Some hip pain relief sleeping can make a big difference to your wellbeing. Many people lie awake for hours each night, unable to sleep as a direct result of their pelvic or hip pain. Reduced sleep can have many negative impacts on your life. This may be directly on your hip pain, and your healing capacity, but also in all facets of your life and coping with the day to day of living, and your overall mental health.
In this blog, we’ll first provide you with our 3 top strategies to find hip pain relief sleeping, and then you’ll find lots more helpful information to help you understand your pain and get a great night’s sleep. Here are the topics we’ll cover:
Here are a few strategies you could try to help give you some hip pain relief sleeping. Medications may need to be addressed in addition so please make sure you discuss this with your doctor, general practitioner or specialist.
If you are a side sleeper, try sleeping with a pillow between your knees and ankles.
When you lie with your top leg resting down on your bottom leg, this can create more of an angle of the top thigh dropping across your body. This may have an impact on pain coming from your hip joint, for example, in conditions such as FAI syndrome, hip dysplasia, and hip OA.
If you are a side sleeper, try sleeping with a pillow between your knees and ankles.
When you lie with your top leg resting down on your bottom leg, this can create more of an angle of the top thigh dropping across your body. This may have an impact on pain coming from your hip joint, for example, in conditions such as FAI syndrome, hip dysplasia, and hip OA.
This position may also have an impact on the soft tissue structures (muscles, tendons, and bursa) around the hip and pelvis, such as in conditions like gluteal tendinopathy, or greater trochanteric pain syndrome.
Nerve related conditions may also become aggravated, such as with hip-related sciatica.
Having the top and bottom legs slightly separated may help position the top leg in a way that takes stress and strain away from these soft tissues, reducing overall pain.
Try sleeping with a pillow between your knees and ankles. Experiment with different pillow thicknesses …..it is far easier to just deal with only one pillow in the night that is the correct size, rather than two pillows!!!
If you sleep on your back, try sleeping with a pillow under your knees. This can relax tension through the lower back and buttock area as well as in the front of the hip. This in turn can help reduce pain related to the front and back of the hip and pelvis, for example in conditions related to the hip joint, the labrum, soft tissue structures (such as the hip flexors) and nerve structures (referred from either the low back or from local nerves involved around the hip or pelvis)
Use a mattress topper – if you struggle to lie on your side because the hip you are lying on becomes sore from the pressure of lying on it, then something softer over the mattress may be of benefit. In conditions such as gluteal tendinopathy or greater trochanteric pain syndrome, the ideal is to avoid side lying. If this is not possible, then a mattress topper may help reduce the pain from compression on the lower hip. You could try to sleep on a thick soft duvet you have at home first to see if there is any benefit before heading out and spending money on a more expensive mattress topper.
This is another topic that we will explore in much more detail in the future.
Sleep hygiene considers many aspects around making sure you select the best internal and external environment to help facilitate better sleep. As a brief overview, here are a few simple things you may include:
This may be through learning to meditate and calm the mind. It may be through reading or listening to music. There are endless possibilities here.
Meditation: many people through this idea out before even trying – “headspace” is a great, easy app with a free trial where you can give meditation a go in many different forms – there may actually be something here that works for you.
Visit our Pain Locator Map to learn more about soft tissue related pain in different regions around the hip and pelvis.
There are many different reasons you may experience hip pain at night. In this section we will cover some of the more common causes of hip pain that can affect your sleep quality, preventing you from getting a restful sleep.
People with hip osteoarthritis, the most common form of arthritis, often experience aching in their hips at night. Hip osteoarthritis is a degenerative joint condition, involving inflammation and gradual deterioration of the smooth cartilage surfaces of the ball-and-socket joint.
Hip osteoarthritis pain at night can be related to inflammation in the joint, which is affected by what you have been doing during the day. You’ll usually notice that if you’ve pushed your hip a bit too much during the day, your hip can ache much more that night. Controlling what you do during the day will help with your night time pain.
Hip osteoarthritis pain at night can also be related to spending hours in positions that stretch or compress sensitive structures in the joint.
For those with hip osteoarthritis, often the worst sleeping positions are:
Sleeping flat on the back with the hips extended puts the hip capsule on increased tension. When the hip is inflamed with increased fluid in the joint, this extended hip position may be difficult to sustain for a prolonged period, resulting in aching.
Sleeping with the knee up close to the chest can also bring sensitive structures at the front of the hip together, causing discomfort over a period of time.
Continue reading to find more information on reducing pain in particular sleeping positions.
Read more about hip osteoarthritis here.
The smooth cartilage lining the hip joint socket merges into a more fibrous cartilage that sits around the edge of the bony socket, like a fringe. This is called the labrum (acetabular labrum). Changes within this labrum, including a labral tear, can cause hip pain at night, especially in certain positions that put more stress in the area where the labral irritation exists.
For those with a labral tear, often the worst sleeping positions are:
Sleep positions that are most painful for those with a labral tear vary depending on which part of the labrum is affected. Back sleeping or tummy sleeping with the bent leg out to the side, can put quite a lot of stretch across the front of the hip capsule and labrum.
Side sleeping with the knee up close to the body can compress an irritated labrum. Try to note which position aggravates your hip pain most, and then try our suggested modifications for that position. Read more on sleep positions below.
These conditions are all interlinked. Pain over the side of the hip is commonly related to changes in the health of the tendons that join the gluteal (buttock) muscles to the hip, and sometimes of the nearby bursae (fluid filled sacks 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 encompasses both.
For those with hip bursitis, greater trochanteric pain syndrome, or gluteal tendinopathy hip, often the worst sleeping positions are:
The painful structures in this condition are located on the outer side of the greater trochanter – the bony point at the side of the hip. Sleeping on your side will compress these tender structures against the bed.
