Sometimes, even after a seemingly average day, you begin to experience hip pain as you wind down at night to rest. Having hip pain at night only or hip pain worse at night than throughout your day has a lot of potential causes, but is often from stress on your hips during the day.

Your iliacus and psoas muscles, also known as your hip flexor muscles, are responsible for an extensive amount of movement, support, and stabilization throughout your day. Even if you’re working a desk job, your hip flexors are engaged all day long.

In fact, extended periods of sitting can cause hip pain just as often as too much strain while exercising can.

Once you’ve had a chance to unwind, sit and relax, or even crawl into bed, your body will be slowing down to heal and recover from whatever activities you participated in that day. As you start to rest, it may also be the first time you have had time to even notice your hip pain.

Whatever the cause of your nightly hip pain, finding actual solutions can help you get a better night’s sleep and avoid further discomfort and sleep disturbances caused by your chronic hip pain.

In this article, we will outline some of the primary causes of hip pain at night, as well as how to address your hip pain and build routines for healthy hips.

Reasons why you might have hip pain at night

Experiencing hip pain at night can cause sleep disruptions and general discomfort - even when lounging on the couch. And that’s the opposite of relaxing.

That’s why you may be eager to get to the healing nighttime routines later in this article, but first you need to know some of the possible causes of your hip pain at night so you can understand how to address and prevent it in the future.

Causes of hip pain at night

While hip pain may come and go in your life from exercise and general muscle soreness, we will focus on chronic hip pain at night in this article. Pain that resolves itself within a day or two may not fall into one of these categories.

Chronic hip pain at night is often associated with osteoarthritis, but that is not the only condition that causes joint or hip pain when sleeping.

Some other common causes of hip pain at night include tight iliopsoas or hip flexor muscles, bursitis, and rheumatoid arthritis. In some cases, sacroiliac joint pain can influence and worsen hip pain at night as well.

For all of these conditions, one of the overlapping factors is that inflammation may be causing the hip pain - and that inflammation can worsen while you’re resting and recovering.

If you have tight muscles causing hip pain, inflammation may not be the root cause, but it can absolutely be a symptom.

It’s important to remember that hip pain at night comes in many forms. Some people that experience hip pain worse at night report that it feels more like an ache or burning sensation, while others experience sharp or twisting pain.

For some people, they may only have hip pain at night lying on one side or another while trying to fall asleep.

Each person is different and although there are commonalities in the causes of hip pain at night, the severity of the hip pain may vary.

Why hip pain is worse at night

If you have hip pain at night, why is it suddenly worse? Why are you not having as severe of (or any) hip pain during the day?

That is a very common question for many of my patients who experience hip pain at night or hip pain while sleeping.

The primary reason is because once you give your body a chance to take a break and truly begin to relax, your body also begins to heal and repair itself.

Essentially, as you strain and stress your hips during the day - whether it is while you are sitting, walking, exercising, etc. - you are using your hip muscles and hip joints. Once you slow down and stop engaging your hips as actively, they have a chance to rest.

As your hip works to heal itself, that can also mean that the area around your hip joint will experience some inflammation.

Inflammation is a natural way your body protects itself and it is one of the stages of healing. Despite that fact, it does put pressure on other areas around the inflammation and can cause pain.

Not only that, but your brain is likely now resting a bit more as well. Sometimes you may have some hip pain during the day, but you don’t even realize it because you are too preoccupied with the task at hand.

Once you lay down to get some sleep though, you have nothing to distract you from how your body is feeling at that moment, putting a laser focus on your hip pain.

Are tight hip flexor muscles causing your hip pain at night?

Although there are a lot of possible reasons you may be experiencing hip pain at night, one of the most overlooked ones is tight iliopsoas muscles. Your iliopsoas muscles are more commonly known as your hip flexor muscles and are made up of the iliacus and the psoas muscles.

These muscles are responsible for a wide range of movements and stabilizations. From walking, to turning your torso, to bending over, your iliopsoas muscles are seemingly always engaged.

What’s more, if you are in the same position for extended periods of time, like sitting at a desk, driving, walking, etc., then your hip flexor muscles experience more strain than if you were engaging in a variety of movements throughout your day.

Since your hip flexors are constantly engaged and experiencing a lot of stress, it is easy to see why they may get tight over time.

But why would tight muscles cause hip pain?

Because of their proximity to your hip joint, when your iliopsoas muscles are tight they begin to pull things out of place. In fact, overly tight hip flexors can cause your hips to move out of alignment.

