Hip pain at night can wake you up during the night or make it nearly impossible to fall asleep in the first place. The pain can come from the position you sleep in, or it could be caused by something else. For example, you don’t move much during sleep, so your joints swell, which can lead to stiffness and pain.

Read on to learn more about what may be causing your hip pain at night, plus how you can manage this symptom.

Hip pain at night can be caused by several conditions. The most common ones are:

  • bursitis
  • osteoarthritis
  • tendonitis
  • sciatic-piriformis syndrome

It can also be caused by your sleeping position, your mattress or pillows, or pregnancy. As well, it’s possible to have another problem, like lower back pain, that causes your hip to hurt. That’s called referred pain.

Sleeping position

If you regularly wake up in the night from hip pain, the way you’re sleeping or your mattress could be to blame. A mattress that’s too soft or too hard could trigger pressure points, which may lead to a sore hip.

Sleep posture can also cause pain. Try sleeping on your back or, if you’re a side sleeper, sleep on the side that doesn’t hurt and put a pillow between your knees to keep your hips aligned. You can find a great selection of knee pillows here.

Bursitis

Around your hip bone and other joints are small sacs filled with fluid that cushion the joint when it moves. These sacs are called bursae. Bursitis occurs then these sacs become inflamed.

Symptoms may include:

  • pain on the outside of your hip and upper thigh
  • pain that starts as sharp pain, causing you to yelp when the area is touched, and later develops into an ache
  • pain when you get up after sitting for a long time, and which may worsen when you take a long walk, climb a lot of stairs, or squat for awhile
  • pain that’s worst at night when you lie down or sleep on the affected hip

People with bursitis don’t have pain while standing.

Hip osteoarthritis and other types of arthritis

Osteoarthritis is the most common type of arthritis in the hip. But other types of arthritis can cause hip pain at night too. These types may include rheumatoid arthritis, psoriatic arthritis, or septic arthritis.

If you have hip arthritis, you may notice:

  • pain in your groin
  • pain also in your buttocks, thigh, or knee
  • pain made worse during rainy weather, in the morning, or after resting or sitting for a while
  • hip pain that keeps you from sleeping
  • pain when bending over, getting up from a chair, or taking a short walk
  • grinding sound with movement (called crepitus), or your hip locking or sticking

Hip tendonitis

Tendons attach muscles to bone, allowing for movement. Hip tendonitis is when the tendon in the hip is inflamed. If you have hip tendonitis, your symptoms may include:

  • a dull, deep ache in your groin, especially when you climb stairs or stand up
  • pain in your buttocks if your hamstring tendon is also inflamed

Sciatic-piriformis syndrome

Sciatic pain is tingling and numbness that runs from the lower back to the buttocks, and sometimes down the leg and into the foot. If you have sciatic-piriformis syndrome, you may feel a burning sensation in your calf when you’re trying to sleep. Or you may have throbbing pain in your foot that jolts you awake or keeps you up.

Pregnancy

Pregnancy puts extra pressure on your spine and hips, especially during your third trimester. Wear supportive shoes during the day and take stretch breaks if you’ve been sitting for extended periods of time. That can help reduce your risk for conditions like sciatica, which may lead to referred pain.

At night, follow the previously made suggestions regarding side sleeping. You can also try rolling up a blanket and placing it behind your back so that you can lean into the blanket while still sleeping on your side. You can use a pillow instead of a blanket if you prefer. That can help provide additional support while sleeping. A pregnancy pillow may also help.

Immediate relief

If hip pain wakes you up, you can try these things to get back to sleep:

  • Change your sleeping position. Keep experimenting to find the most pain-reducing position.
  • Place wedge-shaped pillows under your hip to provide cushioning. If you don’t have a wedge-shaped pillow, try folding a pillow or blanket to create a wedge shape.
  • Sleep with a pillow between your knees to reduce stress across your hips.
  • Put one or more pillows under your knees. This can ease pain from piriformis-sciatica.

