Pain guide · Hip pain

Hip pain at night: lying on your side, the outer hip, arthritis and the warning signs

Hip pain at night is usually one of two things: the tendons on the outside of the hip, pressed when you lie on that side and squeezed when you lie on the other with the top knee dropped, or arthritis in the hip joint, which often aches at night. Outer hip pain is common, especially in women from mid-life, and pain from the lower back can be felt in the hip too.

For now, National Health Service (NHS) advice is to stay off the sore side: lie on your back with a pillow under your knees, or on your good side with a pillow between your knees. For outer hip pain, advice plus exercise did better than a steroid injection in a trial. Night pain that doesn't ease whatever position you lie in, with a fever, weight loss or a history of cancer, needs a general practitioner (GP), and a hot, swollen hip, or a leg you can't put weight on, needs help the same day or accident and emergency (A&E). This guide covers those warning signs, how to tell the causes apart, how to sleep, how much pain is fine, and a three-stage plan with a 3D demo of every move.

3-stage exercise plan When to get help 36 sourcesUpdated 23 October 2026

When to get help first

Exercise is for pain that has been checked or is clearly mild and settling.

Get urgent medical help if

Severe hip pain after a fall or injury, or you cannot stand, walk or put weight on the leg. In an older adult this can be a broken hip; the leg may look shorter or turned outward.
Tingling or loss of feeling in the hip or leg after an injury.
Buttock or leg pain with numbness around the genitals or bottom, new trouble controlling your bladder or bowels, or weakness or numbness in both legs.
A hot, swollen hip, or hip pain with a fever or feeling generally unwell (a possible joint infection).
A child or teenager with sudden hip, thigh or knee pain, a limp, or who will not put weight on a leg. Hip problems in children can sometimes be felt in the thigh or knee, and in some children knee pain is the only sign.
Same day, and stop running now: groin or front-of-hip pain in a runner, sometimes felt in the thigh or knee, that builds with running, hurts with every step or at night, or hurts when the hip is turned to the end of its range. Keep weight off the leg, using crutches if you have them, and get an urgent GP appointment or help from NHS 111 the same day: a stress fracture of the hip (femoral neck) needs urgent imaging.
Same day (urgent GP appointment or NHS 111): severe hip pain that started suddenly without a fall or injury, or the skin around your hip has changed colour.

See a doctor or physiotherapist if

Hip pain that stops normal activities or disturbs sleep, keeps getting worse, or has not improved after 2 weeks of looking after it at home.
Stiffness lasting more than 30 minutes after waking.
Bone pain that is constant or worse at night, especially with a lump, unexplained weight loss, fever or tiredness, or a past history of cancer.
Hip or groin pain that hasn't settled after 6 weeks, especially with a normal X-ray, or new hip pain if you take high-dose steroids, drink heavily, or have sickle cell disease or lupus: ask your GP about an MRI (magnetic resonance imaging) scan and a hip specialist. It can be avascular necrosis, which an X-ray can miss early on.
You are 60 or over with bone pain in your hips, back, ribs or shoulders that won't go away, especially with tiredness, feeling very thirsty or weight loss: see a GP. The National Institute for Health and Care Excellence (NICE) asks GPs to offer blood tests for myeloma in people 60 and over with persistent bone pain.
You are over 50 and your hips and shoulders stay stiff and painful for more than 45 minutes each morning: see a GP (possible polymyalgia rheumatica).
Outer hip pain that hasn't improved within 6 weeks of following this advice, or that gets worse: talk to a GP or physiotherapist. In many areas you can refer yourself.
Pelvic pain in pregnancy that makes it hard to move around, hurts when you get out of a car or turn over in bed, or makes going up or down stairs painful: call your midwife or GP. You may be referred to a physiotherapist who specialises in pelvic joint problems in pregnancy.

Where does it hurt?

Location narrows the likely causes; it does not diagnose.

The bony point on the outside of the hip, worse lying on it

Or lying on the other side with the top knee dropped, after sitting cross-legged, on stairs and standing on that leg: gluteal tendon pain, often called hip bursitis or greater trochanteric pain syndrome.

