Having hip pain at night or while sleeping can cause major disruptions in your life. This is especially true if you are a side sleeper. Hip pain when sleeping on your side, either whether it is one side or both sides, often puts additional strain or pressure on your hips - exacerbating preexisting pain.

For many side sleepers, having hip pain when sleeping on either side is especially annoying because it becomes more difficult to find a comfortable position to fall asleep. As hip pain progresses, it can even develop into a general pain at night no matter what sleeping position you are in!

The best way to approach hip and leg pain when sleeping on your side is to first understand the root cause of that pain.

While you may be able to do some research and narrow down the possible causes of your hip pain when sleeping on your side, it is recommended that you consult a medical professional to ensure you are treating your pain most effectively.

We will cover some of the most common causes of hip pain when sleeping, but that will not be the main focus. The bulk of this article will cover ways that you can reduce your pain and manage symptoms so that you can get a better night’s sleep and wake up feeling rested.

What causes hip pain when sleeping on your side?

There are several causes of hip pain when sleeping on your side.

No one person is exactly the same and neither is their hip anatomy. The shape of the hip sockets is different from person to person, some people may experience hypermobility issues, and it is also possible that your hip pain is residual from a past or current injury.

Chronic hip pain is something that is often associated with arthritis, bursitis, and osteoarthritis as well. That being said, one of the most common, yet easiest to overlook, causes of hip pain at night is having tight hip flexor muscles.

Your hip flexor muscles are also known as your iliopsoas. The iliopsoas consists of two muscles that overlap each other: the iliacus and the psoas muscles.

Because the iliopsoas muscles are used so extensively throughout the day, even when you are sitting, they can easily become tight enough to cause discomfort and can pull your hips out of alignment.

The stress on your hips does not stop when you lay down to sleep either. Especially for side sleepers.

You see, when you are lying on your side, your legs are usually stacked on top of each other - sometimes connecting at the knees and ankles. Depending on your mattress, the bottom hip may not experience much strain, but the top hip does.

Since the top hip and the rest of your leg are not on the same level, your knee pulls the hip slightly down and the hip feels a strain. If you sleep on your side, you may not notice any discomfort or irritation at first. It may take some time - even years - for your muscles to become affected by that pull from your knees.

If your hip flexor muscles are already tight, this additional nightly stress can cause hip pain when sleeping on your side.

Most side sleepers also tend to curl their knees slightly towards their chest, compounding the tight iliopsoas issue. Despite being in a resting position, your iliopsoas muscles are fully engaged when you’re drawing your thighs and knees slightly up.

All this just goes to say that, although there are many other possible reasons for hip pain when sleeping on your side, don’t overlook something as seemingly simple as tight muscles.

5 ways to manage hip pain when sleeping on your side

While the best way to address hip pain of any kind is to get a diagnosis and understand the cause of the pain, it can also be beneficial to address some of the symptoms.

Even if you are receiving treatment for the underlying condition, hip pain when sleeping on your side can still occur. And sometimes, hip pain is worse at night.

So in order to get a good night’s sleep, having a few ways to minimize your hip pain is a must, especially for side sleepers.

1. Invest in a quality mattress

Likely the most expensive way (and arguably most worthwhile) to reduce hip pain at night is to invest in a quality mattress. Most of us do not realize how much our mattresses really impact our lives until we get an upgrade.

One basic thing to avoid in a mattress if you experience any kind of hip pain when sleeping on your side is the mattress being too firm.

While spring mattresses tend to be an affordable option, they do not have much “give” and don’t conform to your body well enough. When sleeping on a spring mattress, there is more pressure applied to the hips and shoulders when you are sleeping on your side.

The main factors you want to look for in a quality mattress are support, firmness that suits your body and sleep style, and the ability to conform to the contours of your body. The idea is to maintain a straight line with your spine - whether you sleep on your back, stomach, or either side.

Many people that have hip pain when sleeping on their side should consider medium-firm mattresses that almost creep into the soft side. These offer enough give to gently cradle your shoulder and hip, but won’t let you sink completely into the mattress and cause your back to be out of alignment for the entire night.

Now I know, finding a good mattress can become tricky if you sleep in the bed with your significant other. Especially if you each have different sleep styles and needs. But there are beds that address that concern of differing mattress preferences - such as a sleep number mattress. Beds like this allow each person to set their preferred firmness to reach optimal comfort.

2. Get into a morning hip stretching habit

When you have tight hip flexor muscles, it can help to stretch them at least a little bit. Be aware that it is possible to overstretch your hip flexors. People with hypermobility, or people who sit a lot (such as with a desk job) should be careful of overdoing it with the stretches.

That being said, getting into the habit of doing a short yoga or hip flexor stretch session right when you get up is a good way to wake up your muscles and get them ready for the day. You don’t need to be a yogi and/or go to a fancy studio to effectively stretch your body (though, if you want to, yoga can be a wonderful practice!)

These stretches can be hip specific, but they can also be general to get more blood flow to your muscles. And you often don’t need to stretch as deep as you think you should. Everyone’s natural range of motion is a bit different and can even change day to day. So listen to your body, and never continue a stretch if it hurts.

Especially for those of you that sit for extended periods of time, stretching in the morning and getting up and moving throughout the day is important for hip health.

