Hip Pain When Lying on Your Side: 5 Simple Ways to Sleep More Comfortably
Hip pain when sleeping on your side can turn a good night’s rest into hours of tossing and turning. You might wake every time you roll onto the sore hip, or avoid that side altogether.
For many people the pain sits on the outside of the hip. It may also flare when walking, running or climbing stairs.
The good news is that night-time hip pain usually has an identifiable cause, and simple changes often help.
Below, our osteopaths explain the most common reasons your hip hurts at night, five practical ways to sleep more comfortably, and when it’s worth getting it checked.
Why does my hip hurt when I lie on my side?
The most common cause of outer hip pain when lying on your side is greater trochanteric pain syndrome (GTPS). It’s often called hip bursitis, but it usually involves irritation of the gluteal tendons on the outside of the hip. Lying on that side compresses these sensitive tissues, which is why pain is often worst at night.
GTPS is an umbrella term. It covers
• Gluteal tendinopathy: irritation of the tendons that attach your buttock muscles to the bony point on the outside of your hip (the greater trochanter). This is now thought to be the main driver in most cases.
• Trochanteric bursitis: inflammation of the small fluid-filled sac (bursa) that sits over the same bony point. It often occurs alongside tendon irritation rather than on its own.
Common signs of GTPS include:
• Pain when lying on the affected side, especially at night
• Tenderness when you press on the outside of the hip
• Pain when walking, climbing stairs or standing on one leg
• Stiffness or pain when getting up after sitting for a while
GTPS is most common in people over 40 and in women, and it often follows a change in activity levels.
Other causes of hip pain at night
Not all hip pain at night comes from the outside of the hip. Other common causes include:
• Hip osteoarthritis: tends to cause pain in the groin or front of the hip, along with stiffness in the morning or after rest. You may notice difficulty putting on shoes and socks.
• Lower back problems: irritation of joints or nerves in the lower back can refer pain into the buttock and hip. This pain may change with back movements or come with pins and needles down the leg.
• Hip joint problems in younger, active people: such as labral irritation or femoroacetabular impingement, which usually cause deep groin pain with deep bending or twisting.
Because these conditions are managed differently, identifying the source of your pain is an important first step.
Recovery depends on the cause, how long you’ve had symptoms and how your hip responds to changes in load. Pain that has been present for many months can still improve, but it usually needs a more structured rehabilitation approach.
When to see someone about hip pain
Consider booking an assessment if your hip pain:
• Is getting worse or isn’t improving after two to three weeks
• Regularly wakes you or stops you getting back to sleep
• Is stopping you from walking, exercising or doing things you enjoy
Seek urgent medical care if you have sudden severe hip pain, can’t bear weight after a fall or injury, or have hip pain with fever, chills or feeling generally unwell.
5 ways to sleep more comfortably with hip pain
1. Sleep on the opposite side or your back
If lying on one hip consistently aggravates your pain, start the night on the other side to take pressure off the sore area. Sleeping on your back with a pillow under your knees is another comfortable option for many people.
If both hips are sore, experiment to find the position that feels best. You don’t need to hold one position all night.
2. Place a pillow between your knees
When you sleep on your side, your top leg tends to drop forward and across your body. This stretches and compresses the tendons on the outside of the top hip, which is a common reason side sleeping hurts.
A pillow between your knees (and ideally your ankles) keeps your top leg level and reduces this load. A regular pillow is fine to start with. If it helps, a longer body pillow can keep you supported through the night.
3. Soften your sleeping surface
A very firm mattress concentrates pressure on the bony point of the hip. If yours is firm, a soft mattress topper (such as memory foam or a folded doona) can spread the load and make side sleeping more tolerable. Very soft, sagging mattresses can also be uncomfortable, so aim for something that supports you evenly.
4. Look at your recent activity levels
Hip pain doesn’t always start in bed. Think about whether you’ve recently increased walking, running, hill work, stairs, gym training or sport. A sudden jump in activity can place more demand on the hip tendons than they’re ready for.
Temporarily easing back on activities that clearly flare your symptoms can help. Complete rest usually isn’t necessary, though. Finding a manageable level of activity and building back up gradually tends to work better.
5. Gradually build hip strength
The muscles around your hip help you walk, climb stairs and balance on one leg. For tendon-related hip pain, research supports a combination of education and progressive strengthening exercise as an effective long-term approach. See the simple exercises below for a starting point.
What to avoid during the day
What you do during the day can affect how your hip feels at night. With outer hip pain, positions that pull your thigh across your body tend to compress the gluteal tendons. Try to limit:
- Crossing your legs when sitting, or sitting with your knees pulled together.
- Hanging on one hip when standing, such as resting your weight on one leg while waiting in a queue or holding a child on your hip.
