Hip Pain When Sleeping: Common Causes and How to Relieve It

Hip pain when sleeping is a common complaint among adults, especially those aged 40 and above or people who live active lifestyles. Whether the discomfort appears suddenly or has been gradually building over time, it can significantly disrupt sleep quality and overall wellbeing. Understanding what causes hip pain at night — and what you can do to manage it — is the first step toward more comfortable, restful sleep.

Below are the most frequent causes of night-time hip pain and practical strategies to help ease symptoms.

Common Causes of Hip Pain When Sleeping

1. Bursitis

Bursae are small, fluid-filled sacs that cushion the bones, tendons, and muscles. When one of these sacs becomes inflamed — a condition known as bursitis — the outer part of the hip can become tender and painful, especially when lying on the affected side.

People often describe hip bursitis pain as:

• A sharp or aching discomfort over the outer hip
• Pain when lying on the painful side
• Pain that worsens with climbing stairs, standing up from a chair, or prolonged walking

Bursitis is often caused by repetitive movement, muscle tightness, altered biomechanics, or previous injuries. It is also common in runners and people who spend long hours standing.

2. Tendinopathy

Tendinopathy refers to irritation or degeneration of a tendon — the thick tissue that connects muscle to bone. Around the hip, tendinopathy commonly affects the gluteal tendons. These tendons play a crucial role in stabilising the pelvis and maintaining proper alignment during movement.

Symptoms of hip tendinopathy often include:

• A deep ache on the outer hip
• Pain when lying on either side (not just the injured one)
• Discomfort when standing on one leg
• Pain that worsens with prolonged walking or climbing hills

Tendinopathy is generally caused by overloading the tendon — either doing too much too soon, or long-term repetitive stress without adequate strengthening.

3. Hip Osteoarthritis

Hip osteoarthritis occurs when the cartilage that cushions the hip joint gradually wears down. Although commonly associated with ageing, arthritis can affect younger adults too, especially those with previous injuries or high-impact sport backgrounds.

Night-time hip pain from arthritis may show as:

• A deep ache in the groin, buttock, or outer hip
• Stiffness in the morning or after sitting
• Clicking or grinding sensations
• Reduced movement

Arthritis-related inflammation can intensify at night due to prolonged positioning or stiffness from inactivity.

4. Muscle Imbalances and Postural Stress

Weakness or tightness in the hip, gluteal, or lower back muscles can place excess strain on the hip joint and surrounding tissues. This imbalance affects alignment and can cause structures to become irritated — especially when lying in certain positions.

Common contributors include:

• Weak gluteus medius
• Tight hip flexors
• Poor posture (prolonged sitting, crossing legs)
• Sedentary lifestyle
• Working long hours at a desk

5. Side Sleeping Pressure

Some people naturally prefer sleeping on their side. However, this position can compress the outer hip and irritate sensitive structures, especially if the mattress is too firm or too soft.

Signs the issue may be position-related include:

• Pain only when lying on a specific side
• Immediate relief when changing positions
• Increased discomfort on older mattresses with sagging areas

6. Pregnancy-Related Changes

Pregnancy can shift the body’s centre of gravity, loosen ligaments, and increase strain on the hips. Many pregnant women experience hip pain at night during the second and third trimesters, especially when side sleeping becomes necessary.

How to Relieve Hip Pain When Sleeping

Improving night-time hip pain typically requires a combination of position adjustments, strengthening, and addressing inflammation. Below are practical strategies you can start immediately.

1. Adjust Your Sleeping Position

• Use a pillow between your knees to keep your pelvis aligned and reduce strain on the hip.
• Avoid sleeping on the painful side until symptoms improve.
• If you are a side sleeper, try placing a thin pillow under your waist for support.
• A mattress that is too soft may cause sinking, while a very firm mattress increases pressure — consider a supportive medium-firm mattress if possible.

2. Apply Heat or Ice

• Ice can help reduce redness, irritation, or warmth associated with bursitis or acute inflammation.
• Heat is beneficial for muscle stiffness or chronic tightness.

Apply for 10–15 minutes before bed to settle symptoms.

3. Gentle Stretching

Improving flexibility around the hip can help relieve compression and tension.

Useful stretches include:

• Hip flexor stretch
• Gluteal stretch
• Piriformis stretch
• Quadriceps stretch

Hold each stretch for 20–30 seconds without bouncing.

4. Strengthening Exercises

Targeted strengthening helps restore stability and reduce strain on the hip joint. This is particularly important for tendinopathy and bursitis.

Great exercises include:

• Side-lying leg lifts
• Clamshells
• Hip bridges
• Standing hip abduction
• Step-ups

Progress gradually to avoid overloading the tendon or joint.

5. Improve Daytime Movement Habits

Small changes throughout the day can reduce hip irritation at night:

• Avoid prolonged sitting
• Take short standing or walking breaks
• Adjust your desk ergonomics
• Avoid crossing your legs
• Warm-up before exercise and cooldown afterwards

6. Anti-Inflammatory Strategies

A healthcare professional may recommend short-term use of anti-inflammatory medication, if appropriate for your health situation. Anti-inflammatory creams may also provide targeted relief.

7. Physiotherapy

If hip pain persists beyond a week or two, a physiotherapist can assess joint mobility, strength patterns, and movement habits. Treatment may include manual therapy, exercise programming, dry needling, and education on lifestyle factors.

8. When to Seek Further Assessment

Seek professional help if you experience:

• Hip pain lasting longer than two weeks
• Pain severe enough to affect walking
• Difficulty weight-bearing
• Night pain that wakes you frequently
• A history of hip injury or fall

Early treatment can prevent worsening symptoms and long-term complications.

Frequently Asked Questions

1. Why is my hip pain worse at night?

Hip pain often intensifies at night due to prolonged positions, reduced movement, and increased sensitivity when pressure is placed on irritated structures such as tendons or bursae.

2. Should I avoid sleeping on my side if my hip hurts?

If lying on your side causes discomfort, avoid the painful side. Using a pillow between your knees can also help align the pelvis and reduce pressure.

3. Can a bad mattress cause hip pain?

Yes. A mattress that is too soft or too firm can place uneven pressure on the hips, especially for side sleepers. A supportive, medium-firm mattress usually works best.

4. Will hip pain go away on its own?

Some causes — such as mild muscle strain — may settle with rest and gentle care. However, persistent hip pain from bursitis, tendinopathy, or arthritis often requires targeted treatment.

5. Is walking good for hip pain?

In most cases, low-impact walking helps maintain mobility and reduce stiffness. However, if pain increases during or after walking, consult a physiotherapist.

6. When should I consider seeing a physiotherapist?

If pain interferes with sleep for more than one to two weeks, limits movement, or keeps returning, a physiotherapist can assess the underlying cause and provide tailored treatment.