Top tips for relieving hip pain while sleeping - learn how
01 augustus 2020
Hip pain,Information,Pain relief,Self-help
A little sleep for hip pain relief can make a big difference to your well-being. Many people lie awake for hours every night and cannot sleep as a direct result of their pelvic or hip pain. Decreased sleep can have many negative consequences on your life. This can directly relate to your hip pain and your healing abilities, but also to all facets of your life and coping with everyday life and your overall mental health.
In this blog, we'll first give you our top 3 strategies for finding relief from hip pain, and then you'll find plenty more helpful information to help you understand your pain and get a good night's sleep. These are the topics we will cover:
1. How can you reduce your hip pain when you sleep?
Here are a few strategies you can try to relieve hip pain while sleeping. Medication may also be required. Therefore, always discuss this with your doctor, general practitioner or specialist.
Hip Pain at Night Lying on Side – Hip Pain Relief Sleep Strategy 1
If you are a side sleeper, try sleeping with a pillow between your knees and ankles.
Lying with your top leg on top of your bottom leg can create a greater angle at which the top leg falls over your body. This can affect the pain coming from your hip joint, for example in conditions such as FAI syndrome, hip dysplasia and hip osteoarthritis.
If you are a side sleeper, try sleeping with a pillow between your knees and ankles.
Lying with your top leg on top of your bottom leg can create a greater angle at which the top leg falls over your body. This can affect the pain coming from your hip joint, for example in conditions such as FAI syndrome, hip dysplasia and hip osteoarthritis.
This position can also affect the soft tissue structures (muscles, tendons, and bursae) around the hip and pelvis, as in conditions such as gluteal tendinopathy or greater trochanteric pain syndrome.
Nerve-related conditions can also worsen, such as with hip-related sciatica.
Spreading the upper and lower legs slightly apart can help position the upper leg in a way that takes the strain and tension off these soft tissues, reducing overall pain.
Try sleeping with a pillow between your knees and ankles. Experiment with different pillow thicknesses...it's much easier to use just one appropriately sized pillow at night instead of two!!!
Hip Pain at Night While Lying on Your Back – Hip Pain Relief Sleep Strategy 2
If you sleep on your back, try sleeping with a pillow under your knees. This can reduce tension in the lower back and buttock area and the front of the hip. This in turn can help reduce pain associated with the front and back of the hip and pelvis, for example in conditions related to the hip joint, labrum, soft tissue structures (such as the hip flexors) and nerve structures (also called the lower back or from local nerves around the hip or pelvis)
Hip pain Sleep strategy 3 – use a mattress topper
Use a mattress topper – if you have difficulty lying on your side because the hip you are lying on becomes painful from the pressure you put on it, then something softer over the mattress may be an advantage. In conditions such as gluteal tendinopathy or greater trochanteric pain syndrome, it is ideal to avoid side-lying position. If this is not possible, a mattress pad can help reduce pain from compression on the lower hip. You can first try sleeping on a thick, soft comforter you have at home to see if it has any benefit before going out and spending money on a more expensive mattress topper.
Other sleep strategies for hip pain relief
Sleep hygiene
This is another topic that we will explore in much more detail in the future.
Sleep hygiene takes many aspects into account to ensure that you choose the best internal and external environment to facilitate better sleep. As a quick overview, here are a few simple things you can include:
- Think about what you eat and drink before you go to sleep
- Don't exercise right before you go to sleep
- Stay away from screens for at least an hour before going to sleep
- Provide a dark room
- Block out noise - earplugs are so simple and so effective
- Routine: Keep a routine where you try to fall asleep and wake up at the same time every day.
Look at relaxation strategies before you go to bed – meditate
This can be done by learning to meditate and calm the mind. This can be done by reading or listening to music. There are endless possibilities here.
Meditation: Many people have gone through this idea before even trying it - "headroom' is a fantastically simple app with a free trial that allows you to try meditation in many different forms. Maybe there is something here that works for you.
Visit ourPain localization mapfor more information about soft tissue pain in different areas around the hip and pelvis.
What's causing your hip pain at night? – causes of hip pain during sleep
There are many different reasons why you may experience hip pain at night. In this section, we'll discuss some of the most common causes of hip pain that can affect your sleep quality and prevent you from getting a good night's sleep.
