Hip pain at night - what's behind it?
definition
Hip pain can occur in people of all ages. They exist on one or two sides and, depending on the cause, are felt either directly in the hip joint, in the groin or on the lateral thigh. If the pain occurs at night, it is felt to be particularly stressful and prevents good sleep hygiene.
The cause can either be in the joint itself, or it can be found in the bursae, nerves, or muscles. An unsuitable mattress can also sometimes trigger nighttime hip pain.
Read more on the topic: Hip pain
causes
Basically, there are many possible causes of nocturnal hip pain. In general, however, it can be assumed that pain that occurs at rest is more inflammatory, while complaints that occur during exertion tend to suggest wear and tear. Inflammation of the hip joint can be caused by rheumatism, for example if there is rheumatoid arthritis or ankylosing spondylitis. In addition, a metabolic disorder such as gout can rarely lead to inflammation of the hip joint. Bursitis also leads to nightly symptoms.
It must always be clarified whether the hip pain actually originates from the hip or whether it is radiating pain that originates, for example, from the spine. A herniated disc can also lead to hip pain at night.
Read more on the topic: Pain in the hip
Appointment with a hip expert?
I would be happy to advise you!
Who am I?
My name is dr. Nicolas Gumpert. I am a specialist in orthopedics and the founder of .
Various television programs and print media report regularly about my work. On HR television you can see me every 6 weeks live on "Hallo Hessen".
But now enough is indicated ;-)
The hip joint is one of the joints that are exposed to the greatest stress.
The treatment of the hip (e.g. hip arthrosis, hip impingement, etc.) therefore requires a lot of experience.
I treat all hip diseases with a focus on conservative methods.
The aim of any treatment is treatment without surgery.
Which therapy achieves the best results in the long term can only be determined after looking at all of the information (Examination, X-ray, ultrasound, MRI, etc.) be assessed.
You can find me in:
- Lumedis - your orthopedic surgeon
Kaiserstrasse 14
60311 Frankfurt am Main
Directly to the online appointment arrangement
Unfortunately, it is currently only possible to make an appointment with private health insurers. I hope for your understanding!
Further information about myself can be found at Dr. Nicolas Gumpert
Bursitis of the hip
Bursae are small bags of tissue a few centimeters in size that are filled with the same fluid that is found inside joints. They serve as natural cushions and are found on particularly stressed parts of the body, such as large joints or in the space between tendons and bones. When the bursa becomes infected, there is painful swelling, redness, and overheating of the affected area. The corresponding joint can usually not be fully moved due to the pain. The bursitis can occur as a result of trauma, but it can also be the result of over-stimulation or incorrect loading of the joint. Rheumatic diseases or bacterial inflammation after surgery on the relevant joint can also lead to bursitis. In very rare cases, gout is the cause.
There are many bursa on the hip that lie directly on the hip joint capsule. Most often, however, an external bursa is affected by inflammation. This bursa is located on a protruding bone of the thigh bone, over which a large tendon plate runs. Therefore, this bursa is exposed to a lot of pressure when moving and is quickly overexcited.
A bursitis of the hip usually shows up as hip or groin pain. At night, the pain usually occurs when lying sideways on the side of the thigh, as the pressure on the inflammatory bursa is increased.
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Hip osteoarthritis
As society ages, the number of people with hip osteoarthritis is steadily increasing. Osteoarthritis refers to wear and tear on the joint cartilage. Due to the lack of cartilage, the bones at the joint rub directly against each other. This can be very painful. Cartilage wear and tear is a natural phenomenon in old age. On average, the patients are between 50 and 60 years old when the symptoms first appear.
Hip osteoarthritis is noticeable through pain in the groin and on the upper, lateral thigh. Classically, the pain is not initially present at night, but rather during the day when moving. With osteoarthritis of the hip, walking uphill is particularly painful and internal rotation is only possible to a limited extent. The beginning of a movement and very long-lasting loads are particularly painful. As the disease progresses, the disease becomes chronic and the symptoms also occur at rest and at night. A pain that occurs at night and gets better with plenty of exercise during the day, on the other hand, is not indicative of osteoarthritis. This is more of an inflammatory disease. The diagnosis of hip osteoarthritis is made by the doctor by looking at the symptoms, the physical examination and an X-ray examination of the hip joint.
Read more on the topic: Symptoms of hip osteoarthritis
Concomitant symptoms
The symptoms that accompany the pain can also be very helpful in making a diagnosis. Overheating, swelling and reddening of the joint suggest an inflammatory process. If the inflammation is of rheumatic origin, symptoms usually also occur in other joints. In rheumatoid arthritis, the finger joints are particularly affected. Bechterew's disease usually involves the spinal joints and the sacrum and iliac joint. In addition, this clinical picture often leads to stiffening of the joints and inflammation of the muscle tendons. Irritation of the iris of the eye can also occur. This is also present in the arthritis associated with psoriasis. It is important here that the extent of the skin findings of the psoriasis does not have to run parallel to the joint complaints.
