inflammation and pain. A mattress that is too old or saggy can also lose shape and support, worsening your hip pain. 

You may also benefit from changing your sleeping habits, such as using pillows to support your hips and legs, switching to a different sleeping position, or getting a new mattress. 

Underlying Conditions: Other Common Causes of Hip Pain 

Hip pain can have various causes, some of which may not even be related to the hip joints. For example, you may experience hip pain due to problems with your lower back, pelvis, or legs. This is called referred pain, which can be tricky to diagnose and treat. 

Some common medical causes of hip pain include: 

• Sciatic piriformis syndrome: This occurs when the sciatic nerve, which runs from your lower back to your feet, is compressed or irritated by the piriformis muscle, which is located deep in your buttocks. This can cause pain, numbness, or tingling in your hips, buttocks, or legs. 
• Hip joint arthritis: This degenerative condition affects the cartilage and bones of your hip joints. It can cause inflammation, stiffness, and pain in your hips, especially when you move or put weight on them. 
• Hip tendonitis is an inflammation of the tendons that connect your hip muscles to your bones. It can be caused by overuse, injury, or infection. It can cause pain, swelling, and reduced mobility in your hips. 
• Hip bursitis is an inflammation of the bursae, which are small fluid-filled sacs that cushion your hip joints. It can be caused by physical trauma, infection, or repetitive stress. It can cause pain and tenderness in certain areas of your hips. 

If you have persistent or severe hip pain at night (or during the day), consult a doctor for diagnosis and treatment. Your doctor may prescribe medications, exercises, injections, or surgery depending on the cause and severity of your hip pain. 

Tips and Tricks for Managing Hip Pain While Sleeping 

While there is no one-size-fits-all solution for hip pain while sleeping, some strategies may help you find some relief and improve your sleep quality.

Here are some tips to try: 

Change your sleeping position 

Depending on the cause of your hip pain, you may find sleeping on your back, side, or stomach more comfortable. Experiment with different positions and pillows to see what works best for you.  

For example, if you have sciatic piriformis syndrome, you may want to avoid sleeping on your back or side with your legs crossed. If you have hip arthritis or bursitis, avoiding sleeping on your affected side is commonly recommended or using a pillow between your knees to reduce pressure on your hips. 

If sleeping on your back and side is uncomfortable, you can try sleeping on your stomach with a pillow under your pelvis or lower abdomen. In this position, most pressure on your hips in other positions is removed, and adding a pillow under your hips can help keep your spine in a more neutral position.  

While I typically don’t consider stomach sleeping the best for hip pain, it’s essential to try different positions and find what works best for you—that may be sleeping on your stomach! 

The Benefits of Using a Pillow for Hip Pain 

Just like how you can try different sleeping positions to relieve your hip pain at night, experimenting with different pillows can also help cushion and support your hip joint or the alignment of your spine.

Although there is no one-size-fits-all pillow for hip pain, a few popular options are wedge-shaped, memory foam, and body pillows. 

Wedge-shaped pillows help lift your thigh while sleeping on your back. This slightly changes the angle of your pelvis and, for many people, relieves some of the pressure on your lower back and hips. Using a wedge-shaped pillow is unique from simply stacking pillows together because it allows your legs to bend and relax more, which many of my patients have reported makes a big difference. 

Memory foam pillows are a popular choice because they contour the shape of your body and provide very stable support. This is especially helpful to set your legs apart while lying on your side. One popular option for hip pain is advertised as a “sciatica” pillow.

It includes a large notch to comfortably fit between your legs while lying on your side. A good memory foam pillow is one of my top recommendations for patients with hip pain during or in the morning after sleeping. 

Body pillows come in many shapes and sizes. They’re an excellent option for managing hip pain at night because they can be used in various positions and folded as needed. This means you can use a body pillow to support one leg or both while lying on your back or side or get support however you like while lying on your stomach. 

Many patients report the best results by trying different pillows and sleeping positions to find what works for them. It’s also important to know that what works best for you might change over the years, so feel free to try something new with your pillow setup. 

The Best Stretches for Hip Pain Before Bed 

In addition to having a good sleeping setup, a good bedtime routine can contribute to less pain and better sleep. Stretching is a great way to help relax the muscles around the hip joint for improved blood flow and flexibility, improving comfort and recovery while sleeping. [3] 

The best stretches before bed will depend on the type of pain you’re having and your health history, but there are a few simple and effective stretches that you can try to get started.

Hip Flexor Stretch 

Start by kneeling on one knee supported by a pillow on the floor.

• Slowly tuck your pelvis under—imagine you are trying to bring your belt line closer to your chest.
• Gently lean forward to feel a stretch in the front of your thigh and hip flexor muscles. You should not feel any pinching or a sense of making the pain worse. If so, stop the stretch.
• Hold for 30 seconds, then switch to the other leg.

Piriformis Stretch 

Start by lying on your back and crossing the ankle of your painful side over the opposite knee.