Hip joint pain at night - osteoarthritis pain at night
People with hip osteoarthritis, the most common form of arthritis, often experience pain in their hips at night. Hip osteoarthritis is a degenerative joint disease involving inflammation and gradual deterioration of the smooth cartilage surfaces of the fetlock joint.
Hip osteoarthritis pain at night may be related to inflammation of the joint, which is affected by what you have done during the day. Typically, you will find that if you have pushed your hip a little too much during the day, your hip may hurt a lot more that night. Controlling what you do during the day can help ease your nighttime pain.
Hip osteoarthritis pain at night may also be related to spending hours in positions that stretch or compress sensitive structures in the joint.
For people with hip osteoarthritis, the worst sleeping positions are often:
- sleep flat on your back, or
- sleep on your side with your knee elevated.
If you sleep flat on your back with your hips extended, the hip capsule is placed under increased tension. When the hip is inflamed and there is more fluid in the joint, this extended hip position can be difficult to maintain for extended periods of time, resulting in pain.
Sleeping with the knee close to the chest can also bring together sensitive structures in the front of the hip, causing discomfort over time.
Read on to learn more about reducing pain in specific sleeping positions.
Read more about hip osteoarthritisher.
Hip pain at night - labral tear hip pain at night
The smooth cartilage that lines the hip socket fuses to form a more fibrous cartilage that sits like a fringe around the edge of the bone socket. This is called the labrum (acetabular labrum). Changes in this labrum, including a labral tear, can cause hip pain at night, especially in certain positions that place more pressure on the area where labral irritation exists.
For people with a labral tear, the worst sleeping positions are often:
- sleeps back with the bent leg outwards,
- stomach sleeps with the knee to the side, or
- sleep on your side with your knee elevated.
The sleeping positions that are most painful for people with a labral tear vary depending on which part of the labrum is affected. Back sleeping or stomach sleeping with the leg bent to the side can cause quite a bit of tension on the front of the hip capsule and the labrum.
Side sleeping with the knee close to the body can compress an irritated labrum. Try to determine which position aggravates your hip pain the most and then try our suggested adjustments for that position. Read more about sleeping positions below.
Bursitis of the hip, greater trochanteric pain syndrome or gluteal tendinopathy pain at night
These conditions are all connected. Pain on the side of the hip is often related to changes in the health of the tendons that connect the gluteal muscles (buttocks) to the hip, and sometimes in the nearby bursae (fluid-filled sacs that help reduce friction between tendons and bones) . The condition may be diagnosed as gluteal tendinopathy or tendinitis, trochanteric bursitis, or greater trochanteric pain syndrome (GTPS), which includes both.
For people with hip bursitis, greater trochanteric pain syndrome, or hip-buttock tendinopathy, the worst sleeping positions are often:
- side sleep on the painful hip,
- side sleep on the good hip, or
- sleeps back with crossed ankles
The painful structures in this condition are located on the outside of the greater trochanter – the bony point on the side of the hip. When you sleep on your side, these sensitive structures are pressed against the bed.
The upper hip is also often painful if you sleep on your side with the condition. This is due to the relative stretch of these structures when your knee is lower than your hip in the side-lying position.
If you have pain next to your hip at night, some simple strategies can go a long way in improving your overall pain due to this condition. Read more about sleeping positions below.
Read more about hip bursitis, greater trochanter pain syndrome and gluteal tendinopathyher.
Lower back pain causing hip pain at night
The lower back can be associated with hip pain at night. Lower back structures such as discs and facet joints can refer pain directly to the hip area. Irritation of the nerve roots from the lower back can also cause pain in the hip area and along the thigh, lower leg and foot (radicular pain).
For people with hip pain referred from the lower back, the worst sleeping positions often include:
- back to sleep
- stomach sleeps, or
- Side sleeping with the lower back rotated too much.
These positions tend to increase the arch in the lower back, increasing compression of painful structures. Read more about changing these sleeping positions below.
The relationship between back and hip pain can be a complex area to understand. You can read more about it by clickingher.
Sciatic nerve-related pain, known as deep gluteal syndrome or piriformis syndrome, which causes hip pain at night
The sciatic nerve is a large, thick nerve that collects in the upper to middle area of the buttock and runs deep through the lower buttock and then down the back of the leg. When the nerve in the buttock area is irritated, it is called Deep Gluteal Syndrome or Piriformis Syndrome. When the sciatic nerve causes hip pain while sleeping, it is usually felt through the back of the hip into the buttock and often down the back of the leg.