Read: Outer hip pain (hip bursitis) →A deep ache in the groin, buttock or front of the thigh at night and on first getting up

Stiff for under 30 minutes in the morning, with socks and car seats hard, from 45: hip arthritis.

Read: Hip arthritis →A pinch in the groin with deep bending and low seats, in a younger active adult

Possibly hip impingement.

Read: Hip impingement (FAI) →Deep in the groin, with clicking, catching or locking

Possibly a labral tear. Get it assessed.

Read: Hip labral tear →Buttock pain, sometimes down the back of the leg below the knee with tingling

Worse at night or sitting: the lower back and a nerve (sciatica).

Read: Sciatica →Burning, tingling or a numb patch on the outer thigh, with no weakness

Worse standing, often in pregnancy or with tight clothing: meralgia paresthetica, a squeezed skin nerve.

Read: Meralgia paresthetica →A deep ache low in the buttock, at the sitting bone

Worse sitting or running uphill: high hamstring tendon pain.

Read: High hamstring tendinopathy →Low on one side, by the dimple at the back of the pelvis

Worse turning in bed: possibly the sacroiliac (SI) joint.

Read: SI joint pain →The back of the pelvis or the pubic bone, in pregnancy or after birth

Worse turning over in bed, on stairs and getting out of a car: pelvic girdle pain.

Read: Pelvic girdle pain (SPD) →Buttock pain worse sitting, without back pain

Often blamed on the piriformis muscle, though the buttock can also be the back, the hip or a tendon.

Read: Piriformis syndrome and buttock pain →Deep groin, buttock or thigh pain with high-dose steroids, heavy drinking, sickle cell disease or lupus

Not settling after 6 weeks: possibly avascular necrosis. Ask your GP about a magnetic resonance imaging (MRI) scan.

Read: Avascular necrosis (hip) →Groin pain in a runner or walker that builds with every step, and later hurts at night

A possible stress fracture of the hip: stop and get it checked the same day.

Read: Stress fracture →

Constant bone pain that doesn't change with position, worse at night, with weight loss, a fever or a history of cancer

See a GP soon: the warning signs explain.

Hips and shoulders stiff for more than 45 minutes every morning, over 50

Possibly polymyalgia rheumatica: see a GP.

Joint pain and stiffness worse in the morning, lasting more than 30 minutes, with swollen joints

Possibly an inflammatory arthritis such as rheumatoid arthritis: see a GP.

A hot, swollen hip with a fever or feeling unwell

A possible joint infection: get help the same day.

A child or teenager with hip, thigh or knee pain, or a limp

Get help the same day: hip problems in children can be felt in the thigh or knee.

Read: SUFE (slipped hip growth plate) →

Understand it

Outer hip pain: the commonest cause of pain lying on your sideStrong evidence

Gluteal tendon pain (often called trochanteric bursitis or greater trochanteric pain syndrome) is common. In 3,026 adults aged 50 to 79, it affected one side in 15% of women and 7% of men, and both sides in 8.5% and 1.9%; women had 3.4 times the odds, and it went with low back pain and knee arthritis. NHS inform says it's commonest in women aged 40 to 60.

Lying on your side often disturbs sleep, the LEAP trial's protocol says, and in 62 women with outer hip pain, pain was highest in the evening and median sleep was 6 hours. It can affect quality of life and work about as much as severe hip arthritis.

Sources 1, 2, 3, 4, 5

Why lying on it hurtsEmerging evidence

The gluteal tendons wrap over the bony point on the outside of the hip. Lying on that side presses them against the bone, and lying on the other side lets the top knee drop across the body, which squeezes them under the band of tissue down the outer thigh; sitting cross-legged or standing "hanging" on one hip does the same by day. That's why NHS inform and an NHS hospital advise a pillow between your knees when you lie on your good side. The LEAP trial's protocol describes squeezing combined with load as the leading explanation; it's a model, not a proven fact.