You can think of this muscle tightness as causing somewhat of a domino effect with neighboring muscles and joints.

Once your iliacus or psoas muscle tightens, it will begin to impact other movements and alignment enough that your hip joint can rub together wrong or cause an injury that further exacerbates your hip pain.

So what can you do about that hip pain? Here are my top tips.

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Create a healing nighttime routine with the Hip Hook

There are several treatments for conditions like arthritis and bursitis, and many of them involve managing symptoms. When it comes to hip health though, your iliopsoas muscles play a huge role.

One of the more effective ways that I’ve found to help patients experiencing hip pain at night is to get them into a healthy nighttime routine that focuses on the root of their hip pain.

For many, this is tight hip flexor muscles. Or rather, releasing them.

Releasing tight hip flexor muscles can be quite the battle because of their location. The safest and most accessible locations to release the iliacus and psoas are inside the structure of the pelvis and somewhat deep within our core. This makes them hard to reach with other types of muscle release equipment like foam rollers and massage balls.

That’s why I invented the Hip Hook. This is a muscle release tool specifically designed to target tight psoas and iliacus muscles and apply prolonged pressure to release trigger points.

With just a few extra minutes each night, you can be well on your way to releasing built-up muscle tension, realigning your hips, and preventing hip pain at night.

The psoas & iliacus muscles are located within the soft spot inside the surface of your pelvic bone. That is why you need to line the tip of the Hip Hook up with that part of your hip. The tip needs to be pointing upward initially so it doesn’t slip underneath you.

Feel free to move the Hip Hook around and adjust it slightly to find the right spots along each of the muscles. There will be different tight spots that you find in your psoas and iliacus, and these may also differ whether you’re on the right or left side of your pelvis.

This can cause some discomfort at first, and the intensity will vary from person to person depending on their level of tightness, but try to breathe deeply and let your body melt into the Hip Hook.

After 30 seconds or so, the intensity will lessen and you will feel your muscles begin to release. Continue to hold that pressure and focus on taking relaxed breaths. The tightness and pressure applied by the Hip Hook into your muscles should begin to reduce.

Use the Hip Hook once on each side for 90 seconds or until the soreness lessens. Do this once a day or every other day. If you’re just starting out, it may be best to do it every other day as it can cause some soreness similar to bruising at first.

Wake up with gentle morning stretches

Your morning routine can be just as influential in lessening your hip pain at night.

After a night of rest, your hip muscles and other muscles are usually quite stiff. Take a few minutes each morning to wake up your muscles and your mind with a few hip flexor stretches.

Some examples of hip flexor stretches to try include:

• Figure 4 stretch
• Crossover stretch
• Half kneeling hip flexor stretch
• Couch stretch

No matter the stretches you employ during a morning stretch routine, be aware of how your hip feels during these stretches.

But be aware that there is such a thing as overstretching your muscles. And this can end up causing more muscle tightness and other hip issues throughout the day.

Just like with overstretching, stretching the wrong way can cause more harm than good. So, learn how to stretch your hip muscles correctly to avoid doing unnecessary damage.

If you are new to stretching, especially with your hips, it can help to get some advice from your physical therapist. Ask them which stretches would be right for your needs, and have them help you practice the stretches using the proper form.

Don’t settle for hip pain at night

Having chronic hip pain at night can impact your sleep habits - and eventually the rest of your daily life - because you aren’t able to get a good night’s sleep.

There are several possible causes of hip pain at night but, no matter the cause, it is important to seek proper diagnosis so you can treat the issue before it impacts your life further.

If you think tight hip flexors could be the root of your hip pain at night, reach out to a physical therapist for some targeted stretches and exercises, and consider investing in your health with the Hip Hook so you can relieve your hip pain from the comfort of home.

Frequently asked questions about hip pain at night

Why is my hip so painful at night?

There can be several reasons why you are experiencing hip pain at night. Perhaps the most common is that the muscles around the hip or even the hip joint itself are inflamed from a long day of being used (sitting, walking, working out, etc.) and you are lying directly on them, adding more pressure and increasing the pain.

How do I get rid of hip pain at night?

To improve your hip pain at night, you may need to adjust your sleeping position. Reducing the amount of pressure placed on your hip by using pillows for added support and to improve the alignment of your hips can help prevent hip pain when sleeping.

Other ideas include performing hip stretches before bed or even releasing tight hip muscles by applying pressure directly to the muscles to help them relax.