If you are a side sleeper with aching hips, trying to get comfortable so you can fall asleep isn’t an easy task. Wincing and twinging before, during, and after sleep is both literally and figuratively a pain in the you-know-what — and not all solutions have the same effect. Untreated hip pain can start a vicious cycle of sleep deprivation and more aches due to decreased pain tolerance.
The cause of your hip pain can also influence which treatments bring the most effective relief. For example, general hip pain in adults over 60 — for whom 12 to 15% report experiencing hip pain — may be managed differently from sports-related hip pain in adults, where likelihood is 30 to 40%.
A 2019 study of 106 people with hip osteoarthritis suggests that sleep quality increasingly suffers when depression symptoms are also present. Researchers did note, however, that holistic and comprehensive care, including understanding of the condition, can help with overall treatment.
For immediate pain relief, try hot and cold compresses over the area. Heat can relax stiff joints while ice helps with inflammation and swelling. Over-the-counter non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, is also an option for relief.
For lifestyle remedies that may work overnight, as well as possible causes of hip pain, we spoke to experts. If you’ve these techniques do not improve your sleep, it may be time to seek help from your doctor.
Soothe sore muscles with self-care
Self-care practices to alleviate pain in your in your hip muscles, including the gluteal, lateral rotators and adductor muscles, can put both your mind and body in the right state for sleep. Harness the therapeutic power of heat by soaking in a warm bath one hour before bed or snuggling up next to a heating pad as you read before bed.
Jordan Duncan, DC, owner of Silverdale Sport & Spine, a clinic that specializes in difficult-to-treat musculoskeletal pain conditions also suggests giving your hips a gentle massage at night.
“The muscles surrounding the hips can accumulate stress and tension throughout the course of the day,” he says. “Releasing these muscles prior to bed, such as by using a foam roller, can go a long way in decreasing pain and making sleep more comfortable.”
No foam roller at home? A tennis ball also works. Stand with your back against a wall, and place the tennis ball between your hips, gently leaning into the ball and rotating your hips to give yourself an at-home massage using this technique.
Upgrade or modify your sleep position
If you’re a side sleeper, transitioning to your back can take pressure off your sore spots and offer needed relief. It’s also one of the easier options, if the cause of your pain isn’t a medical concern.
“The best sleeping position for people with hip pain is sleeping on the back with your hips and knees bent at 45 degrees, and a bolster beneath your knees,” says Lev Kalika, DC, owner of New York Dynamic Neuromuscular Rehabilitation & Physical Therapy. “This position decreases joint pressure and allows better healing due to optimum tissue tension and the most optimal exchange of joint fluids.”
With that said, changing sleep positions can be a hassle and sometimes even a sleep deterrent. If you need to sleep on your side, try to keep whichever hip is more painful on top, to avoid excess compression, and slip a pillow between the knees.
“The pillow between your knees takes tension and strain off of the soft tissues surrounding the hip, which can be stretched and irritated if the top knee is allowed to fall toward the other knee,” explains Duncan.
For back sleepers, a pillow under the knees or calves may also help ease pain. Feel free to also experiment with the pillow placement, like under the hips, too.
Take a note of your pillow or bolster in the morning. If it slips during the night, then it may not be doing the job. Try different shapes or consider an adjustable base. An adaptable frame can help take pressure off certain areas of the body and keep the spine in alignment by elevating the legs.
And if you’re a stomach sleeper, you might also want to consider flipping onto your back. While sleeping on your stomach might not directly contribute to hip pain, it can strain other areas of your body (such as your neck), compounding your sleep problems.
Consider upgrading your mattress
If you are opting for an adjustable base, do some math on the lifespan of your mattress too. An old, worn-out mattress that can’t provide pressure relief isn’t doing you any favors. In fact, it might be making it worse because without proper support, your spine won't be in alignment while you sleep.
Look for a mattress that’s firm and supportive, advises Pete Colagiuri, a physiotherapist who has created an injury diagnosis app.
“Although softer mattresses feel comfortable initially, they tend to cause more pressure on the hips as you relax and sink into the mattress, stretching the hip tendons,” he explains. This doesn’t mean you should gun for the firmest mattresses you can find, however.