The top hip is also often sore when side sleeping with the condition. This is because of the relative stretch of these structures when your knee is lower than your hip in side lying.
If you have pain at the side of the hip at night, some simple strategies can go a long way in improving your overall pain from this condition. Read more on sleep positions below.
Read more about hip bursitis, greater trochanteric pain syndrome and gluteal tendinopathy here.
The lower back can be linked to hip pain at night. Low back structures like discs and facet joints, can directly refer pain to the hip area. Irritation of the nerve roots from the low back may also cause pain in the hip area, as well as down the thigh, lower leg and foot (radicular pain).
For those with hip pain referred from the lower back, often the worst sleeping positions are:
These positions tend to increase the arch in the lower back, increasing compression of painful structures. Read more about modifying these sleep positions below.
The relationship between the back and hip pain can be a complex area to understand. You can read more about it by clicking here.
The sciatic nerve is a large thick nerve that comes together in the upper to mid buttock region, running deep through the lower buttock and then down the back of the leg. When the nerve is irritated in the buttock area, it is called Deep Gluteal Syndrome or Piriformis Syndrome. When the sciatic nerve causes hip pain sleeping, this is usually felt through the back of the hip in the buttock, and frequently travels down the back of the leg.
Worsening of nerve pain at night is very common. This can be due to i) lack of daytime distractions and ii) congestion of fluid around a nerve in tight nerve tunnels or pathways.
For those with deep gluteal syndrome or piriformis syndrome, often the worst sleeping positions are:
During the day, movement and higher blood pressure helps normal fluid around nerves move through tight tunnels or pathways that might be constricted by tight muscles. Night-time positions that put the muscles in the buttock on tension, like side lying with the knee high, can further constrict the nerve.
You can read more about deep gluteal syndrome and piriformis syndrome by clicking here.
If you have buttock pain, check out our course and see if it is suitable for you.
Pregnant women frequently experience pain in the hip and pelvic region at night, resulting in sleep deprivation before the baby even arrives!
This may be due to the hormonal changes happening in the body, the positioning of the baby, or as a result of the effects of carrying the baby, such as the increased weight and changes in the way a pregnant woman moves.
For those with pregnancy related hip pain at night, often the worst sleeping positions are:
Pregnancy related pelvic pain at night can come from the sacroiliac joints or SIJs, which become a little 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 modifying sleep positions below. Aim to support the extra weight of the baby with pillows and keep your legs in a fairly symmetrical position to avoid twisting strain across the pelvis.
And one more tip, draw up your pelvic floor and draw in your tummy to roll in bed when pregnant. This can help reduce those sharp little pains that can happen when moving after you’ve been lying in one position for a while.
Night-time pain should always be treated with caution. There are many other medical reasons that night-time pain can occur. Should the night pain persist, you must see a health care provider, such as your doctor, to discuss and investigate this further.
This blog has already covered 3 common strategies on how to reduce hip pain while you are lying down. Below you will find more position-specific sleep strategies to help you find the best sleeping position for hip pain at night. We will briefly summarise these below.
These are the positions that the Hip Pain Help clinicians most frequently are asked about. There is not a single best sleep position that will suit everyone, or work throughout the whole night.
To ensure a good night’s sleep you may need to change between positions. Although you might find a comfortable sleep position when you first go to sleep, you might wake up later with hip pain.
Spending long periods of time in just one position is often not great for anyone after a period of time. Having a couple of options that you can swap between can help you get through the night.
Conditions that are most likely to be painful when side sleeping:
Ways to reduce hip pain when side sleeping:
You can read more about memory foam, mattress toppers for hip pain relief here.
Conditions that are most likely to be painful when back sleeping:
Ways to reduce hip and pelvic pain when back sleeping:
You can read more about memory foam, mattress toppers for hip pain relief here.
Conditions that are most likely to be painful when back sleeping with the leg dropped out:
Ways to reduce hip, groin and pelvic pain when back sleeping with the leg dropped out:
Conditions that are most likely to be painful when stomach sleeping:
Apart from these conditions, often the most problematic thing about lying flat on your stomach, is having your neck twisted to the extreme. This may also result in neck pain. Modifying your position can improve comfort for your hip and neck!
Ways to reduce spinal and hip pain when stomach sleeping:
In addition to finding a comfortable sleeping position at night and practising good sleep hygiene, you should establish better daytime care of your condition. You can see a physical therapist / physio to help. Physiotherapy / physical therapy will help to provide a treatment plan that will:
Authors
This blog was written by Dr Alison Grimaldi and Kirsty McNab, physiotherapists who have over 50 years of combined professional clinical experience, dealing with patients suffering from a wide range of hip and pelvic conditions.
Dr. Alison Grimaldi BPhty, MPhty(Sports), PhD is Practice Principal of Physiotec Physiotherapy, an Australian Sports Physiotherapist and Adjunct Senior Research Fellow at the University of Queensland, author and global educator.
Kirsty McNab BSc Hons, MPhty(Sports), is Practice Principal of Physiologix and a highly experienced Sports and Exercise Physiotherapist having worked extensively with elite athletes, the Olympic Winter Institute of Australia, and Tennis Australia.
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Top Tips for Hip Pain Relief Sitting, when Socialising or Travelling: here we discuss strategies that may help reduce your hip and pelvis pain when sitting, for example with work, travel and play.
What is the Best Good Posture for Hip Pain Relief: Is there any one good posture that could best help with hip pain relief is not such an easy question to answer!
Our next series of blogs will focus on hip dysplasia, a condition often detected at childbirth and well treated, but also often missed resulting in many younger people struggling with early-onset hip pain, and often earlier requirements of having hip surgery when misdiagnosed. Check out our next blog to find out more!
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