The short answer: if your hip only hurts at night, the Arthritis Foundation says your sleep position or mattress is the likely cause. Pain that’s also there in the day may be bursitis, osteoarthritis or a tendon problem. Try sleeping on your back, or with a pillow between your knees. See your doctor if it’s affecting your sleep.
You lie down tired, and the moment your hip touches the mattress it starts. You roll over. Now the other side aches. By 3am you’re doing the maths on how much sleep is left.
There’s usually a reason, and often something you can change tonight.
Why do hips hurt more at night?
Spire Healthcare lists several reasons: overuse during the day, the position you sleep in, moving in bed and joints swelling at night. The Arthritis Foundation adds that with many conditions the pain is constant, and you’re simply more aware of it at night.
If it only happens at night, look at your bed first. Side sleepers are especially prone, because of the pressure on the hip joint. The top hip can hurt too, if it strains forward.
What causes hip pain at night?
These are clues, not a diagnosis. The NHS advises against working out the cause yourself, because many problems feel alike.
| What you notice | Possible cause |
|---|---|
| Outer hip and upper thigh, worse when you lie on that side | Bursitis |
| Groin, thigh or buttock, worse in the morning or after sitting | Osteoarthritis |
| Pain linked to overuse, tendons at the side of the hip or buttock | Gluteal tendinopathy |
| Numbness, pain and tingling from your lower back down your leg | Sciatic-piriformis syndrome |
| Pain that starts in your lower back and spreads to your hip | Referred pain from your back |
| Stiffness after not moving, such as when you wake up | Possibly rheumatoid arthritis |
For more on what each location means, read what hip pain means, by where it hurts.
What is the best sleeping position for hip pain?
- On your back. The Arthritis Foundation calls this the best solution, because it takes pressure off the hip.
- On your other side. The NHS suggests your back or your other side, with a pillow between your knees.
- Pillow slightly behind your back. If you can’t stop rolling, the Arthritis Foundation says this can relieve pressure and keep your hips aligned.
- Check your mattress. Spire says one that’s too soft or too hard can cause pressure points. A topper or a more supportive mattress might help.
What can you try tonight?
- Use a cold or hot pack. The Arthritis Foundation says both can help bursitis pain that’s worse at night. The NHS suggests a wrapped ice pack for up to 20 minutes, every 2 to 3 hours.
- Have a warm bath, then stretch, which the Arthritis Foundation suggests for hip flexor strains.
- Ask about pain relief gel. For osteoarthritis, the Arthritis Foundation says to try a topical anti-inflammatory right before bed. Check with a pharmacist if you take other medicines.
What can you change during the day?
Nights often improve when days do. The NHS says it’s best to keep moving if you can, without overdoing it. If overuse is the cause, the Arthritis Foundation suggests cutting back on intense exercise for a week or so. In most other cases, it says exercise or physical therapy matters, to strengthen the muscles around your hip.
Be patient with tendons. The Arthritis Foundation says tendon injuries can take three to six months to heal.
When should you see a doctor about hip pain at night?
See your doctor if:
- Hip pain is stopping your normal activities or affecting your sleep
- It’s getting worse or keeps coming back
- It hasn’t improved after 2 weeks of treating it at home
- Your hip is stiff for more than 30 minutes after waking up
Get an urgent appointment if:
- Severe pain started suddenly with no fall or injury
- Your hip is swollen and feels hot, or the skin has changed color
- You have hip pain, feel unwell and have a high temperature
Call emergency services or go to the emergency department if:
- You have severe hip pain after a fall or injury
- You can’t walk or put weight on your leg
- You have tingling or loss of feeling in your hip or leg after an injury
Don’t drive yourself. Ask someone to take you, or call an ambulance.
Your next step
Tonight, put a pillow between your knees and stay off the sore side. Give it a few nights. If your pain starts in your lower back, a daily routine may help more than a new pillow.
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Quick questions
Why do my hips ache at night?
If it happens only at night, the Arthritis Foundation says your sleep position or mattress is the likely cause. Pain that continues in the day may come from bursitis, osteoarthritis or a tendon problem.
What is the best sleeping position for hip pain?
The Arthritis Foundation says on your back. If you sleep on your side, stay off the sore hip and put a pillow between your knees.
Should I sleep on the side that hurts?
Try not to. The NHS suggests sleeping on your back or your other side. It lists pain that feels worse when lying on your side as a possible sign of bursitis.
Can a mattress cause hip pain?
It can. Spire Healthcare says a mattress that is too soft or too hard can cause pressure points. A topper or a more supportive mattress might help.
When should I worry about hip pain at night?
See your doctor if it’s affecting your sleep, hasn’t improved after 2 weeks, or your hip is stiff for more than 30 minutes after waking. Get urgent help for a hot, swollen hip, a high temperature or severe pain after a fall.
This article is general information, not medical advice. If you’re worried about your pain, please talk to your doctor.
Sources
- NHS. Hip pain in adults.
- Arthritis Foundation. Hip Pain at Night?, 2022.
- Spire Healthcare. Hip pain at night (sleeping): causes and symptoms, 2022.