Why does my hip hurt when I lie on my side?
Do you find yourself constantly changing position at night because your hip is uncomfortable? Perhaps you fall asleep without any problems, only to wake up a few hours later with an aching pain around the outside of your hip.
It's something I hear quite often in clinic, and it can be incredibly frustrating, particularly when it's starting to affect your sleep.
The good news is that there are a few common reasons this might be happening, and often some fairly simple changes can help.
What causes hip pain when lying on your side?
One common cause of pain around the outside of the hip is something called greater trochanteric pain syndrome (GTPS).
It's a bit of a mouthful, but it describes pain around the bony prominence on the outside of your hip. Often, the tendons of your gluteal muscles are involved.
These muscles do an important job. They help stabilise your pelvis when you're walking, climbing stairs, running or standing on one leg.
Sometimes the tendons become sensitive to the amount of load or pressure being placed on them.
You might notice:
Pain when lying on the affected side.
Tenderness when pressing on the outside of your hip.
Discomfort when walking longer distances or climbing stairs.
Pain when standing on one leg.
Aching that interrupts your sleep.
Not everyone with hip pain has GTPS, though. Pain can also come from the hip joint itself, the lower back or other structures, which is why a proper assessment can be helpful.
Why is it often worse at night?
When you lie directly on your side, you're putting pressure through the tissues around the outside of your hip.
If these structures are already irritated, that extra pressure can make them uncomfortable.
Even lying on your opposite side can sometimes cause problems if your top leg drops across your body, increasing compression around the sore hip.
And once your sleep starts being disturbed, everything can feel that little bit harder to manage the following day!
Why has it started happening?
Sometimes there's an obvious trigger, such as suddenly increasing your walking distance, taking up running or doing more exercise than usual.
But it isn't always that straightforward.
A few things that may contribute include:
Changes in activity
Perhaps you've recently started walking more, increased your gym sessions or spent more time on your feet. Your muscles and tendons may need time to adapt.
Muscle strength
The muscles around your hips help support you during everyday activities. If they're not coping well with the demands being placed on them, symptoms can develop.
Everyday positions
Frequently standing with your weight pushed onto one hip, sitting with your legs crossed or lying directly on the painful side can sometimes aggravate symptoms.
Hormonal changes
GTPS is more common in middle-aged women, and hormonal changes may be one contributing factor. However, there are usually several things to consider rather than one single cause.
What can you do to help?
There are a few things worth trying before assuming you need to stop being active altogether.
1. Change your sleeping position
If possible, avoid sleeping directly on the painful hip.
Try lying on your back with a pillow beneath your knees, or on your more comfortable side with a thick pillow between your knees to keep your top leg supported.
Sometimes a small change like this can make nights much more comfortable.
2. Look at what's aggravating it
You don't necessarily need to stop walking or exercising.
But if a particular activity consistently makes your hip worse, especially later that evening or the following morning, it may be worth temporarily reducing how much you're doing.
Think about adjusting the distance, duration or intensity rather than giving up the activity completely.
3. Gradually build your hip strength
Strengthening the muscles around your hips can be an important part of improving how well they cope with everyday activities.
Exercises such as bridges, carefully selected hip-strengthening movements and gradual step-up exercises may be useful.
The important thing is finding the right starting point for you. Exercises shouldn't repeatedly leave your symptoms significantly worse.
4. Be careful with stretching
This one sometimes surprises people!
When something feels tight or sore, our first instinct is often to stretch it.
But if the tendons around the outside of your hip are irritated, some stretches that pull your leg across your body can actually increase compression and make things more uncomfortable.
It's not always a case of stretching more. Sometimes modifying aggravating positions and gradually improving strength is a better approach.
When should you get your hip checked?
If your pain keeps coming back, is affecting your sleep or is stopping you doing your usual activities, it's worth having it assessed.
Sudden severe hip pain after a fall, difficulty bearing weight, or a hot, swollen hip with a fever needs urgent medical assessment.
Persistent or worsening pain, particularly alongside unexplained symptoms or a history of cancer, also warrants medical review.
How can chiropractic care help?
At Queensferry Chiropractic, I'll take the time to listen to what's been happening, assess your hip and look at any other areas that might be contributing to your symptoms.
From there, we can talk about what might help, whether that's advice on managing activities, specific exercises, appropriate hands-on treatment or referral for further investigation if needed.
"If you'd like to understand more about the different causes of hip pain, I've written a guide to hip pain and self-help advice."
My aim is to help you understand what's going on and find a way forward that works for you.
Struggling with hip pain?
You can book an appointment at Queensferry Chiropractic in South Queensferry or Dalmeny.
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