You go to bed feeling fine. A few hours later, the outside of your hip starts aching. You roll onto the other side, but eventually that hip becomes uncomfortable too.
By morning, you’re stiff and wondering why sleeping seems to make your hip hurt more than walking around during the day.
Hip pain when sleeping on your side is often related to pressure on sensitive tissues around the outside of the hip, although joint problems, tendon irritation and pain referred from the lower back can also contribute.
Understanding exactly where the pain occurs and which movements aggravate it can help determine what needs attention.
Why Does Side Sleeping Put Pressure on Your Hip?
When you sleep on your side, much of your body weight rests against the outside of the hip.
That area contains muscles, tendons, bursae and bony structures that help stabilize your pelvis and control leg movement.
If those tissues are already irritated, direct pressure from the mattress may make them more uncomfortable.
You might notice:
- Pain directly over the outside of the hip
- Tenderness when pressing on that area
- Discomfort when lying on the affected side
- Pain after walking or climbing stairs
- Stiffness when getting out of bed
The location of the pain is useful, but it doesn’t establish a diagnosis by itself.
Could It Be Greater Trochanteric Pain Syndrome?
One common explanation for pain along the outside of the hip is greater trochanteric pain syndrome, often abbreviated GTPS.
This term describes pain involving structures around the greater trochanter, the prominent bony area on the outside of the upper thigh.
It commonly involves irritation or problems affecting the gluteal tendons. The nearby bursa can also be involved.
People with GTPS may find that lying on the painful side is uncomfortable. Standing on one leg, walking longer distances or climbing stairs may also aggravate symptoms.
It’s important not to assume that every case of nighttime hip pain is bursitis. Tendon-related problems and other conditions can produce similar symptoms.
Can Your Sleeping Position Make Hip Pain Worse?
Yes.
Sleeping directly on a painful hip places pressure on already sensitive tissues.
Sleeping on the opposite side may also be uncomfortable if the upper leg drops across the body and places additional tension on the affected area.
Some people find it helpful to place a pillow between their knees and thighs to support the upper leg.
Others are more comfortable temporarily sleeping on their backs with appropriate support.
These changes may reduce irritation, but they won’t necessarily correct the underlying reason the hip became painful.
What If the Pain Is Deep in the Groin?
Hip pain isn’t always felt on the outside of the joint.
Discomfort deep in the groin or toward the front of the hip can be associated with problems inside the hip joint, including arthritis and other joint conditions.
You might also notice difficulty putting on shoes, getting into a car or rotating the leg.
Those symptoms deserve a proper clinical evaluation rather than assuming that a new pillow or mattress will solve the problem.
Could My Lower Back Be Causing Hip Pain?
Sometimes pain felt around the hip originates elsewhere.
The lower back can refer pain into the buttock or hip region. Nerve irritation may also produce symptoms extending into the leg.
Clues that the back may be involved include:
- Back pain occurring with hip discomfort
- Pain extending below the knee
- Tingling or numbness
- Symptoms that change with spinal movement
- Pain aggravated by certain sitting or standing positions
These symptoms don’t prove a spinal diagnosis, but they help explain why examining only the painful spot may not be enough.
At Revive Injury & Wellness in West Linn, the chiropractic team evaluates the spine and extremities as part of its approach to musculoskeletal complaints.
Does Your Mattress Matter?
It can influence comfort.
A very firm surface may increase pressure on the outside of the hip. A mattress that allows the pelvis to sink excessively may also be uncomfortable for some sleepers.
However, there’s no single mattress firmness that treats every hip condition.
If the pain is new or worsening, buying an expensive mattress before identifying the cause may not be the most useful first step.
What Can You Try at Home?
If the pain is mild and there are no concerning symptoms, a few temporary adjustments may help:
- Avoid lying directly on the painful hip.
- Try a pillow between your knees when sleeping on your side.
- Reduce activities that consistently aggravate the area.
- Continue comfortable movement rather than remaining completely inactive.
- Avoid aggressive stretching that reproduces sharp lateral hip pain.
Exercises can be useful for some hip conditions, particularly when appropriately selected to improve strength and load tolerance. But an exercise that’s helpful for one diagnosis may aggravate another.
Persistent symptoms are a reason to obtain an individualized assessment.
How Can Chiropractic Care Fit Into a Hip Pain Evaluation?
Hip pain can involve several interacting structures, including the hip joint, surrounding muscles, tendons and lower back.
Revive Injury & Wellness uses a 5-Phase Bio-Structural Evaluation that includes a health history and orthopedic, neurological and chiropractic examinations.
Depending on the findings and whether conservative care is appropriate, a treatment plan may include gentle chiropractic techniques, therapeutic exercises or massage therapy.
The goal is to identify relevant movement limitations and contributing factors rather than assuming that every hip complaint requires the same treatment.
Some conditions require medical imaging, physical therapy, medication or evaluation by another healthcare professional.
When Should Hip Pain Be Evaluated?
Schedule an evaluation if the pain repeatedly interrupts sleep, persists despite reasonable activity changes or interferes with walking and everyday movement.
Seek urgent medical care after a significant fall or injury if you cannot bear weight, or if the hip appears deformed. A hot, swollen joint accompanied by fever also requires prompt medical attention.
New significant weakness, numbness or other neurological symptoms should not be ignored.
Frequently Asked Questions About Hip Pain at Night
Why does my hip only hurt when I lie on it?
Direct pressure may aggravate sensitive tissues around the outside of the hip. Greater trochanteric pain syndrome is one possibility, but other hip and back conditions can cause similar symptoms.
Should I sleep on the opposite side?
That may help, especially with a pillow supporting the upper leg. Avoid positions that increase pain, and seek evaluation if the problem continues.
Can hip pain come from my lower back?
Yes. Some spinal and nerve conditions can refer pain toward the hip, buttock or leg. A clinical examination helps distinguish potential sources.
Will stretching fix nighttime hip pain?
Not necessarily. Some hip conditions respond better to carefully selected strengthening and load management than aggressive stretching. Treatment depends on the cause.
When is nighttime hip pain serious?
Persistent or worsening pain deserves evaluation. Inability to bear weight after an injury, fever with a hot swollen joint or significant new neurological symptoms require prompt medical care.
Get Help Understanding Your Hip Pain
If hip pain keeps interrupting your sleep, the most useful next step is understanding what’s causing it.
Revive Injury & Wellness provides chiropractic evaluations and conservative musculoskeletal care in West Linn, serving patients from Oregon City, Lake Oswego, Gladstone, Tualatin, Wilsonville and surrounding Clackamas County communities.
To discuss persistent hip discomfort or schedule an evaluation, visit Revive Injury & Wellness or call (503) 344-4378.