You settle into bed, roll onto your favourite side and within a few minutes your hip starts to ache.
You change position. It settles. Then, sometime later, you roll back onto that side and the discomfort wakes you again.
Hip pain when sleeping on your side can be particularly frustrating because it interferes with something your body really needs: a good night’s sleep. And while it is tempting to assume there must be something wrong inside the hip joint, pain at night can have several possible causes.
Often, the position you sleep in is only part of the picture.
Why does my hip hurt when I sleep on my side?
If the discomfort is mainly around the outside of your hip, one possible explanation is irritation of the muscles, tendons or other soft tissues around the bony prominence at the side of the hip.
Healthcare professionals sometimes use the term greater trochanteric pain syndrome (GTPS) to describe pain in this area.
The tendons of your gluteal muscles attach around the outside of your hip. Like other tendons in the body, they can become sensitive when the demands placed upon them change.
When you lie directly on a sensitive hip, your body weight can compress these tissues. Even lying on the opposite side can sometimes be uncomfortable if your top leg drops forwards and inwards, placing additional compression through the area.
This is why you may feel reasonably comfortable during parts of the day but struggle once you get into bed.
It isn’t always just about your sleeping position
If side sleeping suddenly becomes uncomfortable, it is worth thinking about what has changed recently.
Perhaps you have:
- started walking further than usual
- increased your running or exercise
- returned to sport after a break
- spent more time climbing stairs
- changed your usual activity levels
- had a knock or fall onto your hip
Changes in physical activity can alter the load placed through the muscles and tendons around your hip. Strength and control around the hip can also influence how those tissues cope with everyday movement.
That does not necessarily mean you need to stop moving altogether. In many cases, managing the activities that aggravate the area while gradually building strength can be more useful than prolonged rest.
And importantly, not every painful hip is GTPS. Hip pain has a number of possible causes, including injuries and problems affecting the joint itself, so persistent symptoms are worth having assessed rather than trying to diagnose them yourself.
What can I do about hip pain when sleeping on my side?
A few simple changes may make bedtime more comfortable.
Try a pillow between your knees
If you sleep on your non-painful side, place a pillow between your knees and thighs.
This can help prevent your upper leg from dropping across your body and may reduce compression around the outside of the hip.
Try sleeping on your back
If side sleeping is particularly uncomfortable, sleeping on your back may temporarily reduce pressure on the area.
You could experiment with a pillow underneath your knees and calves to see whether this feels more comfortable.
Notice what happens during the day
Night-time pain does not necessarily begin at night.
Think about whether your hip is also uncomfortable when climbing stairs, walking longer distances or standing with your weight pushed into one hip.
Sometimes changing a few of these habits can reduce the amount of irritation building up throughout the day.
Avoid repeatedly testing the painful position
When something hurts, it is surprisingly tempting to keep checking whether it still hurts.
If lying directly on that hip reliably causes discomfort, give it a break for a while rather than repeatedly putting pressure on the area.
Keep moving, but adjust the load
Complete rest is not necessarily the answer.
If a recent increase in running, walking or another activity seems to coincide with your symptoms, you may need to temporarily adjust how much you are doing and then gradually build up again.
The right approach will depend on what is causing your pain, which is where an individual assessment can be useful.
How physiotherapy may help with hip pain
At Luck’s Yard Clinic, our musculoskeletal physiotherapy service treats joint pain, hip bursitis and gluteal tendinopathy, among other joint and soft tissue problems.
A physiotherapist can assess your hip movement, strength and the activities that trigger your symptoms.
Treatment will depend on what they find, but may include advice about managing aggravating activities and a progressive exercise programme designed to improve strength and your ability to tolerate everyday loads.
For some types of pain around the outside of the hip, gradual strengthening can be an important part of management.
Could chiropractic care help?
Hip discomfort does not always occur in isolation.
Your chiropractor can assess the way your hip and surrounding joints and muscles are moving and consider whether restrictions or mechanical problems elsewhere may be contributing to your symptoms.
Luck’s Yard Clinic’s chiropractic team assesses and treats musculoskeletal problems throughout the body, including hip pain and other joint problems.
As with physiotherapy, treatment should be based on your individual assessment rather than assuming that every painful hip has the same cause.
When should I get hip pain checked?
If your hip pain is regularly disturbing your sleep, keeps returning, is getting worse or has not improved after around two weeks of self-care, seek medical advice.
Seek urgent medical advice if you develop severe hip pain suddenly without an injury, or your hip becomes hot or swollen, the skin changes colour, or you feel generally unwell or feverish.
After a significant fall or injury, severe pain, being unable to walk or put weight through the leg, or tingling or loss of feeling following an injury require urgent assessment.
Still changing position all night because of your hip?
You shouldn’t have to spend every night trying to find the one position that doesn’t hurt.
If hip pain when sleeping on your side is becoming a regular problem, an assessment can help establish what may be contributing and what you can do about it.
The physiotherapy and chiropractic teams at Luck’s Yard Clinic in Milford can assess musculoskeletal hip pain and advise you on appropriate next steps.
Sources
- NHS: Hip pain in adults
- Dynamic Health NHS: Greater Trochanteric Pain Syndrome
- BNSSG NHS My Joint Health Hub: Greater Trochanteric Pain Syndrome
- Kingston and Richmond NHS Foundation Trust: Greater Trochanteric Pain Syndrome
- Luck’s Yard Clinic: Musculoskeletal Physiotherapy & Sports Rehab
- Luck’s Yard Clinic: Chiropractic
