The good news is that there are practical steps you can take to ease hip pain at night. Below, our orthopaedic specialists share helpful tips to reduce discomfort while sleeping and improve your overall sleep quality.

Common Causes of Hip Pain That Worsen at Night

Hip pain can stem from a variety of conditions, many of which tend to feel more noticeable when you lie down. Understanding the potential cause of your discomfort can help guide the right approach to nighttime relief.

• Arthritis is one of the most common reasons people experience hip pain at night. Osteoarthritis causes cartilage to wear down over time, leading to joint stiffness and inflammation that can become more pronounced after a day of activity. Inflammatory forms of arthritis may also cause aching or throbbing pain when the joint is at rest.
• Hip bursitis occurs when the bursae (small, fluid-filled sacs that cushion the hip joint) become inflamed. This condition often causes sharp or burning pain on the outside of the hip, especially when lying on the affected side.
• Tendonitis and muscle strain can also flare up at night. Overuse, repetitive movements, or sudden increases in activity may irritate the tendons or surrounding muscles, making it uncomfortable to stay in one position for long periods.
• Injuries, such as labral tears, fractures, or soft tissue damage, may cause lingering pain that worsens when pressure is placed on the hip or when the joint stiffens during rest. Even old injuries can resurface as nighttime discomfort.

The Best Sleeping Positions for Hip Pain

Your sleeping position can make a significant difference in how your hips feel overnight. In fact, small adjustments in posture and support can help reduce pressure on the joint and keep your hips properly aligned.

Sleep on Your Back

Sleeping on your back is often considered the best option for hip pain. This position evenly distributes body weight and minimizes stress on the hip joints. Placing a pillow under your knees can also help maintain the natural curve of your lower back and reduce tension through the hips.

If You Sleep on Your Side, Use the Right Support

Side sleeping can still be comfortable with the right support. If you sleep on your side, try lying on the pain-free side and placing a firm pillow between your knees. This keeps your hips aligned and prevents the top leg from pulling the painful hip forward or downward.

Don’t Sleep on Your Bad Hip

Avoid sleeping on the painful hip whenever possible, as direct pressure can worsen inflammation and discomfort. If you tend to roll during sleep, use pillows behind your back or between your legs to keep yourself in a more supportive position.

Don’t Sleep on Your Stomach

Stomach sleeping is generally not recommended for hip pain, as it can place the hips and lower back in an unnatural position and increase strain on the joints.

Consider a Supportive Mattress and the Proper Pillow

The right mattress and pillow play a major role in how your hips feel while you sleep. In fact, a surface that’s too soft may allow your hips to sink too deeply, while one that’s too firm may create pressure points.

A medium-firm mattress is often ideal for people with hip pain, as it provides enough support to keep the spine and hips aligned while still offering some cushioning for comfort. If replacing your mattress isn’t an option, a high-quality mattress topper can add extra support or softness where needed.

When it comes to pillows, focus on maintaining proper alignment. A knee pillow or body pillow can be especially helpful for side sleepers, while a small pillow under the knees works well for back sleepers. The goal is to reduce stress on the hip joint by keeping your body in a neutral position throughout the night.

Simple Stretches and Habits to Ease Hip Pain Before Bed

Establishing a relaxing bedtime routine can help reduce hip pain while you’re sleeping. Consider adding one or more of these practices to your nightly ritual:

• Knee-to-Chest Stretch: While lying on your back, gently pull one knee toward your chest until you feel a stretch in the glute and hip. Hold for 30 seconds and switch. This helps reset the joint.
• Figure-Four Stretch: Cross your ankle over the opposite knee. Gently push down on the crossed knee or pull the bottom leg toward you. This targets the deep hip rotators.
• Heat Therapy: Applying a heating pad to the hip for 15-20 minutes before bed can increase blood flow and relax tight muscles, making it easier to fall asleep.
• Mindful Movement: Avoid high-impact exercise right before bed, which can increase inflammation. Stick to gentle yoga or stretching.

When to Seek Professional Care for Hip Pain

While lifestyle adjustments and sleep modifications can make a meaningful difference, persistent hip pain during sleep should not be ignored. If discomfort continues to interfere with sleep, daily activities, or mobility, it may be time to seek professional care.

Get Relief From Your Hip Pain

For individuals in the Greater Philadelphia area, the hip specialists at Premier Orthopaedics are here to help. Our experienced team can accurately diagnose the underlying cause of hip pain and develop a personalized treatment plan tailored to your needs. Depending on your condition, this may include non-surgical options such as physical therapy, pain management, or lifestyle modifications, as well as surgical solutions when appropriate.

You don’t have to live with ongoing hip pain or sleepless nights. Taking the next step toward proper care can help restore comfort, improve mobility, and allow you to get the restful sleep your body needs.

