Woman sleeping on her side with a contoured support pillow

Hip Pain When Sleeping on Your Side: Why It Happens and How to Sleep Better

Short answer: pain on the outer hip when you lie on that side usually comes from the soft tissues over the bony point of the hip: an irritated bursa (hip bursitis) or the gluteal tendons beside it. The AAOS notes that bursitis pain is typically worse at night, when lying on the affected hip, and when getting up from a chair after sitting. Pain felt deep in the groin is more likely to come from the hip joint itself, often osteoarthritis. For both, the best sleeping setup is on your back, or on the pain-free side with a pillow between your knees so the top leg does not drop across and pull on the sore hip.

Why does my hip hurt more at night?

  • Direct pressure. Lying on the sore side compresses the bursa and tendons between the mattress and the bone.
  • Stretch from the other side. Lying on the good side without a knee pillow lets the top leg fall forward and inward, which pulls the same tendons tight over the bone. That is why both sides can hurt.
  • Stillness. Arthritic joints stiffen when they do not move for hours.
  • Fewer distractions. Pain that you tune out during the day is more noticeable in a quiet bedroom.

What is the best sleeping position for hip pain?

  • On your back with a pillow under your knees. No pressure on either hip.
  • On the pain-free side with a firm pillow between your knees and ankles, thick enough to keep the top thigh level with the hip. A contoured knee pillow stays in place better than a bed pillow. A full body pillow also supports the top arm.
  • If you must lie on the sore side, add a soft mattress topper to spread the pressure and try rolling slightly backward onto a pillow wedged behind you, so the weight shifts off the bony point.

You will find knee pillows, body pillows and other supports in our sleep support range and pillows.

Does my mattress matter?

Yes. A very firm mattress creates a pressure point at the hip for side sleepers. A worn, sagging mattress lets the pelvis drop and twists the lower spine. Medium-firm generally works best. A two to three inch foam topper is an inexpensive way to soften a too-hard surface before replacing a mattress.

What helps hip pain during the day?

  • Avoid the aggravators for a few weeks: standing with your weight hitched onto one hip, sitting cross-legged, sitting in low, deep chairs, and lots of stairs or hills.
  • Ice the outer hip for 15 to 20 minutes after activity if it is sore to touch. Heat suits the deep, stiff ache of arthritis, especially before bed. See heat or ice for pain.
  • Strengthen the hip muscles. Bridges, side-lying leg lifts and standing hip abduction, done slowly and without pain. Weak gluteal muscles are the most common underlying reason for outer hip pain.
  • Stay active with walking on level ground, swimming or cycling.
  • Weight. Less load means less pain for both tendons and arthritic joints.

Note that vigorous stretching of the outer hip, such as pulling the knee across the body, often makes tendon-related pain worse rather than better.

Could it be coming from my back?

Yes. Pain in the buttock or back of the hip that travels down the leg, with tingling or numbness, often originates in the lower spine. See sciatica relief at home.

When should I see a doctor about hip pain?

Seek urgent care if hip pain follows a fall, if you cannot put weight on the leg, if the leg looks shortened or turned outward, or if you have hip pain with fever and feel unwell. See a doctor if night pain persists beyond two to three weeks despite these changes, if you have groin pain with stiffness that makes it hard to put on socks and shoes, or if you limp.

Key takeaways

  • Outer hip pain at night usually comes from the bursa or gluteal tendons. Groin pain points to the joint.
  • Sleep on your back, or on the good side with a pillow between knees and ankles.
  • Soften a very firm mattress with a topper.
  • Strengthen the hip muscles and avoid hitching onto one hip or crossing legs.
  • Pain after a fall, inability to bear weight or fever needs urgent care.

Sources

This article is general wellness information and is not medical advice. It does not replace an examination by a qualified healthcare professional. If your pain is severe, sudden or getting worse, please see a doctor.

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