• Hold the back of your opposite thigh and pull your thigh towards your chest to feel a stretch in the back of your hip. Be sure to support your head with a rolled blanket or pillow.
• Hold for 30 seconds, then switch to the other side. 

Butterfly Stretch 

Start by sitting on the floor with your knees bent. For comfort, you may also sit on a pillow or blanket.

• Hold the soles of your feet together and let your legs fall wide like opening a book.
• Gently lean forward to feel a stretch in your back and hips. Hold for 30 seconds, then repeat. 

When working with seniors with hip pain, I always pay special attention to their comfort in various positions. If you are uncomfortable or feeling pain, try searching for a modified version that uses a chair or other furniture to make the position more comfortable. 

Medication Options for Hip Pain at Night 

Suppose you need more relief beyond position changes, special pillows, or stretching before bed. If so, medication can be a practical choice to manage hip pain while sleeping.  

Medications can be helpful to reduce pain and limit inflammation in the short term. Still, they should be used sparingly over longer periods. This is because most medications—even over-the-counter medicines—have side effects that can result in health complications with long-term use. 

Many older adults I see use anti-inflammatory drugs such as ibuprofen or Naproxen to help manage hip pain before bed. These medications can help reduce inflammation, indirectly affecting hip pain by bringing down swelling around nerve endings. 

Another popular over-the-counter medication option is acetaminophen or Tylenol. This type of medication has a direct effect on hip pain by acting on the pain receptors throughout the body. It’s important to know that because this medication doesn’t address inflammation like anti-inflammatory drugs, it may not be the best option for your symptoms. 

Sometimes, your doctor may prescribe medications like corticosteroids to aggressively address inflammation in your hip. Options like prednisone can be taken orally, while a trained professional administers cortisone injections during a clinic visit. Most of my patients see dramatic benefits from short-term use of corticosteroid treatments. 

As always, talk to your doctor about medication questions to get the best results and avoid harmful side effects. 

When to See a Doctor for Hip Pain 

If lifestyle changes and responsible medication use aren’t making a difference in your hip pain at night, it might be time to seek medical help. This is especially important for severe, persistent pain or pain that doesn’t change with your position. 

One common condition for older adults that requires medical attention is arthritis. Arthritis comes in two primary forms: osteoarthritis, which is due to wear and tear, and rheumatoid arthritis, which is an autoimmune condition. Arthritis can develop slowly and result in new symptoms, which your doctor should assess to ensure you are on the best self-care plan. 

Another condition that I commonly see is hip fractures. For older adults, especially women, hip fractures become more likely during falls or heavy lifting due to reduced bone density.

When a stress or hairline fracture develops, it may go undetected and cause persistent pain or swelling. In some cases, an X-ray can be the only way to correctly diagnose a stress fracture and start on the path to a full recovery. 

If you have doubts or worries about your hip pain, it’s best to schedule a visit with your doctor to talk more. Even if you can still push through your daily activities or get some sleep each night, your doctor may be able to identify signs of a new problem that should be addressed as soon as possible for your long-term health. 

Key Takeaways 

• Hip pain during the night, often experienced by older adults, can be influenced by factors like sleeping position and mattress quality.
• Adjusting sleep posture, using supportive pillows, or getting a new mattress can alleviate pain.
• Referred pain from the lower back, pelvis, or legs, or conditions like sciatic piriformis syndrome, arthritis, tendonitis, or bursitis, can cause hip discomfort.
• Severe or persistent hip pain may require medical interventions, including medications, exercises, or surgery.
• Testing different sleeping positions and pillow arrangements may help manage pain.
• Pre-bedtime stretching can relax hip muscles and improve comfort.
• Temporarily using anti-inflammatory drugs or acetaminophen medications can help manage pain. Corticosteroids may also be used in some cases.
• Persistent pain, especially if not relieved by self-care measures, should be assessed medically, as conditions like arthritis or hip fractures might be the cause.

FAQs

References 

1. Fu K, Makovey J, Metcalf B, Bennell KL, Zhang Y, Asher R, Robbins SR, Deveza LA, Cistulli PA, Hunter DJ. Sleep Quality and Fatigue Are Associated with Pain Exacerbations of Hip Osteoarthritis: An Internet-based Case-crossover Study. J Rheumatol. 2019 Nov;46(11):1524-1530. doi: 10.3899/jrheum.181406. Epub 2019 Apr 1. PMID: 30936279. 
2. Cibulka MT, Bloom NJ, Enseki KR, et al. Hip pain and mobility deficits—hip osteoarthritis: revision 2017. J Orthop Sports Phys Ther. 2017;47(6):A1-A37. doi:10.2519/jospt.2017.0301 
3. D’Aurea CVR, Poyares D, Passos GS, Santana MG, Youngstedt SD, Souza AA, Bicudo J, Tufik S, de Mello MT. Effects of resistance exercise training and stretching on chronic insomnia. Braz J Psychiatry. 2019 Jan-Feb;41(1):51-57. doi: 10.1590/1516-4446-2018-0030. Epub 2018 Oct 11. PMID: 30328967; PMCID: PMC6781703.