In joint osteoarthritis caused by wear and tear, there are usually no other symptoms besides pain, which can initially only be present when moving, but later also at night at rest.
If the cause of the nocturnal hip pain can be traced back to a malignant tumor, it can lead to fever, an unwanted weight loss of over 10% of the body weight and increased sweating at night.
If a poorly adapted mattress is the cause, there is usually not only hip pain, but also back or neck pain. The muscles are tense and painful.
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diagnosis
The diagnosis can be made by an orthopedic surgeon. This takes into account the symptoms described, the results of the physical examination and an x-ray examination of the hip. Osteoarthritis, for example, can be reliably detected on the X-ray. If rheumatic diseases are to be clarified, a blood test to test for certain antibodies can also help. An MRI scan may also be performed.
treatment
Depending on the cause of the nocturnal pain, therapy can either consist entirely of tablet therapy or it can be based primarily on physiotherapy. Surgical therapy is also an option if there are few causes.
Hip arthrosis is initially treated with the help of targeted physiotherapy, consistent training and the temporary use of painkillers. If the symptoms do not improve in the long term, an artificial hip joint can be installed. The prognosis in this case is very good.
Bursitis is usually treated conservatively. This means that the main focus is on immobilizing and cooling the leg or hip joint. In addition, pain relievers such as Ibuprofen, be taken. If it is a bacterial inflammation that affects the entire body, antibiotics can be useful. Surgical relief of the pus cavity in the bursa should also be considered.
Long-term physical training also plays a major role in rheumatic diseases. In the acute episode, the affected joint should be cooled and protected. Cortisone can also provide short-term relief. In order to avoid further relapses, so-called basic therapeutic agents (DMARD) such as methotrexate, which is also used for psoriasis, treated. If this does not help, immunosuppressive drugs such as Cyclosporine or new antibody drugs, such as Infliximab, can be used. The suitability of the various drugs must be discussed individually with a doctor.
Duration of hip pain
The duration of the complaints depends on the cause. In rheumatic diseases such as rheumatoid arthritis or ankylosing spondylitis and psoriasis with joint involvement, no cure is expected. The goal of drug therapy is to contain the disease and thus prevent relapses of the disease. In this way it can be achieved that the disease remains silent for longer.
Osteoarthritis, on the other hand, can be cured by performing a joint replacement. In earlier stages, exercise and short-term pain medication may help the pain go away temporarily.
Read more on the topic: Treatment of hip osteoarthritis
Hip pain when lying down
Nocturnal hip pain when lying down can be caused by inflammation or it can be due to compression of inflammatory regions. If the pain is mainly when lying on your side, it may be a bursitis. On the lateral thigh, between the thigh bone and the tendon plate, the muscles that run from the hip to the leg, there is a bursa that can be irritated by the strong mechanical stress.
In addition, rheumatic, inflammatory diseases of the hip joint are particularly noticeable when lying down at rest. In rheumatic joint diseases, in addition to the pain when lying down, there is also an initial stiffness of the joints when standing up, which is improved by increased movement. It can be rheumatoid arthritis, ankylosing spondylitis or arthritis associated with psoriasis.
Furthermore, in rare cases a tumor disease of the bone can be the reason for hip pain when lying down. The tumor can primarily be located in the bone, but it can also be a metastasis of a tumor from another organ system. In general, cancer is only extremely rarely the cause of hip pain, but should always be clarified if there is pain at rest for which no other reason can be found.
Read more on the topic: Hip pain when lying down
Hip pain in pregnancy
Since pregnant women are advised to always sleep lying on their side, hip pain can quickly occur when lying down. For many, this sleeping position is unfamiliar or women tense up due to an unfamiliar poor posture when lying down. This can lead to pain.
In addition, the pregnancy belly can compress sensitive skin nerves running through the groin. In addition to pain, this also leads to a tingling sensation in the area of the lateral thigh. Hormonal factors also play a role in pregnancy, as the ligamentous apparatus of the hip becomes more elastic and this can lead to a painful opening of the pubic symphysis.
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What role does the mattress play?
Choosing the right mattress plays a crucial role in rest at night. When buying a mattress, care should be taken that the mattress is just hard or soft enough to fill the natural curves of the body and allow protruding parts of the body to sink in. The narrow curves include the lower spine in the supine position and the waist in the side position. Outstanding parts of the body are, for example, the hips and shoulders when lying on the side.
The aim is for the spine to be just as straight when lying down, both in the side position and in the supine position, as when standing. A constant bad posture at night can not only lead to hip pain, but also to back or neck pain.
Are you interested in this topic? Read more about this in our next article: Pain in the thigh and hip
