Hip pain can disrupt a good night’s sleep, leaving you tossing and turning. More than a third of adults report hip, knee, or foot pain interfering with their sleep. Understanding the causes of nighttime hip pain can help you find relief and get a better night’s rest.
Is Your Sleeping Position the Problem?
If your hip pain only occurs at night, your sleep position or mattress might be the culprit. Side sleeping often puts pressure on the hip joint, leading to discomfort. Even the opposite hip can hurt if it strains forward. Sleeping on your back can alleviate this pressure. If changing positions is difficult, try placing a pillow between your knees or slightly behind your back to maintain hip alignment. A mattress topper or a more supportive mattress may also provide relief.
Common Causes of Nighttime Hip Pain
Numerous conditions and injuries can cause persistent hip pain, often exacerbated at night. Here are some common culprits:
1. Osteoarthritis
Osteoarthritis (OA), the most prevalent form of arthritis, can cause pain in the groin, thigh, or buttocks. Pain is typically worse in the morning or after prolonged sitting. While associated with aging, OA can affect adults of any age. Physical activity, acupuncture, and massage can help manage pain and improve mobility. Topical NSAIDs are often recommended as a first-line treatment. Apply before bed for potential relief. Oral NSAIDs should be used cautiously, especially by those over 65, due to increased risks of cardiovascular and gastrointestinal issues.
2. Bursitis
Bursae, small fluid-filled sacs that reduce friction between tissues, can become inflamed, causing bursitis. Trochanteric bursitis, affecting the bursa on the outer hip, is more common than iliopsoas bursitis, which affects the inner hip. Causes include overuse from activities like running or cycling, rheumatoid arthritis, hip injuries, and hip surgery.
For overuse injuries, rest and cold packs are recommended initially. In other cases, exercise and physical therapy are crucial for strengthening surrounding muscles. Hot packs can provide long-term relief. Use NSAIDs sparingly due to potential side effects.
3. Gluteal Tendinopathy
Gluteal tendinopathy involves damage to the tendons connecting the glutes to the hip bone. Overuse, repetitive stress, and certain medications can contribute to this condition. Eccentric exercises, focusing on the slowing down portion of a movement (like slowly lowering down from a glute bridge), are now recommended over rest and corticosteroids. Stretching, sleeping with a pillow between your knees, applying heat, and weight loss can also help. Recovery can take several months. Platelet-rich plasma injections or tenotomy may be considered for persistent pain.
4. Hip Flexor Strain
A hip flexor strain involves injury to the muscles connecting the thigh bone to the lower back, hips, and groin. Overuse or overstretching can cause pain, swelling, weakness, and limited mobility. Icing, elevation, and modifying exercise routines are recommended initially. Physical therapy can help strengthen and stabilize the hip flexors. Maintaining hip flexibility with targeted exercises can prevent these injuries. A warm bath and stretching before bed may improve sleep.
When to Seek Medical Advice
While many hip issues resolve on their own, persistent or severe pain warrants medical attention. Home remedies like warm baths, massage, hot/cold packs, and proper sleep positioning can provide temporary relief. Stretching and low-impact exercise are beneficial for long-term healing. Consult your doctor if your pain doesn’t improve, interferes with sleep, or is accompanied by persistent redness and swelling.
