If you have hip pain at night, you may find that symptoms that feel manageable during the day become much more noticeable when you are trying to sleep.
You may wonder why your hip hurts when you are lying still, why turning over wakes you up or why you can’t sleep with hip pain even though you have not been particularly active that evening.
There are several possible explanations. Hip osteoarthritis is one of them, but it is not the only cause. Hip pain can also be related to muscles, tendons, bursitis, previous injury or other conditions affecting the hip or surrounding areas.
Understanding the possible causes can help you decide when it is worth seeking medical advice.
Why can hip pain be worse at night?
There is not one explanation for everyone’s symptoms.
During the day, you are usually moving between different positions and focusing on other things. At night, lying still can make you more aware of discomfort. Your sleeping position can also place pressure on the hip or surrounding tissues.
If you have hip osteoarthritis, pain can occur during rest or sleep as the condition becomes more troublesome. The NHS explains that hip osteoarthritis can cause pain in the groin or outside of the hip and that symptoms can affect people while resting or sleeping.
The NHS also advises speaking to your GP if hip pain is affecting your sleep, getting worse or repeatedly returning.
Is arthritis pain worse at night?
It can be.
Hip osteoarthritis is one possible explanation for night pain from hip arthritis. Osteoarthritis can cause pain, stiffness and reduced movement. As symptoms become more severe, pain may become more persistent and can occur even when you are resting.
The NHS England decision aid for hip osteoarthritis notes that some people with hip osteoarthritis have trouble sleeping because of pain.
However, having hip pain at night does not by itself mean that you have arthritis.
Other symptoms that may occur with hip osteoarthritis include:
- Pain in the groin, buttock or side of the hip
- Stiffness, particularly after periods of inactivity
- Difficulty walking or climbing stairs
- Difficulty putting on shoes and socks
- Reduced movement in the hip
- Pain when bending or getting in and out of a car
- Pain that becomes more frequent or starts affecting rest and sleep
If these symptoms sound familiar, an assessment can help establish what may be causing your pain.
Why does my hip hurt when I lie on my side?
Your sleeping position can sometimes contribute to hip discomfort.
Lying directly on a painful hip can put pressure on the tissues around the outside of the joint. Conditions affecting the tendons or bursae around the hip can cause pain that becomes more noticeable when lying on that side.
The NHS lists bursitis as one possible cause of hip pain and notes that it can feel worse when lying on your side.
You may also find that your symptoms change depending on whether you sleep on your back, side or front.
If you regularly wake because of hip pain, it is worth discussing this with a healthcare professional rather than assuming that changing your sleeping position will address the underlying cause.
Can hip osteoarthritis cause pain when resting?
Yes.
Although hip osteoarthritis often causes pain with movement and activity, it can also cause symptoms during periods of rest or sleep.
The severity of symptoms varies considerably between people. Some people have changes associated with osteoarthritis but relatively few symptoms, while others can experience significant pain and difficulty with everyday activities.
This is one reason why an X-ray alone does not necessarily explain how much pain someone is experiencing. Your symptoms and how they affect your daily life are important parts of an assessment.
You can learn more about the condition, its symptoms and treatment options in our guide to hip osteoarthritis.
What can you do if hip pain is stopping you sleeping?
The most appropriate approach depends on what is causing your pain.
Some general measures may help while you arrange an assessment:
Keep gently active
If movement is comfortable, staying active can help maintain strength and mobility. The NHS recommends regular exercise as an important part of managing osteoarthritis symptoms.
Avoid activities that significantly aggravate your symptoms and consider speaking to a physiotherapist about exercises appropriate for you.
Consider your sleeping position
If lying directly on your painful side makes your symptoms worse, changing position may help reduce pressure on the area.
Some people find a pillow between their knees helpful when sleeping on their side, although this will not address the underlying cause of persistent hip pain.
Follow appropriate pain-relief advice
If you need pain relief, speak to a pharmacist or healthcare professional about what may be suitable for you. Some medicines are not appropriate for everyone, particularly if you have other health conditions or take other medicines.
Don’t ignore persistent night pain
If pain repeatedly wakes you, is getting worse or is affecting your normal activities, arrange an assessment.
When should you seek urgent help for hip pain?
Most hip pain is not an emergency, but some symptoms need prompt assessment.
Seek urgent medical advice if you have severe hip pain that starts suddenly without an injury, particularly if the hip is swollen or feels hot, or if you feel generally unwell or have a high temperature.
If you have severe hip pain following a fall or injury and cannot walk or put weight on your leg, the NHS advises calling 999 or going to A&E.
Do not assume that severe or sudden night pain is simply arthritis.
When might hip replacement be considered?
Having hip pain at night does not automatically mean that you need a hip replacement.
For people with hip osteoarthritis, treatment may include exercise, physiotherapy, weight management where appropriate, medication and other non-surgical approaches.
Hip replacement may be discussed when symptoms such as pain, stiffness and reduced function are having a substantial effect on quality of life and non-surgical treatment is no longer providing enough benefit or is unsuitable.
Your symptoms, medical history, examination and overall health will all be considered before surgery is recommended.
If you do eventually have a hip replacement, sleep can also be affected during the early stages of recovery. Our guide, How to Sleep After Hip Replacement Surgery, explains how sleeping positions and comfort can change after surgery.
Why is it important to find the cause of your hip pain?
Night pain can be frustrating, particularly when it starts affecting your sleep and leaves you tired during the day.
But the location, pattern and severity of your pain can provide useful information to a healthcare professional.
For example, pain associated with activity and stiffness may suggest a joint problem, while pain around the outside of the hip that is worse when lying on that side can have a different cause.
Hip pain can also sometimes come from structures outside the hip joint, including the lower back. This is why persistent symptoms should be assessed rather than self-diagnosed.
Book a consultation
If ongoing hip pain is affecting your sleep, walking or everyday activities, a specialist assessment can help you understand what may be causing your symptoms and what treatment options may be appropriate.
You can book a consultation with us to discuss your hip symptoms and treatment options.
A consultation does not automatically mean you need surgery. Your symptoms and medical history will be assessed, and your consultant can discuss appropriate treatment options with you.
Final thoughts
Hip pain at night can have several possible causes. Osteoarthritis can cause pain while resting or sleeping, particularly when symptoms become more troublesome, but night pain does not necessarily mean that you have hip arthritis.
If pain is repeatedly disturbing your sleep, getting worse or affecting your everyday activities, speak to a healthcare professional. Finding the underlying cause is an important first step towards choosing appropriate treatment.