Over-the-counter (OTC) nonsteroidal anti-inflammatories (NSAIDs), such as ibuprofen (Advil, Motrin IB) and naproxen (Aleve) may help relieve your pain. Talk to your doctor about the best NSAIDs for you and how often it’s safe to take them. Your doctor may also prescribe topical NSAIDs, such as diclofenac gel (Pennsaid, Voltaren).

Ice or heat may also help relieve pain. Ask your doctor which is best for you. If your pain is caused by swelling, ice may be more beneficial as it can help reduce the inflammation. Heat can help relieve arthritis pain, stiffness, or muscles spasms.

Avoid applying the ice directly to your skin. Instead, wrap an ice pack in a towel, and then place it over your hip. You can apply heat with a heat wrap, heating pad, or hot water bottle.

Long-term relief

If you regularly experience hip pain at night, you may need solutions for long-term relief.

You may want to consider changing your mattress. A mattress that is too firm may be especially painful for people who have hip bursitis. You can also try putting a foam pad on top of your mattress to help distribute your weight.

Your doctor may also talk with you about these treatments:

  • seeing a physical therapist, getting regular massages, or both
  • removing fluid from the bursa
  • arthroscopic surgery to remove the bursa
  • steroid or cortisone injection into your bursa or hip joint
  • hyaluronic acid injections to lubricate your hip joint
  • arthritis medicines, including DMARDs and biologics
  • arthroscopy, which is surgery to remove loose pieces of cartilage or bone spurs around the hip
  • hip resurfacing to remove and replace damaged bone in the hip socket
  • arthroplasty, also known as total hip replacement surgery

When hip pain keeps you awake, you can try these things throughout the day and before bedtime:

Low-impact exercise

Low-impact exercise, such as swimming, water exercise, or walking, may help reduce your pain and improve sleep. You may also want to try tai chi or yoga. As well, you should avoid sitting for long periods of time throughout the day.

Stretching

In addition to low-impact exercise during the day, you can try stretching your hip. You can stretch throughout the day or at night if the pain is keeping you awake.

  1. Stand up and hold on to something for balance if you need to.
  2. Cross your legs, and reach to touch your toes.
  3. Hold for 20 to 30 seconds.
  4. Cross your legs the other way and repeat.

You can also try these exercises to help relieve hip bursitis pain or these exercises to strengthen your hip flexor.

Sleep hygiene

Practicing good sleep hygiene can help you fall and stay asleep.

  • Go to bed and get up at the same time every day.
  • Have a relaxation routine before bedtime.
  • Consider taking a warm bath one-to-two hours before bedtime to release your body’s natural pain fighters, called endorphins. A warm bath also relaxes muscles around the sciatic nerve. Don’t make the water too hot, though, because it will raise your temperature and make it hard to fall asleep.
  • Make your room dark and quiet, and keep the temperature cool to avoid waking up from being too hot.
  • Avoid using electronics close to bedtime, including televisions, computers, and smartphones.
  • Avoid consuming caffeine five or less hours from your bedtime. Learn more about how long it takes for the effects of caffeine to wear off.

You should also avoid using alcohol to help you fall asleep. It may make you drowsy, but you’ll likely wake after just a few hours of restless sleep. Also, beware of using OTC sleep aids. Over time, you’ll need higher doses to go to sleep, and this habit can be hard to break.

If your hip pain is regularly keep you from sleep or waking you up at night, see your doctor. They may check for tenderness and swelling around your hip. They’ll also assess the range of motion of your hip for signs of arthritis and tendonitis. Reduced motion is a sign of arthritis. They may also take blood or fluid samples, or order X-rays to rule out various conditions.

Go to an urgent care facility or to an emergency room if your hip pain is caused from an injury. Also seek immediate care if you have any of these symptoms:

  • a joint that looks deformed
  • inability to move your leg or hip
  • inability to put weight on the leg with the sore hip
  • intense pain or sudden swelling in your hip
  • fever, chills, redness, or other signs of infection

Not getting enough sleep can make your pain worse, so it’s important to work with your doctor to develop a treatment plan. Making some adjustments to your lifestyle, like adding in gentle exercise and improving your sleep hygiene, can take you a long way toward preventing long, painful nights. Work with your doctor to find the best treatment for the condition that’s causing your hip pain.

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