Firmness refers to the top layers, meaning you can have a plush, softer top layer and a firm base and still get the right support. If you don’t like the firm mattress surface, look into mattress interiors. While memory foam, spring, and latex all feel different, you may find your answer in a hybrid of all materials.
Can’t spring for a new mattress right now? Consider investing in a firm foam mattress pad.
These toppers “can help distribute your weight, easing the stress on larger joints such as the hips and back,” says Brittany Ferri, Ph.D., an occupational therapist and founder of Simplicity of Health. Toppers may be a good option for people who change sleep positions throughout the night.
Stretch your hip muscles
Stretching out your hips might be the last thing you feel like doing when they hurt, but certain exercises might lead to lower pain and better sleep.
“There is a saying in the physical therapy world that ‘motion is lotion,’” says Duncan. “Movement is essential for people in pain, affecting both the joints and muscles as well as the nervous system.”
Duncan points out that moving the hips and stretching in pain-free directions can help promote positive change prior to sleep.
Specific exercise moves that can help loosen up painful hips include:
- Hip flexor stretch
- Reclined half pigeon
- Bridge pose
- Illiotibial band (ITB) stretch
- Piriformis stretch
Some stretches might not be safe for certain conditions that cause hip pain, so be sure to talk with a healthcare professional, such as a physical therapist, before doing any hip exercises.
Practice good posture before bed
One of the worst things you can do is slouch on the couch and watch TV in the hours before bed.
According to Duncan, poor posture can encourage the discs of your spine to draw in fluid, potentially worsening hip pain.
“Spinal posture prior to bed is very important,” he explains. “If you sit and watch television prior to sleep, choosing a chair that promotes optimal spinal posture will put the back in a better state prior to sleep, rendering spinal discs less likely to become symptomatic.”
In fact, the TV itself might also be contributing to your sleep problems.
Blue light from screens can make it difficult for your body to produce the natural melatonin you need to wind down. Relaxation and mindfulness are shown to help some people with pain relief, with most research focusing on back pain. In your last waking hour of the day, turn off your screens and consider reading a book, instead.
Long-term pain management for hip pain
In addition to soothing and stretching your hip muscles, practicing good posture, and considering a mattress upgrade, there are other tips that might help you sleep better with hip pain, including:
- Medications. Prescription medications, as well as over-the-counter drugs, can reduce pain and help with sleep troubles. Talk with your doctor to see if a medication is right for you.
- Practicing sleep hygiene. This practice includes making behavioral and environmental changes that promote better sleep. Check out these 10 helpful sleep hygiene tips.
- Relaxation techniques. Meditation, yoga, breathing exercises, and other calming activities can be helpful for some seeking to break free from the cycle of chronic pain and insomnia.
When it comes to hip pain at night, remember to take a holistic approach. Look beyond the degrees of pain and focus on the bigger picture of improvement and progress. If you aren’t noticing improvement and the pain is taking a toll on your sleep quality, then there may be a more serious cause.
Causes of hip pain at night
According to a 2010 study of over 3,000 participants, one in four people will develop serious hip pain from osteoarthritis in their lifetime.
However, age is not the only factor for developing pain. You may have hip pain if you are a younger adults who play sports. Medical conditions such as bursitis, osteoarthritis, tendonitis, and snapping hip syndrome can also cause pains that feel like a dull ache, tingling numbness, and worsen with movement. Hip injury and fractures, which affect older women more than men, may also result in pain, and subsequently surgery — which, during healing, can also affect sleep.
Sometimes hip pain is a result of pain from other areas of the body. Pregnancy is one example where body changes and pressure can cause hip pain. Endometriosis is another condition where pelvic pain feels like hip pain. In these cases, addressing the root cause may decrease overall pain.
Other common causes of hip pain include:
- loss of blood supply to hip bones (osteonecrosis)
- abnormal growth
Whenever the pain becomes intolerable or starts to seriously affect your mental health, talk to your doctor. Signs of swelling, tenderness, and limited mobility are all good reasons to get a professional check-up. You may need prescription medication, surgery, or recommendations for a physical therapist to help with massages and proper stretching techniques.
Don’t forget to make room for your own methods of relaxation too. Caring for yourself produces inner peace, which can go a long way when it comes to being truly relaxed before bedtime.