The fastest way to relieve hip pain while sleeping is to change your position and add a pillow between or under your knees to keep your hips aligned. But lasting relief usually takes a combination of approaches: the right sleeping position, a supportive mattress, targeted stretches before bed, and sometimes temperature therapy. Here’s how to put all of that together.
Why Your Hip Hurts More at Night
During the day, you shift your weight constantly. At night, you stay in one position for hours, which concentrates pressure on specific points. For side sleepers, that pressure lands directly on the bony outside of the hip (the greater trochanter), compressing the bursa and tendons underneath. For back sleepers, tight hip flexor muscles can pull on the joint when the legs are fully extended.
Several conditions make this worse. Osteoarthritis causes pain in the groin, thigh, or glutes that tends to flare after long periods of stillness. Trochanteric bursitis, an inflammation of the fluid-filled sac on the outer hip bone, is particularly sensitive to the sustained pressure of lying on your side. Gluteal tendinopathy, where the tendons connecting your glutes to your hip bone break down from overuse or repetitive stress, also tends to announce itself at night. And hip flexor strains from overstretching or overuse during the day can produce pain, swelling, and stiffness that peaks once you’re lying down.
If your pain is on the outside of your hip, right where it presses into the mattress, your sleep surface is a likely contributor. If the pain is deeper in the groin or front of the hip, positioning and muscle tightness are more likely culprits.
Best Sleeping Positions for Hip Pain
Your sleeping position is the single biggest variable you can control tonight. The goal is keeping your pelvis level and your spine in a neutral line, so no one joint absorbs disproportionate load.
Side Sleepers
If one hip hurts, sleep on the opposite side. Place a firm pillow between your knees so your upper thigh is elevated enough to keep the hip joint in a neutral position. If your pillow is thin, or you tend to slide your top leg forward during the night, stack two pillows. You can also tuck a small pillow or folded towel under the curve at your waist to prevent your spine from sagging. U-shaped or C-shaped body pillows work well here because they hold everything in place even if you shift during sleep.
Back Sleepers
Place a pillow or rolled blanket under your knees. This slightly bends your legs, which reduces tension in the hip flexor muscles along the front of your hip and takes pressure off the lower back. A second thin pillow under the small of your back can help maintain a gentle natural curve in the spine. This position distributes your weight evenly across both hips and is often the most comfortable option if both sides are painful.
Stomach Sleepers
Sleeping face-down pushes your lower back into an exaggerated arch, which compresses the hip joints. If you can’t break the habit, place a pillow under your pelvis to keep your hips and lower back closer to neutral. Over time, though, transitioning to your back or side will give you better results.
How Your Mattress Affects Hip Pain
A mattress that’s too firm creates pressure points at the hip. One that’s too soft lets your pelvis sink, pulling your spine out of alignment. Research suggests a medium-firm mattress, roughly a 6.5 on the standard 1-to-10 firmness scale, strikes the best balance between pressure relief and support for most people.
If your mattress is older or showing visible sagging, it may no longer provide adequate support. Before replacing it entirely, try a mattress topper and assess whether your hip pain improves over a week or two. Memory foam and latex toppers tend to do the best job of cushioning the bony prominence on the outside of the hip while still supporting your pelvis. Side sleepers in particular benefit from a slightly softer surface that lets the hip and shoulder sink in just enough to keep the spine straight.
A thin pillow placed directly under the side of your hip can also reduce pressure if you’re not ready to change your mattress. It’s a simple fix worth trying tonight.
Stretches to Do Before Bed
Tight hip flexors, glutes, and piriformis muscles all contribute to nighttime hip pain. A short stretching routine before bed can loosen these areas enough to reduce discomfort once you lie down. Hold each stretch for 30 seconds per side, and repeat for three sets.
Half-Kneeling Hip Flexor Stretch
Kneel on the floor and step your right foot forward so your right thigh is parallel to the ground with the knee at 90 degrees. Keep your left knee on the floor with the shin pointing straight back. Place your hands on your hips, tuck your pelvis under by squeezing your glutes, and shift your weight forward until you feel a stretch through the front of your left thigh and groin. For a deeper stretch, reach your left arm overhead and lean slightly to the right. Repeat on the other side.
Supine Hip Flexor Stretch
Lie on your back at the edge of your bed with both legs extended. Let one leg hang off the side of the bed while you bend the opposite knee and pull it gently toward your chest. Keep your back flat against the mattress. You should feel a stretch along the front of the hip on the hanging leg. This one is especially convenient because you’re already in bed.
Side-Lying Hip Flexor Stretch
Lie on your left side with your knees bent at 90 degrees, lined up with your hips. Reach back with your right hand, grab the top of your right ankle, and gently pull your foot behind you. Keep your pelvis tucked and avoid arching your back. This targets the front of the hip and the quadriceps on the top leg.
90/90 Stretch
Sit on the floor with your right leg in front, knee bent at 90 degrees, the bottom of your foot facing the left wall. Place your fingertips on either side of your right shin for balance and focus on sinking both hips toward the floor. For more intensity, lean your chest forward without collapsing your torso or letting your hips lift. This stretch opens the deep hip rotators, which are often tight in people with lateral hip pain.
Beyond stretching, strengthening exercises done earlier in the day, like glute bridges, clamshells, and planks, help build the stability your hips need to stay comfortable through the night. Stronger glutes and core muscles take load off the hip joint itself.
Heat and Ice Before Bed
Temperature therapy applied 15 to 20 minutes before you get into bed can make a noticeable difference.
If your hip pain is chronic or achy (no visible swelling or redness), heat is the better choice. It raises your pain threshold and relaxes the muscles around the joint. A heating pad, warm towel, or microwavable heat pack applied to the hip for 15 to 20 minutes works well. Always wrap it in a towel or pillowcase rather than placing it directly on your skin.
If you’ve recently aggravated your hip, or there’s swelling, redness, or warmth around the joint, use cold instead. Cold packs reduce inflammation and muscle spasms. Apply for no more than 20 minutes, wrapped in a towel. Do not use heat on a swollen, red, or hot area, as it can increase inflammation.
For many people with ongoing hip issues, a simple routine of heat before bed followed by gentle stretching is enough to take the edge off and make it easier to fall asleep.
Other Adjustments That Help
A few smaller changes can add up. Wearing loose-fitting sleepwear prevents fabric from bunching and creating extra pressure at the hip. Keeping your bedroom cool (around 65 to 68°F) helps your body relax into deeper sleep, which reduces how often you shift positions and wake up from pain. If you tend to roll onto your painful side during the night, placing a body pillow behind your back acts as a physical barrier.
Over-the-counter anti-inflammatory medications taken 30 to 60 minutes before bed can reduce joint inflammation enough to get you through the night, but they work best as a short-term bridge while you address the underlying causes through positioning, stretching, and strengthening. If your hip pain persists for more than a few weeks despite these changes, or if it’s accompanied by a catching sensation, sudden weakness, or pain that radiates below the knee, a physical therapist or orthopedic specialist can help identify what’s driving it.