Worsening of nerve pain at night is very common. This may be due to i) lack of distraction during the day and ii) fluid overload around a nerve in narrow nerve tunnels or pathways.
For people with deep gluteal syndrome or piriformis syndrome, the worst sleeping positions often include:
- side sleep, where the painful hip is at the top and the knee is high, or
- back to sleep
During the day, exercise and higher blood pressure cause normal fluid around the nerves to move through narrow tunnels or pathways that may be constricted by tight muscles. Night positions that tighten the muscles in the buttocks, such as lying on the side with the knee high, can further constrict the nerve.
You can read more about deep gluteal syndrome and piriformis syndrome by clickingher.
If you have pain in your buttocks, take a look at our course and see if it suits you.
Pregnancy-related hip pain at night
Pregnant women often experience pain in the hip and pelvic area at night, resulting in sleep deprivation before the baby even arrives!
This may be due to the hormonal changes that occur in the body, the position of the baby or due to the effects of carrying the baby, such as increased weight and changes in the way a pregnant woman moves.
For people with pregnancy-related hip pain at night, the worst sleeping positions often include:
- sleeping flat on the back, or
- side sleeping without support
Pregnancy-related pelvic pain at night can come from the sacroiliac joints, or SIJs, which become slightly more flexible in the later stages of pregnancy. This SIJ pain is usually felt through the back of the hip/pelvis and buttock area.
Read more about changing sleeping positions below. Try to support the baby's extra weight with pillows and keep your legs in a reasonably symmetrical position to avoid torsional stress on the pelvis.
And another tip: lift your pelvic floor and pull in your stomach to roll over in bed when you are pregnant. This can help reduce the sharp pains that can occur when you move after sitting in the same position for a while.
Other causes of hip pain while sleeping
Night pain should always be treated with caution. There are many other medical reasons why nighttime pain may occur. If nighttime pain persists, contact a healthcare provider, such as your doctor, to discuss and investigate further.
How to prevent hip pain at night
This blog has already discussed three commonly used strategies for reducing hip pain while lying down. Below are several position-specific sleep strategies to help you find the best sleeping position for hip pain at night. We briefly summarize these below.
How to Relieve Hip Pain While You Sleep – A Position-by-Position Breakdown
These are the features that hip pain care physicians are most often asked about. There is no one best sleeping position that suits everyone or that works all night long.
To ensure a good night's sleep, it may be necessary to change positions. Although you may find a comfortable sleeping position when you first go to sleep, you may wake up later with hip pain.
Spending long periods of time in just one position is often not pleasant for anyone after a while. Having a few options to switch between can help you get through the night.
Hip pain when you sleep on your side
Conditions most likely to be painful for side sleepers:
- Hip bursitis, greater trochanteric pain syndrome or gluteal tendinopathy
- Hip joint pain - osteoarthritis or labral tear
- Deep gluteal syndrome or piriformis syndrome
- Pregnancy-related pelvic pain
Ways to Reduce Hip Pain in Side Sleepers:
- Try a mattress topper. This is especially helpful if you sleep on a firm bed and can also reduce shoulder pain.
- Keep your knees further away from your chest (knees under your hips).
- Use a pillow between your legs or under your upper hip and thigh. You can try anything from a small pillow between the knees to a full-body pillow. The goal is to keep your lower back, pelvis and hips in a neutral position.
- Support your belly with a small pillow, especially if you are pregnant - support the baby's weight.
You can read more about memory foam mattress topper for hip pain reliefher.
Hip pain when you lie on your back
Conditions most likely to be painful when you return to sleep:
- Hip and leg pain referred from the lower back
- More advanced or irritable hip joint conditions such as osteoarthritis
- Pelvic pain, including pregnancy-related pelvic pain or SIJ pain
Ways to Reduce Hip and Pelvic Pain While Sleeping:
- Try a mattress topper over your bed to reduce pain from pressure while lying down.
- However, be careful with a bed that is too soft if you think your hip pain is related to your lower back. Back sleepers often find that a bed that is too soft can further irritate back and hip pain. Just because you have a new mattress doesn't mean it's always the right mattress for you!