Sources 2, 6, 3

The hip joint: night pain is common in arthritisEmerging evidence

Night pain was reported by 81% of 123 people with hip or knee arthritis in focus groups, at every stage of the disease, varying from night to night; the authors warn it "may not be a distinct marker of disease severity". In an online survey, 75% of 101 people with hip or knee arthritis had night pain, and in people with early signs of hip arthritis it was reported by 22 to 35% over 10 years. The NHS says hip arthritis pain is often worse when you move the hip, "although it can also affect you when you're resting or sleeping".

Sources 7, 8, 9, 10

Where hip joint pain is feltEmerging evidence

In 51 people whose hip joint pain was confirmed with an injection, the pain was felt in the buttock (71%), the thigh (57%) and the groin (55%), sometimes below the knee, and not in the low back. So a deep buttock ache at night can be the joint, not only the back.

Source 11

Pain from the back, pregnancy and menopauseEmerging evidence

NHS inform says hip problems can occasionally come from the back even without back pain, often felt as pins and needles or a sharp, hot or burning pain in the leg. In pregnancy, pelvic girdle pain is often worse turning over in bed, and from 28 weeks the NHS says go to sleep on your side. Outer hip pain is common around and after menopause, but in a trial in postmenopausal women, hormone therapy helped only those with a body mass index (BMI) under 25.

Sources 12, 13, 14, 15

Night pain on its own is rarely seriousEmerging evidence

In 482 people seen at a back pain clinic, 44% had night pain and none was found to have a serious disease, so night pain on its own is a weak warning sign; that study was in back pain, not hip pain. What matters is the company it keeps. The NHS says see a GP for pain or tenderness in a bone, "particularly if it's worse at night", or with a lump, weight loss or a fever, and the National Institute for Health and Care Excellence (NICE) asks GPs to offer blood tests for myeloma in people 60 and over with persistent bone pain, particularly back pain.

Sources 16, 17, 18

When a scan helpsEmerging evidence

Usually not needed. In 65 people with outer hip pain, no tenderness on the bony point made gluteal tendon pain unlikely, and pain within 30 seconds of standing on that leg made it very likely; a review of clinical tests agreed that simple tests help rule it in or out. In the same study, 31% had tendon changes on MRI but negative clinical tests, so a scan report has to match the story.

NICE diagnoses hip arthritis without imaging in people 45 and over with activity-related pain and morning stiffness of 30 minutes or less. The exceptions are the warning signs, a possible stress fracture and avascular necrosis.

Sources 19, 20, 21

How it usually goesEmerging evidence

Outer hip pain is slow: NHS inform says it "can often take 6 to 12 months of rehabilitation to settle", with flare-ups along the way, and an NHS hospital gives the same range with exercise. In the LEAP trial, about half of the people who waited and saw had also improved by a year, but education and exercise got more people better sooner. Night pain in arthritis comes and goes from night to night. No one can promise a date.

Sources 2, 6, 22, 7

What helps, and how strong the evidence is

Outer hip pain: education plus exercise beat an injectionStrong evidence

In the LEAP trial, 204 people aged 35 to 70 (167 women) with outer hip pain for more than 3 months had education plus exercise, a steroid injection, or wait and see. At 8 weeks, 51 of 66 rated education plus exercise a success, against 38 of 65 after the injection and 20 of 68 who waited, with lower pain (1.5 against 2.7 and 3.8 out of 10). At a year, it still did better than the injection on success, though pain was similar.

The programme was 14 physiotherapy sessions over 8 weeks with a daily home programme of 4 to 6 exercises taking 15 to 20 minutes: holds first, then bridges, squats and side steps with no increase in outer hip pain allowed, and heavier slow strengthening twice a week. The education taught people to avoid positions that squeeze the tendon.

Sources 22, 3

The advice may matter as much as the exercisesEmerging evidence

In 132 postmenopausal women with outer hip pain who all had advice on avoiding squeezing positions and managing load, tendon-specific exercise did no better than sham exercise, and every group improved. Exercise ranked first among conservative treatments in a 2025 network meta-analysis of 19 trials (1,701 people), though there were few trials of each treatment.

