Causes of Hip Pain at Night and Treatment Options

If you have ever woken with an aching hip, you are not alone. In fact, around 20% of people over the age of 65 report chronic hip pain. Hip pain can prevent you from exercising or being active, but it can also wreak havoc on your sleep schedule.

When your hips hurt during the night, you may find it more difficult to sleep. You may twist and turn in your sleep to try to find a more comfortable position. If you experience more pain in your left hip or right hip, it may be difficult to fall asleep on your side.

If your hip pain keeps you awake at night, the first step to a better night’s sleep is consulting with a healthcare provider to pinpoint the cause of your discomfort. 

Potential Causes

Hip pain can emerge from various causes. Many people experience occasional aches and pains in this active area of their body, from bruises or muscle tightness due to a minor injury, for example. These pains often resolve themselves in several days.

However, others may experience chronic pain in their hip joints from osteoarthritis, bursitis, or rheumatoid arthritis. Each of these diseases can disrupt your sleep with pain and stiffness because they can cause your hip joints to swell or become inflamed.

For some, these lingering pains may feel like pins and needles. Others may feel a burning or an ache. Those people with more severe forms of arthritis may report a deep twisting sensation, as if someone is grabbing their hips.

Osteoarthritis

Out of the three conditions, osteoarthritis is the most common. Over time, as your hips move during normal exercise, the soft tissues that cushion those joints degrade. Without those soft tissues, the bones in your joints scrape against each other, which can make movement uncomfortable. Your hips may become inflamed or stiff.

Osteoarthritis is a long-term condition. While patients can protect their joints to prevent further damage and pain, they cannot completely reverse the existing erosion in their joint tissues.

Bursitis

Hip bursitis can cause similar symptoms to arthritis, but bursitis is a temporary condition. Patients with bursitis may feel stiffness or pain when they move, but the cartilage between their joints hasn’t degraded.

Instead, the bursa—a sac of fluid that helps cushion your joints—becomes inflamed. People who play sports, who have to lift or carry heavy materials at work, or who engage in other physically demanding activities report higher rates of hip bursitis than their peers.

There are 150 bursae throughout your body to protect areas like your arms, legs, back, and hips. Hip bursitis can be quite painful. A bursa is located near the outside of your hip. With each step, this bursa could be irritated by the tendons near the top of your leg. 

Fortunately, bursitis often improves with rest and proper treatment.

Rheumatoid Arthritis

Like osteoarthritis, rheumatoid arthritis is a chronic condition. However, RA doesn’t involve aging or weathering of joint tissue. Instead, patients with RA have an autoimmune condition that attacks the tissue in their joints. This immune response causes the soft tissues in their joints to harden over time and can even cause permanent bone damage.

RA symptoms can progress over time, but many patients experience pain in their hips and groin. This pain can contribute to insomnia and other sleep issues.

There is no complete cure for osteoarthritis or RA, but a healthcare provider can help you manage your individual symptoms and cope with your hip pain. 

When to See a Healthcare Provider

Any pain might be a cause for concern. Sleep is a vital bodily function. When you sleep, your body can rest and recuperate. But if you suffer from hip pain at night, your sleep may not feel very healing. Your disturbed sleep may cause a cycle of frustration, exhaustion, and joint aches.

Your pain may be relatively new, low to moderate in severity, or you may have an injury that doesn’t require you to visit the emergency room or a specialist. Perhaps you are uncertain of the cause of your hip pain. In these situations, you may wish to consult your primary care provider.

If your pain is more severe, chronic, or might result from arthritis or a musculoskeletal condition, your primary care provider may refer you to a specialist.

An orthopedist is a medical professional who specializes in joint and bone conditions, such as osteoarthritis. A rheumatologist focuses on autoimmune conditions like RA. If you have arthritis, these specialists can provide specific insights and treatments to help you mitigate your symptoms. 

Diagnosis

A general healthcare provider or another medical specialist may use several different methods to diagnose the cause of your hip pain. 

Physical Exam

A physical exam is normally the first step of a diagnosis. It can help your healthcare provider understand where exactly you are hurting. The healthcare provider may feel your sides and your hip area to pinpoint swelling, irritation, or potential injuries. They may ask you to walk, stretch, or bend over to observe your range of motion.

Lab Tests

After a physical exam, a healthcare provider may request additional tests. If your healthcare provider suspects that RA may cause your nighttime hip pain, they may order blood samples drawn. A blood test can also help identify other conditions such as cancer or an infection.

Blood samples do not always show evidence of RA. However, patients often have elevated rates of certain proteins or antibodies that can indicate a potential autoimmune condition.

Imaging

An X-ray or magnetic resonance imaging (MRI) can show your healthcare provider the condition of your skeletal system. With these technologies, healthcare providers can determine any lasting damage to your joints. These tests will demonstrate if you have advanced osteoarthritis or RA, a bone fracture, or another painful skeletal issue.

Treatment

Treatment for your hip pain will depend on the diagnosis. But it is likely to include lifestyle changes, medications, and other therapies.

Lifestyle

Certain lifestyle changes may help alleviate or prevent hip pain. If you’re in pain, you might cringe at the thought of working out. However, an active lifestyle can help prevent future hip pain.

Yoga or Pilates can keep your hips flexible. Moderate strength-building exercises can also help you avoid back and hip injuries. Regular walking and other easy-to-moderate aerobic exercises are recommended.

While no food has been proven as a sure treatment to hip pain, an anti-inflammatory diet can supplement your normal medical routine. Foods with turmeric, lemon water, antioxidants, and omega-3 fatty acids may help reduce the inflammation in your hip joints.

Medications

Your healthcare provider may prescribe you medication to help you cope with your hip pain, especially if your symptoms keep you awake. If your pain interrupts your sleep, make sure to tell your healthcare provider; some medicines for rheumatoid arthritis, like the steroid prednisone, can actually cause insomnia, which perpetuates your broken sleep cycle.

You may try an over-the-counter pain reliever such as Tylenol (acetaminophen) to relieve less severe pains. Holding a cold or hot compress to your hip may provide some relief.

Otherwise, a healthcare provider may recommend an opioid drug such as oxycodone or hydrocodone. If you are prescribed an opioid, use it only as prescribed to avoid addiction. Always consult your healthcare provider before trying any new medications or major lifestyle changes.

Complementary and Alternative Approaches

Complementary and alternative practices are, as the name suggests, meant to complement and not replace your healthcare provider's recommended medical routine. Some patients may try acupuncture, cupping therapy, tai chi, or massages. Others may try CBD supplements.

While these practices will certainly not cure a condition like arthritis, they may help provide relaxation or temporary relief from some of your hip pain. Before trying any alternative therapies, consult your healthcare provider to plan which approach works best for you. 

Coping

Alongside your healthcare provider's recommendations, you may want to try these strategies to sleep better, even with hip pain:

• Put a pillow between your knees when you lay on your side.
• Put a pillow under your knees if you lay on your back.
• Invest in a more supportive mattress or bed topper.
• Use a heating pad or hot water bottle.
• Stretch.
• Practice good sleep hygiene each night.
• Take a pain reliever as needed and prescribed.

A Word From Verywell

Hip pain can be frustrating and exhausting, especially when that discomfort keeps you awake at night. While there are many causes for hip pain, your healthcare provider can help you pinpoint any potential conditions like bursitis or arthritis. Fortunately, you can manage your pain and sleep easier when you combine an active lifestyle, your healthcare provider-approved medical regimen, and other coping strategies.