Why Does My Hip Hurt When I Lay on My Side? Common Causes & Relief

Why Does My Hip Hurt When I Lay On My Side?

If you consistently experience hip pain when laying on your side, you're not alone. Many people, especially women, report discomfort in the hips when side-sleeping. While not always serious, recurring hip pain should not be ignored. Understanding the common causes can help you find relief.

The hip is a ball-and-socket joint with a wide range of motion. This complexity also makes it susceptible to various injuries and conditions that can lead to pain. The specific location and type of pain provides clues as to the potential source.

Here are some of the most common reasons your hip hurts when laying on your side, plus tips for finding relief.

Bursitis

Bursae are fluid-filled sacs around the hip joint that cushion and protect the bone. When inflamed, they cause a condition known as bursitis that leads to localized pain.

Sleeping on the side places pressure directly on the bursae, aggravating inflammation and causing sharp hip pain. Pain is usually focused on the outer upper thigh or buttock area.

Bursitis often arises from repetitive movements that irritate the bursae over time. Tight muscles can also contribute by putting extra pressure on bursae. Treating bursitis involves rest, ice, medication, and physical therapy exercises.

Arthritis

Arthritis causes gradual deterioration of the hip joint cartilage and bones. As the cushioning cartilage wears away, bone rubs against bone leading to stiffness, swelling, and joint pain.

There are various types of hip arthritis with osteoarthritis being the most common. Sleeping with arthritis places stress on already inflamed joints and cartilage causing significant discomfort.

Arthritis pain tends to be chronic and worse in the mornings or after activity. Age, obesity, and joint injuries increase the risk. Treatment focuses on pain management, weight loss, physical activity, assistive devices, and possibly surgery.

Greater Trochanteric Pain Syndrome

Greater trochanteric pain syndrome (GTPS) causes pain in the bony protrusion on the outer upper thigh bone. Tendons and bursae around this bony prominence become inflamed and irritated.

Sleeping on the side adds pressure to the already inflamed greater trochanter. Pain is focused on the outer hip and upper thigh and may radiate down the leg. GTPS is most common in middle-aged women.

GTPS arises from repetitive use like running as well as weakness in hip muscles. Physical therapy, steroid injections, and shockwave therapy help treat the inflammation and underlying issues.

Tendinitis

Tendinitis refers to inflammation of the hip tendons that connect bone to muscle. The tendons become irritated from overuse or injury. Laying on the side strained inflamed tendons, causing localized hip pain.

Two common forms of hip tendinitis include iliopsoas tendinitis and hip adductor tendinitis. Iliopsoas runs along the inner hip while the adductors are inner thigh muscles.

Tendinitis treatment involves rest, ice, medication, physical therapy, and modifying activities. Severe cases may require steroid injections or surgery if conservative treatments fail.

Muscle Strain

Tears or strains in muscles surrounding the hip joint lead to inflammation, pain, and muscle spasms. Sleeping on the side of an injured hip muscle worsens pain and delays healing.

The iliopsoas muscle on the inner hip and thigh adductors on the inner thigh are particularly prone to strains. Quick twisting motions and explosive activity often cause strains.

Mild to moderate strains can heal through rest, ice, compression wraps, anti-inflammatory medication, and physical therapy. Severe muscle tears may need surgical repair.

Snapping Hip Syndrome

Snapping hip syndrome involves tendons snapping over bony hip bumps during movement. This leads to snapping, clicking or popping sensations along with pain and inflammation.

Sleeping on the affected side forces the tendon to snap over the trochanter bone causing significant discomfort. The snapping and sensations usually lessen with movement making it most noticeable at rest.

Strengthening exercises, physical therapy, steroid injections and surgery are used to treat snapping hip. Taping the tendon or limiting activities that aggravate it can also help.

Hip Labral Tear

The labrum cartilage provides cushioning around the hip socket rim. Twisting motions and trauma can cause tears in the labrum leading to stiffness, clicking noises, and sharp hip pain.

Sleeping on the side places pressure on the damaged labrum worsening symptoms. Pain is focused deep inside the hip joint rather than the outer surface.

Anti-inflammatory medication, physical therapy, and cortisone injections help manage pain from labral tears. Surgery may be required to repair severe tears and restore hip function.

Piriformis Syndrome

The piriformis muscle runs diagonally across the butt area and can compress the sciatic nerve if tight or inflamed. This causes radiating butt, hip and thigh pain called piriformis syndrome.

Sleeping on the affected side worsens sciatic nerve compression. Symptoms usually begin gradually with numbness, tingling, and shooting pain from the hip down the leg.