- Sitting in low chairs where your hips sit lower than your knees for long periods.
- Stretching the outside of the hip, such as pulling your knee across your body. These stretches feel tempting but often aggravate tendon pain.
- Big jumps in hills, stairs or distance before your hip is ready for them
Small changes to these everyday habits often make a noticeable difference to night pain within a few weeks.
Simple exercises for hip pain to start with:
These exercises are a gentle starting point for many people with outer hip pain. Mild discomfort (up to about 3 out of 10) that settles within 24 hours is generally okay. Stop if pain is sharp or worsens overnight.
1. Standing isometric hip push: Stand side-on to a wall with the sore hip furthest from it. Bend the knee closest to the wall and press the outside of that knee into the wall, so the muscles of your standing (sore) hip switch on. Hold 30–45 seconds, rest, and repeat 4–5 times. This is often well tolerated even when the hip is quite sore.
2. Glute bridge: Lie on your back with knees bent and feet flat. Squeeze your buttocks and lift your hips until your body forms a straight line from shoulders to knees. Lower slowly. Start with 2–3 sets of 10.
3. Sit to stand: From a chair of normal height, stand up without using your hands, keeping your knees in line with your toes. Sit back down slowly. Start with 2–3 sets of 8–10, and lower the chair height over time as it gets easier.
One exercise to avoid early on is side-lying leg raises. Lying on your side and lifting the top leg can compress the irritated tendons and flare symptoms.
The right program depends on your symptoms, strength and goals. If your pain persists, an individual assessment can help tailor the exercises and how quickly to progress them.
How long does hip pain when sleeping on your side last?
Many people notice better sleep within a few weeks of changing their sleeping position and daily habits. Tendon-related hip pain often takes longer to settle fully, commonly two to three months or more with a gradual strengthening program.
Recovery depends on the cause, how long you’ve had symptoms and how your hip responds to changes in load. Pain that has been present for many months can still improve, but it usually needs a more structured rehabilitation approach.
When to see someone about hip pain
Consider booking an assessment if your hip pain:
• Is getting worse or isn’t improving after two to three weeks
• Regularly wakes you or stops you getting back to sleep
• Is stopping you from walking, exercising or doing things you enjoy
Seek urgent medical care if you have sudden severe hip pain, can’t bear weight after a fall or injury, or have hip pain with fever, chills or feeling generally unwell.
Frequently asked questions
Is it bad to sleep on the hip that hurts?
It won’t cause damage, but direct pressure usually aggravates outer hip pain and disrupts sleep. Starting the night on the other side or your back, with a pillow for support, is generally more comfortable while symptoms settle.
Should I use heat or ice for hip pain at night?
Either can be used for short-term relief, so choose whichever feels better. Many people find heat soothing before bed. Neither treats the underlying cause, so pair them with the strategies above.
Can my mattress cause hip pain?
A mattress rarely causes hip pain on its own, but a very firm one can make existing outer hip pain worse by concentrating pressure on the hip bone. A soft topper is a cheap way to test whether your surface is a factor.
Is walking good for hip bursitis?
Walking is usually fine and helpful at a comfortable distance and pace. Reduce hills, stairs and long distances temporarily if they flare your pain, then build back up gradually.
Do I need a scan for hip pain?
Most people with outer hip pain don’t need a scan to start treatment, as the diagnosis is usually made through a clinical assessment. Imaging may be recommended if symptoms don’t improve or another cause is suspected.
Get help with hip pain in Malvern
If hip pain is keeping you awake or stopping you doing what you enjoy, a thorough assessment can pinpoint what’s driving it. At Equilibrium Sports and Spinal Clinic, our osteopaths assess your hip, lower back and movement, then build a management plan around your goals, from better sleep to getting back to walking, running or sport.
Get help with hip pain in Malvern
If hip pain is keeping you awake or stopping you doing what you enjoy, a thorough assessment can pinpoint what’s driving it. At Equilibrium Sports and Spinal Clinic, our osteopaths assess your hip, lower back and movement, then build a management plan around your goals, from better sleep to getting back to walking, running or sport.
Our Malvern clinic is easy to reach from Glen Iris, Caulfield, Camberwell and surrounding suburbs
and start working towards a better night’s sleep.
References
• Mellor R, Bennell K, Grimaldi A, et al. Education plus exercise versus corticosteroid injection use versus a wait and see approach on global outcome and pain from gluteal tendinopathy: prospective, single blinded, randomised clinical trial. BMJ. 2018;361:k1662. doi:10.1136/bmj.k1662
This article provides general information only and isn’t a substitute for individual advice. If you’re concerned about your symptoms, speak with a qualified health professional.
