Hip Pain When Sleeping On Your Side: Causes And Treatment!

Your sleeping position can directly link to a number of health issues ranging from postural concerns to acid reflux. In short, the way you sleep can increase or decrease your chances of experiencing certain problems. Did you know that side sleeping is easily the most common position to sleep at night? During the most recent research on this topic, 54.1% of time spent sleeping was spent in this position, with back sleeping coming in second at 37.5%. 

It is regularly seen as the most comfortable position to sleep in and has been linked to helping with things such as back pain. There is even substantial evidence to suggest that sleeping on your side is better for your digestive system. However, there are also some possible concerns to be aware of – most notably, hip pain when sleeping on your side. It’s something that a lot of patients suffer from, but why does this happen and what can cause it?

What can cause hip pain when sleeping on your side?

Hip pain at night can be caused by a series of things. Some of these things are pre-existing conditions that worsen at night when sleeping on your side. On the other hand, you can have no prior hip problems yet still wake up with pain in your hip. 

Here are the most common causes: 

Osteoarthritis

Osteoarthritis is an extremely common type of arthritis that affects the hip. Research shows that it can affect nearly 19 in 100,000 people, and this figure has grown substantially from what it used to be two decades ago. This particular condition causes the wearing down of cartilage in your hip, meaning the bones in the joint come into contact with one another. This causes excessive rubbing that leads to chronic pain. 

When you sleep on your side, hip osteoarthritis can worsen because you put more pressure on the joints, causing the bones to rub together. If you sleep on the opposite side, there is still a pain because the hip can rotate internally and cause more pinching and rubbing in the joint. 

Naturally, one way to treat this is by sleeping on your back. You relieve any tension on your hips and can prevent a lot of nighttime pain. Alternatively, sleeping on the unaffected side with a pillow between your legs can also help. The pillow prevents the internal rotation of your hips and keeps them aligned, relieving a lot of pressure. 

Hip bursitis

Your hip will contain something called bursae that are designed to protect the joint when it moves. The bursae are small fluid-filled sacs, but they can sometimes become inflamed and sore. This is called bursitis, and it can lead to a lot of pain in the outside of your hip joint that gets worse when you touch it. You may also see swelling and redness around the area, experiencing difficulty moving your hip through its full range of motion. 

Hip bursitis can cause hip pain when side sleeping both as a pre-existing condition and a condition that starts because of your sleeping position. Constantly lying on one hip for long period might inflame the bursae and leave you with this pain in the morning. But, if you already have bursitis, then sleeping on the affected hip will aggravate the pain. 

Treatment for this hip problem is relatively simple. Icing the area can reduce inflammation and ease your pain. Of course, avoid sleeping on one side of your body all the time to prevent bursitis from happening. Likewise, don’t sleep on the affected hip if you already have bursitis caused by something else. Try sleeping on your back to relieve tension. 

Hip muscle strains

A strain in your hip muscle can go undetected for a long time. Typically, you only notice it if you raise your leg up, triggering the hip flexors to do their job. Consequently, you may feel a sharp pain or pinching sensation in the hip that stops you from raising your leg up too high. Ironically, sleeping on your side can aggravate a hip muscle strain because you are moving your hips/legs into the same position. If you bend your legs at 90 degrees and go into the fetal position, this activates your hip flexors and can trigger a lot of pain if you suffer from a strain. 

Treating a strain is as simple as resting the joint and taking pain medication. You may also need to undergo some physical therapy to strengthen the muscles around the joint, preventing further strains in the future. 

Aggressive internal rotation

Your hip is a ball and socket joint that can rotate both internally and externally. Sleeping on your side will often mean that the top leg rotates internally. We touched upon this earlier, but even if you have healthy hips, too much internal rotation can be a bad thing. It can cause the hip pone to pinch against nerves or tendons, leading to pain and stiffness when you wake up. 

Again, the treatment for this is to change your sleeping position or place a pillow between your knees to align your hips and prevent excessive internal rotation. 

How do you relieve hip pain from sleeping on the side?

As we have mentioned throughout, you can see a lot of relief by taking pressure away from your hips. Don’t sleep on a hip that is already sore and has a pre-existing condition. Try back sleeping as it stops your hips from being under too much force throughout the night. 

Similarly, placing a pillow between your legs is proven to help relieve a lot of pain. You can do this if you like sleeping on your side because sleeping on your back feels uncomfortable or unnatural. But, be sure to sleep on the unaffected side if you have issues like arthritis or bursitis. If you don’t currently have any underlying hip issues, always switch sides to avoid putting too much pressure on one hip. 

When should you see a doctor?

See a doctor if your hip pain persists for longer than two weeks and you are seeing no relief by altering your sleeping position or using a pillow between your legs. If you are struggling with hip range of motion and the pain is incredibly severe, you should also seek medical consultation. 

Get help from an online doctor

The online doctors at DrHouse can provide you with an immediate virtual consultation that will get to the bottom of your hip pain. You can be prescribed the right treatment to help the issue, so download our app today to get started. 

Key Takeaways

Hip pain when sleeping on your side can be caused by pre-existing hip conditions that get worse when sleeping in this position. Likewise, many hip problems can be caused by exerting too much pressure on your hip when sleeping on your side, or by the excessive rotation that often happens when side sleeping. 

Treatments can be provided, with the best options to alter your sleeping position and reduce the pressure/rotation your hips experience while sleeping. 

Sources:

  • Skarpsno ES, Mork PJ, Nilsen TIL, Holtermann A. Sleep positions and nocturnal body movements based on free-living accelerometer recordings: association with demographics, lifestyle, and insomnia symptoms. Nat Sci Sleep. 2017;9:267-275. Available from: https://doi.org/10.2147/NSS.S145777 
  • Dainese R, Serra J, Azpiroz F, Malagelada JR. Influence of body posture on intestinal transit of gas. Gut. 2003 Jul;52(7):971-4. doi: 10.1136/gut.52.7.971
  • Fu, M., Zhou, H., Li, Y. et al. Global, regional, and national burdens of hip osteoarthritis from 1990 to 2019: estimates from the 2019 Global Burden of Disease Study. Arthritis Res Ther 24, 8 (2022) – Available from: https://doi.org/10.1186/s13075-021-02705-6 .

DrHouse articles are written by MDs, NPs, nutritionists and other healthcare professionals. The contents of the DrHouse site are for informational purposes only and are not a substitute for professional medical advice, diagnosis, or treatment. If you are experiencing high fever (>103F/39.4C), shortness of breath, difficulty breathing, chest pain, heart palpitations, abnormal bruising, abnormal bleeding, extreme fatigue, dizziness, new weakness or paralysis, difficulty with speech, confusion, extreme pain in any body part, or inability to remain hydrated or keep down fluids or feel you may have any other life-threatening condition, please go to the emergency department or call 911 immediately.

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