How to manage hip pain at night
Treatments for immediate relief
If your hip pain has woken you up at night, try changing your sleeping position and/or placing a wedge-shaped pillow under your hip, or if sleeping on your side, placing a pillow in between your legs to keep your hips aligned. If you have sciatic piriformis syndrome, placing a pillow under your knees can help reduce pain.
You can also take over-the-counter non-steroidal anti-inflammatory drugs (NSAIDs), eg ibuprofen and naproxen, to reduce inflammation and relieve pain. Long-term use of oral NSAIDs is not recommended due to side effects, so speak to your doctor about how often and how long you should take them. Your doctor may also prescribe topical NSAIDs ie gels and creams, which you can rub into your hip.
Ice packs and heat packs can also provide instant, temporary relief when placed on your hip for up to 20 minutes at a time. Ice packs help reduce swelling while heat packs can relieve pain caused by arthritis, muscle spasms or stiffness. Make sure that you wrap your ice pack in a towel to avoid direct contact of the ice with your skin and use a heat pack in the form of a hot water bottle or heating pad.
Treatments for long-term relief
For frequent hip pain, you may need to speak to your doctor about treatments for long-term relief. You may also need a firmer mattress if you have hip bursitis. You can add a foam topper to your mattress too so that your weight is better spread, which will reduce the pressure on your hips.
If you have hip arthritis, your doctor may recommend medications, including disease-modifying antirheumatic drugs (DMARDs) and biologics. If you have severe hip arthritis, your doctor may recommend:
- Arthroplasty ie total hip replacement surgery
- Arthroscopy — surgery to remove bone spurs or loose pieces of cartilage in your hip joint
- Hip resurfacing — surgery to remove and replace damaged bone in your hip joint
If you have severe bursitis, your doctor may recommend:
- Removing fluid from the inflamed bursa
- Steroid injections into your inflamed bursa
- Surgery to remove inflamed bursa
Other treatments that your doctor may recommend, depending on the underlying cause of your hip pain, include:
- Hyaluronic acid injections to lubricate your hip joint
- Physiotherapy and/or regular massage
- Steroid injections into your hip joint
Lifestyle changes
Regular exercise can help prevent future hip pain, particularly hip and back strengthening exercises, as well as yoga and Pilates to improve the flexibility of your hips. Regular walking and other aerobic exercises that are not intense can also help.
If you have arthritis, your doctor may recommend you follow an anti-inflammatory diet, which includes foods containing antioxidants and omega-3 fatty acids, as well as lemon juice and turmeric. Following an anti-inflammatory diet may also help other hip conditions alongside regular exercise and medication, if needed.
Medications
Depending on the underlying cause of your hip pain at night, your doctor may recommend medication. However, some medications eg prednisolone and certain rheumatoid arthritis medications, can cause insomnia and further worsen your sleep. You should therefore inform your doctor of any side effects from your medication.
You can take over-the-counter painkillers (eg paracetamol) to manage your pain and apply ice or heat packs to your hip.
Exercise
To relieve hip pain at night, you can speak to a physiotherapist about exercises to strengthen and stretch the muscles in your buttocks, hips, pelvis and thighs.
You should also avoid exercises that aggravate your hip pain, which are usually high-impact exercises eg running, step aerobics, and walking up and down inclines. Instead, replace high-impact exercises with low-impact exercises eg cycling, swimming, tai chi, water aerobics, walking or yoga.
Whichever form of exercise you perform, always make sure you warm up beforehand and cool down afterwards.