Schedule an appointment with Premier Orthopaedics today to start your path toward relief and better sleep.

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To understand your hip pain, it’s important to know how your hip works. The hip is a stable ball-and-socket joint that consists of the femoral head, or ball at the top of the femur, that fits into the socket or cavity in the pelvis. Ligaments connect the ball to the socket and stabilize the bones. A problem with any of these areas could cause you significant pain.

Read on to learn more about the five common causes of hip pain.

Osteoarthritis

Osteoarthritis is a degenerative joint disease that causes the cartilage in your joints to break down. The layer of cartilage is meant to cushion your joints and provide padding, but when it wears down, the ends of the bones rub against one another and cause pain.

While there’s no cure for osteoarthritis, there are non-operative treatment methods that can reduce the pain you experience.

Rheumatoid Arthritis

Rheumatoid arthritis occurs when the lining of the joint called the synovium becomes inflamed. When inflammation occurs, the synovium thickens and releases chemicals that damage the cartilage and bone. It also causes pain and swelling, which limits motion.

Fracture

A hip fracture can occur in the upper portion of your thigh bone, or femur. This serious injury often results from a fall and is painful.

There are many factors that can increase your chance of a hip fracture, such as age, disease, and being a woman. A woman is two to three times more likely to suffer a hip fracture than a man. After you’ve reached the age of 50, your chances increase and double every five years.

Hip fracture surgery is done to repair a break in the upper part of the thigh bone.

Osteoporosis

Osteoporosis causes bones to become progressively weaker, which increases the risk of a fracture. This can occur as part of the aging process and is typically more common in women. If you’re dealing with osteoporosis, your risk of experiencing a fracture in a fall greatly increases.

Osteoporisis can be treated with lifestyle changes, medication, and walking aids. In some cases, patients can benefit from hip replacement surgery.

Sprain

A hip strain occurs when one of the muscles supporting the hip joint stretches beyond its limit or tears. The pain you’ll experience will depend on the severity of the strain, which can range from mild to moderate to severe.

If you’re experiencing pain in your hip, upper thigh, or groin area, you could be dealing with any of these common injuries or conditions. While not everything is curable, you can treat your hip pain. Visit your orthopaedic physician to get evaluated and receive treatment.

Premier Orthopaedics is dedicated to providing quality care to all patients. If you’re dealing with pain in your hip and are considering surgery, click here to download our eBook, Your How-To Guide to Choosing an Orthopaedic Surgeon.

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Athletes can also greatly benefit from hip strengthening exercises. When your hips are weak, it causes instability in your knees and your ankles when you’re running. This can lead to many injuries, and the most common injuries that result from weak hips include illiotibial band syndrome, patellofemoral pain syndrome, or other injuries such as tendinopathy, shin splints, and plantar fasciitis.

The following muscles play important roles in hip movement: gluteus medius, gluteus maximus, and tensor fascia lata (TFL). The gluteus medius is the main abductor and external rotator of the hip, while the gluteus maximus extends the hip and assists with abduction and external rotation. The TFL is an abductor and can help with internal rotation. Hip strengthening exercises will focus on working these muscles.

Learn more about hip exercises that will strengthen your hips, making your body stronger and more stable.

Straight Leg Raise

Lay on your back with one leg straight and one leg bent, then slowly lift your leg straight to a 45 degree angle, keeping your knee and toes facing the ceiling.

Hold for three seconds and repeat 10 times.

Bridging

Lie on your back with your feet flat on the floor hip-width apart. Slowly lift your gluteus maximus by pushing through your feet so your knees, hips, and shoulders are in a straight line. Be careful not to arch your back, as this will decrease the effectiveness of the workout. Tighten your gluteals as you hold this position for three seconds and repeat 10 times.

Hip Flexion

Stand at a bench or table for balance. Slowly lift your knee as high as it goes while keeping your back straight and tightening the muscles in the front of your hips. Hold for three seconds and repeat 10 times.

Lying Hip Extension

Start by lying flat on your stomach. Slowly lift your leg while keeping your knee straight and tightening your gluteals. Hold for three seconds and repeat 10 times.

Standing Hip Abduction

Stand at a bench or table for balance. Keeping your back and knee straight and your foot facing forward, slowly lift your leg to the side while tightening the muscles at the side of your thigh. Hold for three seconds and repeat 10 times.

If you perform these exercises daily or three to five times per day, you’ll find that the targeted muscles will get stronger and your legs will feel more stable. If you begin to experience pain at any point during a workout, stop exercising. You don’t want to further injure yourself.

Premier Orthopaedics is dedicated to providing quality care to patients and helping them get back to their daily lives. If you’re considering surgery for your hip pain, download our e-book, Your How-To Guide to Choosing an Orthopaedic Surgeon.

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