- Try placing a pillow under your knees so they can rest in a slightly bent position. This can often be a comfortable position for hip, pelvic and low back pain.
- Don't cross your ankles
- If you are in the last trimester of pregnancy, you will not be able to lie flat on your back for long periods of time. Create an incline with pillows to raise your chest higher than your pelvis, or try sleeping on your side.
You can read more about memory foam mattress topper for hip pain reliefher.
Hip pain lying on the back with the leg out
Conditions most likely to be painful when sleeping with the leg down:
- Hip joint-related hip pain - osteoarthritis, labral tear, posterior hip impingement
- Pubic pain, usually pregnancy-related pelvic pain
- Groin pain – adductor or inner thigh muscles and tendons
- Hip flexor related pain
Ways to reduce hip, groin and pelvic pain when you sleep with your leg down:
- Try placing a pillow between your knee and the bed. This prevents your leg from sagging as much, reducing pressure on the hip, groin and pubic area.
- Limit the time you spend in this position – bring your leg into a parallel position and place a pillow under your thighs, or try lying on your side.
Hip pain lies on your stomach
Conditions most likely to be painful when the stomach is asleep:
- Hip and leg pain referred from the lower back
- More advanced or irritable hip joint conditions such as osteoarthritis
Apart from these circ*mstances, the most problematic thing about lying flat on your stomach is that your neck is twisted to the extreme. This can also result in neck pain. Changing your position can improve your hip and neck comfort!
Ways to Reduce Back and Hip Pain While Sleeping on Stomach:
- Try to sleep with a pillow under your stomach/pelvis. This allows the hips to be slightly flexed, relieving pressure on the lower back, pelvis and hips, resulting in less pain for stomach sleepers.
- Try sleeping with a pillow or body pillow wedged under one side of your body, pelvis and thigh – this also reduces neck twisting.
- Try a firm mattress. Be careful with a bed that is too soft, as you can sink into it and place your hips and back at a more extreme angle, making your pain even worse.
Better day care = less hip pain at night
In addition to finding a comfortable sleeping position at night and practicing good sleep hygiene, you should establish better daytime care for your condition. You can consult a physiotherapist/physiotherapist to help you. Physical therapy/physiotherapy helps create a treatment plan that:
- Include advice and education on ways to manage your pain
- Prescribe an exercise program to help your condition. This will likely include strength exercises, stretching, exercises that correct the way you move, and balance exercises. The most common muscle groups to be treated are the glutes or glutes, which are your glutes. The hip flexors or muscles at the front of the hip are also addressed. The deep gluteal or hip abductor muscles on the outside of the hip also need to be addressed often.
- Use manual therapy such as massage, mobilization, cupping and dry needling to reduce your pain
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This blog is written by Dr Alison Grimaldi and Kirsty McNab, physiotherapists with over 50 years of combined professional clinical experience dealing with patients suffering from a wide range of hip and pelvic conditions.
Dr. Alison GrimaldiBPhty, MPhty(Sports), PhD is practice director of Physiotec Physiotherapy, an Australian sports physiotherapist and adjunct senior researcher at the University of Queensland, author and global lecturer.
Kirsty McNabBSc Hons, MPhty (Sports), is the Practice Director of Physiologix and a highly experienced sports and exercise physiotherapist who has worked extensively with elite athletes, the Olympic Winter Institute of Australia and Tennis Australia.
You can read more about Hip Pain Releif on HipPainHelp:
Lordosis Causes, Effects and Exercises to Reduce Hip and Back Pain:learn more about pelvic positions and how adjustments can help relieve hip or pelvic pain
Hip hopping is easy, but may not be a good way to relieve hip pain:Hip sagging is easy, but over extended periods it can contribute to your hip or pelvic pain. Read more and learn strategies to fix this.
Top tips for hip pain from sitting while socializing or traveling:Here we discuss strategies that can help you reduce your hip and pelvic pain when you sit, for example at work, while traveling and at play.
What is the best good posture for hip pain relief:If there is a good posture that can best help relieve hip pain, the answer is not so simple!
Don't miss our next blog...
Our next series of blogs will focus on hip dysplasia, a condition that is often discovered at birth and treated well, but is also often overlooked, leaving many younger people struggling with early-onset hip pain and often requiring hip surgery sooner, when they were misdiagnosed.Check out our next blog for more information!
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