Stretching the piriformis muscle along with physical therapy, anti-inflammatories, and steroid injections typically resolves symptoms. Surgery may be needed for severe cases unresponsive to conservative treatment.

Hip Osteonecrosis

Osteonecrosis or avascular necrosis develops when part of the hip bone loses its blood supply and dies. As the bone segment collapses, it leads to severe arthritic hip pain.

Pressure from sleeping on the side accelerates damage to the fragile bone. Pain is focused deep inside the hip and worsens with activity and weight-bearing.

Early intervention includes protected weight-bearing, medication, and physical therapy. Surgery like bone decompression or total hip replacement is often necessary in later stages to restore hip function.

Hip Fractures

Breaks or fractures in the femoral neck, hip sockets, and pelvic bones cause severe hip pain. Hip fractures typically result from major falls and trauma in the elderly.

Attempting to sleep on the side of a fractured hip causes extreme pain and is impossible without correct positioning. Pain is acute and focused at the fracture site.

Most hip fractures require prompt surgical stabilization and repair followed by protected weight-bearing. Full hip function is unlikely to be restored making prevention key.

When to See a Doctor

Occasional hip discomfort that eases with movement or position change is usually not concerning. However, see a doctor if you experience:

• Consistent hip pain when laying on your side that disrupts sleep
• Intense or worsening hip pain
• Hip pain along with weakness, numbness or limping
• Pain, clicking or locking during hip movements
• Swelling, bruising, or deformity around the hip
• Trauma like falls associated with new hip pain

Severe, worsening, or persistent hip pain warrants medical evaluation. Early treatment of many hip conditions can help prevent complications like arthritis down the road.

Diagnosing the Cause of Hip Pain When Sleeping

To pinpoint the cause of hip pain when sleeping, the doctor will perform a physical exam and ask questions about symptoms, risk factors, and medical history. They may order imaging or other tests like:

Hip X-Ray

X-rays provide clear images of bone allowing the doctor to visualize damage, arthritis, fractures, and other issues. This is usually the first imaging test ordered.

MRI

MRIs use magnets to map soft tissues like cartilage, ligaments, tendons, muscles, and nerves. MRIs identify labral tears, muscle strains, joint effusions, tumors, and other soft tissue causes of hip pain.

CT Scan

CT scans combine multiple X-ray images for a 3D view inside the hip joint. They help diagnose subtle fractures, osteonecrosis, arthritis, and anomalies that may be missed on regular X-rays.

Ultrasound

Musculoskeletal ultrasound uses soundwaves to visualize muscles, tendons, and other soft tissues around the hip joint. Ultrasounds identify tendinitis, bursitis, muscle tears, and soft tissue masses.

Hip Injection

Injecting numbing medication into the hip joint helps determine if the pain originates inside the joint itself. Pain relief from injections indicates arthritis, labral tears, or other internal issues.

Bloodwork

Blood tests look for inflammation, infection, and autoimmune disorders that could contribute to hip pain. Bloodwork provides additional insight when the cause remains uncertain.

The combination of a thorough physical exam, medical history, and appropriate diagnostic tests will allow the doctor to make an accurate hip pain diagnosis.

How to Sleep Comfortably With a Painful Hip

Difficulty sleeping due to hip pain can leave you exhausted. Try these tips and aids to help you rest comfortably:

• Place a pillow between your knees to maintain alignment
• Avoid placing pillows under the head as this twists the hip
• Sleep with hips and knees slightly bent
• Use a thick memory foam mattress topper for cushioning
• Try heat therapy before bed to loosen tight muscles
• Take over-the-counter pain medication before bedtime as needed
• Sleep on the back instead of painful side if tolerable
• Ask your doctor about prescription sleep aids if pain remains disruptive

Addressing the root cause of hip pain is key for long-term relief. But in the short term, these tips can help you get your much-needed rest.

How to Prevent Hip Pain When Sleeping

While some causes of hip pain like arthritis are unavoidable, you can take steps to prevent many issues that disrupt sleep. Here are some proactive tips:

• Maintain a healthy weight to avoid putting extra pressure on the hip joint
• Choose low-impact physical activities like swimming to avoid overuse injuries
• Strengthen hip muscles with resistance exercises
• Stretch hip muscles like the piriformis regularly
• Use proper lifting techniques and avoid carrying heavy loads
• Wear shoes with cushioning and arch support
• Stop activities immediately at the first sign of hip pain
• Make dietary changes to reduce inflammation like increasing omega-3s
• Optimize nutritional intake for bone and muscle health

Along with medical treatment, integrating preventative strategies helps stop recurring hip discomfort so you can rest easy.

Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a healthcare professional before starting any new treatment regimen.