Hip pain at night

What is hip pain?

Hip pain is any type of pain or discomfort in the hip joint, the ball and socket joint that connects your pelvis to the top of your thighbone (femur). Hip pain is a common problem that affects around 1 in 10 people and becomes more common as we age. It is more common in women and people between the ages of 40 and 60.

Hip pain is often worse at night and may have a variety of causes, including your sleeping position or an underlying medical condition such as osteoarthritis.

Hip pain at night can often be treated at home, but in some cases, may be a sign of something serious that needs medical treatment.

In this article, we'll look at some common causes of hip pain at night, how you can treat your hip pain at home, some things you can do to prevent hip pain at night, and when to see a doctor.

What is causing my hip pain at night?

The most common causes of hip pain at night are injury and overuse, but hip pain at night may also be caused by your sleeping position, the wrong mattress, or an underlying injury or medical condition.

Let's take a look at some things that could be causing your hip pain at night.

Sleeping position

Your sleeping position is a common cause of hip pain at night. This is especially common among side sleepers, as sleeping on your side can affect your alignment (the correct position of your spine and hips) and increase pressure on your hips.

Sleeping on a mattress that's too soft or too firm could also increase stress on your hips, leading to hip pain at night. If you wake up with hip pain during the night, your sleeping position or mattress may be to blame.

Osteoarthritis

Osteoarthritis is a common condition, especially in people over 50 years of age. It occurs when wear and tear on the joints causes the protective cartilage at the ends of bones to break down. This results in the bones rubbing together, causing inflammation, pain, and stiffness. Arthritis can affect any joint, but is most common in the hands, knees, hips, and feet.

Less commonly, other types of arthritis, such as rheumatoid arthritis, septic arthritis and psoriatic arthritis, can cause hip pain.

Symptoms of hip osteoarthritis may include:

• Pain in your groin, buttocks, thigh, or knee
• Hip pain at night that stops you from sleeping
• Pain may be worse in the morning, during wet weather, or after sitting for a long time
• Stiffness
• A grinding sound when moving your hip
• Difficulty moving your hip joint

Tendonitis

Tendonitis is inflammation of the tendons, which are bands of connective tissue that attach muscles to bones. Hip tendonitis is inflammation of the tendons of the hip flexor muscles, which we use to lift our legs up, for example, when climbing stairs, stepping, or jumping.

Symptoms of tendonitis include:

• Pain, especially after sitting for a long time
• Lower back pain
• Altered posture (the pelvis may be pushed forward, and you may have an exaggerated curve in your lower back)
• Tenderness at the front of the hip
• Tight hip flexors
• Walking with shorter steps

Bursitis

Bursitis is inflammation of the bursae, fluid-filled sacs that cushion and reduce friction in your joints. There are 2 major bursae in each hip, the trochanteric bursa (at the side of the hip) and the ischial bursa (at the back of the hip). Bursitis can occur in either of the bursa and may be due to overuse, injury, hip surgery, or rheumatoid arthritis.

Symptoms of hip bursitis include:

• Pain and tenderness along the outside of your hip and upper thigh
• Pain after sitting for a long time
• Pain when walking, climbing stairs or squatting
• Pain that gets worse at night, or when you lie on the affected side
• Pain may start as a sharp pain and change to a dull ache over time

Greater trochanteric pain syndrome (GTPS)

GTPS is a common condition that causes pain in the outside of the hip and thigh. It is also known as lateral hip pain or trochanteric bursitis. GTPS occurs when the soft tissues, such as the tendons and bursae of the hip, become irritated and inflamed. The condition can affect people of any age, but is most common in women aged between 40 and 60.

Common causes of GTPS include increased pressure on the hips due to prolonged pressure or an increase in activity, injury, hormonal changes, being overweight and a sedentary lifestyle.

Symptoms of greater trochanteric pain syndrome include:

• Pain in the hips, buttocks, or thighs - this may be worse when lying on your side, standing, walking, or running for long periods, sitting with your legs crossed, lifting your legs, and climbing stairs
• Tenderness when you touch the affected area

Sciatic-piriformis syndrome

Sciatic-piriformis syndrome is an uncommon condition that occurs when the piriformis muscle (a muscle that runs from your lower spine to the top of your thigh) presses on the sciatic nerve (the main nerve to your legs). It is caused by inflammation of the piriformis muscle or surrounding tissues, muscle spasm or scarring of the muscle.

Symptoms of sciatic-piriformis syndrome occur in the hip, buttocks and upper thigh and may include:

• Numbness and tingling
• Aching
• Shooting pain
• Burning

Pregnancy

Weight gain during pregnancy puts a lot of stress on the ligaments in the hips, especially during the last trimester. Hormones produced during pregnancy also relax the joints and make them more prone to injury. This makes hip pain very common in pregnancy.

How can I relieve my hip pain at night?

Hip pain at night is a common problem that can stop us from getting a good night's sleep, and leave us feeling tired and irritable the next day. Fortunately, it's not normally serious and there are several things you can do yourself to help relieve your hip pain.

Some things you can do to help with hip pain at night include:

• Sleep on your back or unaffected side
• Place a cushion or pillow underneath your knees when sleeping on your back, or between your legs when sleeping on your side
• Invest in a good mattress that properly supports your body while you sleep
• Practise gentle stretching exercises to increase flexibility, reduce tension and loosen your hips
• Take over-the-counter painkillers like paracetamol or non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen, before you go to bed to reduce pain and inflammation. Always read the patient information leaflet carefully before taking any medication and ask your doctor or pharmacist if you have any questions or concerns
• Apply heat or ice packs to the affected area to help with pain and swelling
• Take a warm bath or shower before bed to relax and soothe your muscles

When should I see a doctor?

In some cases, hip pain at night may be a symptom of an underlying health problem and may need medical treatment.

Make an appointment to see a doctor if:

• Your hip pain at night is severe, is getting worse, or isn't getting better after around a week of home treatment
• You have difficulty moving your leg or hip
• You have difficulty putting weight on the affected leg
• You have difficulty performing normal daily activities because of pain
• Your hip pain has spread to other areas such as your pelvis, knees, or lower back
• Your hip pain isn't helped by over-the-counter painkillers or NSAIDs
• Your hip is swollen

You have signs of infection such as:

• Heat, redness, pain or swelling around the affected area
• A wound that isn't healing or has a strong smelling discharge
• A fever (a temperature above 38C)
• Feeling generally unwell

How is hip pain treated?

How hip pain is treated depends on what is causing the pain. Your doctor will ask you some questions about your symptoms, general health and medical history, and examine your hip. They may also order tests to help diagnose the cause of your hip pain, such as an X-ray, CT scan, MRI, or blood tests.

Treatment for hip pain may include:

• RICE therapy
• Non-steroidal anti-inflammatory drugs (NSAIDs)
• Steroid injections
• Physiotherapy
• Hip surgery

Preventing hip pain

Sometimes hip pain can't be prevented, but there are a few things you can do to reduce your risk of developing hip pain, or to stop it from getting worse.

Some things you can do to help prevent hip pain at night include:

• Avoid activities that put pressure on your hip or make your hip pain worse
• Wear comfortable shoes with a low heel and always wear the correct shoes when exercising or taking part in sports
• Warm up and cool down properly before and after exercise
• Avoid sitting with your legs crossed for too long
• Get up and move around once an hour to avoid sitting for too long
• Lose weight or maintain a healthy weight
• Avoid standing for too long with all your weight on one hip
• Engage in low-impact activities that don't put pressure on your hips, such as swimming or yoga
• Practise good sleep hygiene