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Hip Pain at Night: Why It Happens & What To Do About It

Written by Beth Holloway, RN, M. Ed
2021-03-08

We spend about a third of our lives in bed with the goal of getting a good night’s sleep. Yet, the reality is that for some people, much of that time is spent not sleeping. It can be difficult to sleep, especially with pain. Research shows that pain interferes with sleep and poor sleep worsens pain.

Pain has many causes, among them various musculoskeletal conditions. It is difficult to manage such pain during the day and it can be even more challenging at night.

Here’s an example of hip pain, a common area for musculoskeletal pain. A person, for instance, a 35-year old woman, with hip pain at bedtime or hip pain while sleeping might experience something like this:

  • It’s bedtime and she has mild pain from the day’s activities. 

  • Once in bed, it’s quiet and there are fewer distractions. She focuses more on her pain.

  • That makes her feel anxious and stressed.

  • She tries to find a comfortable position yet can’t. 

  • The pain and frustration worsen. 

  • She dozes off then wakes up in a twisted position with intense pain and her hip throbbing. 

  • She has poor sleep and then wakes for the day with more hip pain.

Does this sound familiar? Perhaps your pain is in your lower back, neck, or knee. Regardless, it interferes with your sleep. And when you don’t sleep well, that aggravates your pain even more. 

In this article, we include:

  • What Is Musculoskeletal Pain and Common Causes

  • Musculoskeletal Pain At Night: What You Can Do

  • Activity and Exercise

  • Medicines and Supplements

  • Mind-Body Techniques

  • Sleep Comfort, including sleep positions

What Is Musculoskeletal Pain and Common Causes

Your musculoskeletal system supports your body. It’s primarily made up of bones, joints, cartilage, muscles, tendons, ligaments, and connective tissue. These structures are present throughout your body, thus you may have pain from a musculoskeletal problem anywhere - from the muscles supporting your neck to a bone in your ankle joint. However, the neck, shoulder, back (especially the lower back), hip, and knee are the areas most often affected.

Many causes of hip pain are similar to the causes of musculoskeletal pain in general. The most common causes include:

  • Sprains and strains: Injuries to muscles, tendons, or ligaments

  • Incorrect or lack of movement, or overuse: This can come from something like poor lifting technique, bad posture, lack of physical activity, or repetitive movements

  • Arthritis: Long-term wear-and-tear on joints, especially osteoarthritis. Bursitis, as in hip bursitis, is another joint-related cause of pain. It is inflammation of the small sacs (bursae) that lubricate the joints.

  • Injuries and accidents: Strains and sprains from sports injuries, slips & falls, or sudden, jarring movements

Musculoskeletal Pain At Night: What You Can Do

You can make some changes to help lessen nighttime pain and improve your sleep. You can try the following changes and techniques to address musculoskeletal pain at night.

Activity and Exercise

  • Daytime activity. Being active during the day helps with sleep. Try to get some exercise every day. Remember to avoid those activities that increase pain. 

  • Gentle stretching. Try slowly moving the painful area before you go to sleep or if you wake up during the night.

  • Strengthening exercises. Keep your bones, joints, and muscles strong. Goodpath has therapeutic exercise videos - for example for hip pain, knee pain, and back pain.

Medicines and Supplements

  • Topical pain reliever. Patches, gels, and rubs applied to the area help lessen pain. Using gentle massage when applying gel or cream adds to the pain relief. 

  • Timing of pain medicines and supplements. Carefully follow instructions. Your doctor, pharmacist (or a Goodpath coach) can answer questions and work with you to determine the best time to take them e.g. to be most effective at night time.

  • Timing of sleep medicines and supplements. As with pain medicines, following instructions and timing are essential.

You could also try the application of heat or ice. Applying heat or ice helps lessen pain. You can apply either method throughout the day or if you wake up during the night with pain. Make sure you use heat or ice for only minutes at a time.

Mind-Body Techniques 

  • Cognitive behavioral therapy (CBT). CBT for insomnia (CBT-I) and CBT for pain are psychological treatments that help you change your thoughts, feelings, and behaviors as they relate to sleep problems or pain.

  • Relaxation techniques. Deep breathing, guided imagery, and other techniques can help you relax before bedtime or get back to sleep if you wake at night. They can help lessen your pain-associated anxiety and stress.

Sleep Comfort

  • Sleep environment. Make sure you’re comfortable

    • An appropriate bedroom temperature helps with sleep. You don’t want to wake up because you’re too hot or too cold. 

    • Staying warm can also help you maintain a healthy sleep position. As an example, an appropriate sleeping position may make it difficult to cover part of body, so you’ll need to wear something to stay warm and comfortable.

    • Keep lights and noise to a minimum.

  • Mattress comfort

    • Your mattress should be medium-firm and allow for good body alignment regardless of your sleep position, your ears, shoulders, and hips should be aligned.

    • An older mattress may no longer provide good support. If it’s been years since you last bought a mattress, it may be time.

  • Sleep position

    • Avoid sleeping on your abdomen as it's difficult to maintain good body alignment.

    • Don’t sleep with your arms under or above your head.

    • When moving from one position to another, do it carefully. Try not to twist or make quick movements.

There are specific sleep positions to consider, depending on the location of your pain. Explore these recommendations for new sleep positions. They are not only comfortable but may also support musculoskeletal health.

Sleeping With Neck Pain

  • Your pillow should support your head and fill the space between your neck and bed.

  • Your neck should be in a neutral position, not bent forward, back, or sideways.

  • Try a small towel underneath your neck instead of a pillow.

Sleeping With Shoulder Pain

  • Avoid sleeping on your affected shoulder. 

  • When sleeping on your other side, support your affected shoulder and keep your back aligned by hugging a pillow.

  • Cushion your elbows if on your back.

Sleeping With Back Pain

  • Sleep on your side with your head on a pillow and your knees bent, a pillow between them.

  • Sleep on your back with small pillows beneath your neck and knees.

Sleeping With Hip Pain

  • Avoid sleeping on your affected hip.

  • Keep your hips aligned with a pillow between your knees if on your side.

Sleeping With Knee Pain

  • While on your back, sleep with a pillow supporting your knees.

  • On your side, your knees should be bent, with a pillow between them to keep them aligned.

If you have musculoskeletal pain at night, Goodpath can help. The first step is our free pain or sleep assessment. Once you complete it, we’ll provide a plan based on your history and symptoms. Get started.