6 Causes of Hip Pain at Night

Hip pain at night can make it more difficult to sleep, but the effects don't stop there. Twisting and turning to find a more comfortable position to sleep in combined with lack of sleep can contribute to health and quality of life issues that you experience during the day, too.

Hip pain can prevent you from exercising or being active, but it can also be a sign of potentially serious health conditions. It's important for your healthcare provider to identify the cause, so you can receive an accurate diagnosis and treatment plan.

This article presents six possible causes for hip pain at night, along with some ways to relieve the discomfort. It will also help you understand possible treatments and ways to prevent hip pain in the future.

Causes of Sleep Pain

Hip pain can emerge for various reasons. If a simple injury or a temporary condition like pregnancy is the cause, the pain usually resolves on its own.

But some people experience chronic pain in their hip joints from osteoarthritis, bursitis, or other conditions. In fact, around 20% of people over the age of 65 report chronic hip pain.

When your hip joints swell or become inflamed, the pain and stiffness can disrupt your sleep. Chronic pain can lead to symptoms of burning or aching, or the feeling of pins and needles (parasthesia).

Sleeping Position

Your sleep position may contribute to your hip pain. That's not uncommon for people who sleep on either their left or right sides. These sleeping positions can affect the body's alignment and place stress on joints.

A pillow or padding placed at the knees can help to lift the top leg. This helps to keep your hip and knee aligned, which may reduce the strain on your hip muscles and your hip joint.

Osteoarthritis

Osteoarthritis is a common condition that develops with normal use over time, as cartilage and bone degrade within and at the hip joints. Osteoarthritis is a progressive disorder, with occasional stiffness or pain at stage 2 and chronic pain, stiffness, and loss of mobility at stage 4. It's very common for sleep disruptions to affect people with stage 4 hip osteoarthritis.

Like osteoarthritis, rheumatoid arthritis is a chronic condition. However, RA doesn’t involve the aging or weathering of joint tissue. Instead, patients with RA have an autoimmune condition that attacks the tissue in their joints.

RA symptoms can progress over time, but many patients experience pain in their hips and groin. This pain can contribute to insomnia and other sleep issues.

Treatment for these long-term conditions is available but they cannot be completely reversed. A healthcare provider can help you manage your individual symptoms and cope with your hip pain.

Bursitis

Hip bursitis can cause similar symptoms to arthritis, but bursitis is a temporary condition. Patients with bursitis may feel stiffness or pain when they move, but not because the cartilage between their joints has degraded. Instead, the bursa becomes inflamed.

The bursa is a sac of fluid that cushions joints throughout the body, including at the hip. The inflammation near the outside of the hip can be quite painful. Bursitis is more common in sports enthusiasts, dancers, and other active people, as are stress fractures.

Two types of hip bursitis include:

• Trochanteric bursitis (pain at the side of the hip)
• Ischial bursitis (pain at the back of the hip)

Healthcare providers may diagnose greater trochanteric pain syndrome (GTPS), which affects the bursa, tendons, and muscles at the hip.

Physical therapy is commonly used to treat hip bursitis.

Pregnancy

Some of the changes to a pregnant person's body affect the hip, including range of motion and hip flexion and extension. Though temporary, these changes affect walking and mobility, and how other joints (like the knee) are aligned with the hips. They also affect sleep.

Tendonitis

Hip tendonitis typically occurs because of an overuse injury, leading to inflammation of the tendons attached to hip muscles that move the leg up and down. The tendonitis or tendon tear often occurs with another condition, such as bursitis, as part of a syndrome like GTPS.

Hip tendons also are implicated in snapping hip syndrome, which can cause a popping sound or sensation when the affected hip moves. Its most common cause is an injury to the iliotibial (IT) band at the outside of the hip joint.

Sciatic Piriformis Syndrome

Piriformis syndrome is thought to occur when the sciatic nerve is trapped or pinched by the piriformis muscle and tendon, found behind the hip joint at the buttocks. It can be caused by variations in anatomy unique to your body, or by muscle spasm, trauma, or an enlarged muscle.

The pain of piriformis syndrome may lead to sleep disruptions, which may improve with lifestyle changes like sleeping on your back or choosing a different mattress or pillows.

Managing Hip Pain at Night

There are steps you can take to try and relieve hip pain at night. They range from immediate actions, like taking an over-the-counter pain medication, to long-term interventions.

Quick Relief

You can try a hot or cold compress at your hip, or take some Tylenol (acetaminophen) or another other pain reliever for less severe episodes. Other measures you can try include:

• Putting a pillow between your knees when you lay on your side
• Putting a pillow under your knees if you lay on your back
• Stretching to relieve the hip tension
• Using a heating pad or hot water bottle
  

Long-Term Relief

Certain lifestyle changes may help alleviate or prevent hip pain. You can:

• Become more active. Yoga or pilates can keep you flexible. Moderate strength-building exercises can also help you avoid back, and hip injuries, and walking and other easy-to-moderate aerobic exercises are recommended. A physical therapist can show you the best exercises to minimize your pain.
• Try an anti-inflammatory diet. Foods with turmeric, lemon water, antioxidants, and omega-3 fatty acids may help reduce the inflammation in your hip joints.
• Take prescription medication. Be aware that some drugs (like steroid prednisone) can contribute to problems sleeping while others (like opioids) have dependency and addiction risks.

You also may consider an alternative medicine approach to complement other hip pain treatments, such as acupuncture or CBD supplement use.

Prevention

Certain factors that may contribute to hip pain at night can't be changed, such as age-related risk or a family history that makes a genetic autoimmune condition more likely to contribute to arthritis.

But there are things you can do to avoid hip pain. Be sure to:

• Maintain a healthy weight or lose excess pounds that create wear on your joints
• Avoid certain sports or tasks that contribute to overuse injury
• Manage underlying health conditions like diabetes or high cholesterol levels

You may be able to limit your hip pain at night by following good overall sleep hygiene practices, as well as taking steps to prevent hip injury or aggravation.

This means choosing the right mattress, creating the optimal sleep environment in terms of sound and temperature, and limiting screen time or other factors known to interfere with sleep.

When to See a Healthcare Provider

Your hip pain may be part of a disturbed sleep pattern that's causing a cycle of frustration, exhaustion, and joint aches.

If your pain lasts several days and/or prevents you from doing your normal tasks, then you may want to visit a healthcare provider for a diagnosis, especially if you can't bear weight on your hip or have trouble walking.

Your provider's assessment may include:

• Physical examination of your hip for signs of swelling or injury and to check range of motion
• Lab tests, to check for markers like elevated rates of certain proteins or antibodies that can signal an autoimmune disorder
• Imaging, such as an X-ray or magnetic resonance imaging (MRI) to identify joint damage or a fracture

Summary

Hip pain at night is disruptive and affects your quality of life. It may happen because of a simple stress injury that resolves quickly with rest and over-the-counter pain relief.

Hip pain also may be a sign of a more serious condition, including osteoarthritis or bursitis that's part of a broader syndrome affecting the hip joint.

While there are many causes for hip pain, your healthcare provider can help you with a diagnosis. It's likely that lifestyle changes, medication, and/or physical therapy can help you to manage hip pain at night, although other interventions may be needed.