The longer you stay seated, the more your hip flexor muscles begin to shorten. These tight, shortened muscles could be the culprit for your hip pain when sleeping on your side. When you stretch, you are counteracting the compressed position your muscles were in and lengthening them again. This often provides a bit of instant relief but is also a practice you should continue doing each day.

3. Have a nightly muscle tension release routine

If muscle tension is the root cause of your hip pain at night, then you need a way to release that muscle tension. If you want to address your hip pain when sleeping on your side, muscle release is one of the most important steps.

Much like getting into the habit of stretching, muscle tension release works best when it is done on a regular basis. This could be every night or every other night.

Your hip flexors, or iliopsoas muscles, are extremely hard to reach with traditional pressure release tools like massage balls or foam rollers. These can work great to release the back of your hip and your glute muscles (which is also an important part of releasing tension in your hip muscles), but they will not reach the iliacus or psoas.

The best way to effectively achieve a muscle pressure release in this area is to use the Hip Hook. The Hip Hook is a muscle release tool specifically designed to replicate the skilled touch of a physical therapist, effectively targeting iliacus muscle tension in the comfort of your own home.

Since the iliacus is only accessible if you reach slightly behind or inside the pelvic bone, the Hip Hook somewhat simulates someone else applying pressure with their hands. The only difference is that you can do it yourself and you are in control of the amount of pressure applied.

It is possible that only one hip is causing you pain, but that doesn’t mean that you should neglect the other hip. It’s important to keep your body as balanced as possible so that nothing else gets pulled out of alignment.

Practice this muscle tension release nightly or every other night on both hips.

Don’t forget to also release the back side of your hip as well using a massage ball or foam roller. If you are experiencing sciatica pain along with hip pain and tightness, you may want to incorporate a gentle self-massage on your sciatica trigger points.

Releasing your hip flexor muscles is a targeted approach that can save you from sleepless nights and the domino effect of an overly tight iliacus muscle. By avoiding the issue and letting your tight muscles carry on, you may start to develop other pain points and problems like sacroiliac joint pain.

4. Sleep with a pillow between your legs

Using a pillow is one of the easiest ways to reduce and even eliminate hip pain at night and while sleeping on your side.

Many side sleepers find that using an extra pillow between their legs is more comfortable, even if they don’t have any existing hip pain or tightness. The pillow can be placed between your thighs and knees but you can also use a longer pillow that extends down to your ankles as well.

The main reason that using a pillow to prop up the top leg relieves the hip pain at night lying on your side is that it helps keep your pelvic bone level, your spine straight, and your knees evenly stacked on top of one another.

Side sleeping is not always the best sleep position for those with hip pain, but this gets you much closer to proper alignment.

When you are sleeping on your side without a pillow between your legs, the gravity, and the weight of your leg, pulls on your hip muscles and irritates the joint area. By allowing your leg to be more in line with your hip, you relieve that strain on the hip joint and muscles.

5. Mix up your sleeping positions

We all have a favorite sleeping position, and if you’re reading this, I’d guess it is on your side. You may switch sides from time to time, but even with the help of a pillow between your legs, your sleep position could be causing more hip pain than you would like.

As I mentioned, it might be time to try some new cuddling and sleeping positions if you have hip pain.

One of the best sleeping positions for hip pain is to sleep on your back. This position allows your body to have your weight evenly distributed across a larger surface area, which means less pressure is being concentrated on your hip joints.

The key with sleeping on your back is, again, to keep your spine in alignment. A good neck pillow will get you far. Try to find one that only slightly raises your head off the mattress. It shouldn’t cause your chin to dip toward your chest, but rather have it be perpendicular to the ceiling.

If your hips are particularly tight, you could also put a pillow under your knees to slightly elevate them and decrease any intensity you are feeling in your hips.

In any case, simply changing up your sleep positions from time to time can be really beneficial for hip pain when you normally find yourself sleeping on your side.

Invest in your hip health for better sleep

Your health is all you have! And chronic hip pain at night can easily become a burden in your life. It’s important to get to the root of your pain and begin treatment to enhance your overall well-being.

Remember, if you have hip pain when sleeping on your side, there are a variety of reasons why that pain started, but how you are sleeping, your daily routine, and even the mattress you have can impact your pain levels.

If you don’t want to invest in a new mattress just yet, investing in a Hip Hook and Hip Release Ball and experimenting with pillows/sleep positions are a great first step to reducing any pain you feel when you’re sleeping on your side. With the proper tools and dedication, you CAN be back to a sound sleep in no time.

Frequently asked questions about side sleeping and hip pain

Why does my hip hurt when I sleep on my side?

When sleeping on your side, a lot of pressure is being placed directly on your hip. If your hips are already feeling a bit unhappy from tight hip muscles or other injuries, sleeping with too much pressure on your hip can exacerbate the discomfort. Consider trying to sleep while on your back and with the support of pillows underneath your legs.

How do I stop my hip from hurting when sleeping on my side?

Taking a look at your sleeping posture may have a lot to do with having hip pain when sleeping on your side. If your hips are not in a good alignment, this can lead to more irritation and pain. To help improve the alignment of your hips, try adding a pillow between your legs. This creates more space within the hip joint to rest and recover as you sleep.