Sources 15, 23

How to sleep: health-service advice, untested in trialsEmerging evidence

NHS inform and an NHS hospital (the Royal Orthopaedic Hospital) advise not sleeping on the painful side, and lying on your back with a pillow under your knees or on your good side with a pillow between your legs to keep them in line with your hips. The NHS adds that extra cushions around a painful joint at night may help. The LEAP trial's education covered positions like these, but the trial reports don't list its sleep advice, and no trial has tested a sleeping position, a pillow or a mattress topper for hip pain.

Sources 2, 6, 24, 22, 3

Hip arthritis: exercise helps a littleStrong evidence

Exercise reduced hip arthritis pain by about 7 points out of 100 against no treatment or usual care, on moderate-certainty evidence; the review judged the size unlikely to matter much to people on its own. NICE still makes exercise a core treatment, with weight loss where it's needed, and says consider walking aids. No trial has measured night pain as its main outcome.

Sources 25, 21

Pregnancy: go to sleep on your sideStrong evidence

The NHS says the safest position to go to sleep is on your side, either side: after 28 weeks, going to sleep on your back can double the risk of stillbirth. If you wake on your back, turn back onto your side. Supporting your bump with pillows and putting a pillow between your knees can help, and the NHS suggests a pillow between your legs for pelvic pain. In a small trial in which a third of women dropped out, a memory-foam mattress and pillow eased night-time pelvic girdle pain over 4 weeks.

Sources 14, 13, 26

How much pain is OK while you exercise?

The 5 out of 10 rule, no squeezing, and tonight is the testEmerging evidence

For the exercises, this guide uses the hip hub's rule. During the exercise, pain up to about 5 out of 10 is acceptable. It should settle within an hour or so, and your hip should be no worse that night or the next morning. If it is, do less next time (fewer repetitions, a smaller range, a lighter load), not nothing.

Pain can go up a little when you start: NICE tells people with osteoarthritis that joint pain may increase when they start exercising, and that keeping going will still help. In long-lasting muscle and joint pain, exercise that allowed some pain did no worse than pain-free exercise, and in an Achilles tendon trial, carrying on with sport under a pain-monitoring rule did no harm. If pain climbs week after week, or a warning sign appears, stop and get it checked.

With outer hip pain, our hip bursitis guide adds the LEAP programme's rule: no increase in outer hip pain during squats, bridges and side steps, because pain there suggests the tendon is being squeezed. During heavier strengthening, pain up to about 5 out of 10 was fine if it eased afterwards and was no worse that night or the next morning.

At night (our suggestion, built on that rule and an NHS hospital's advice): the night after exercise is the check. If the hip wakes you more than usual, the day's load was too much: drop back one step (fewer repetitions, a lower step, a shorter walk), not to nothing. The hospital says that pain which carries on for a long time and disturbs your sleep may mean you're doing too much.

Sources 21, 3, 27, 28, 6

The exercise plan: 3 stages

Start at the first stage. Each move opens a full guide with a 3D demo.

Stage 1

Settle: take the pressure off at night, and load without squeezing

About weeks 0 to 2: the night changes and the day changes in the written steps below (no crossed legs, no hanging on one hip, no low chairs), and holds and small movements that load the tendons without squeezing them, as in the LEAP programme. With arthritis, gentle movement in bed before you get up. With any warning sign, get checked first. Doses are editorial unless a source is named.

Supine isometric hip abduction (belt press) demonstrated on the 3D figure

3D demoSupine isometric hip abduction (belt press)Beginner · A band

3 to 5 holds of 5 to 10 s, twice a day, at a light effort · The move page's dose, from the LEAP trial programme. Lying on your back, not your side

Harder: Lateral band walk

Standing wall-press hip abduction demonstrated on the 3D figure

3D demoStanding wall-press hip abductionBeginner · A wall

3 to 5 holds of 5 to 15 s each side, twice a day · The move page's dose, from the LEAP trial programme. Keep the standing hip level rather than sagging out, as the move page says

Easier: Supine isometric hip abduction (belt press) · Harder: Lateral band walk

Glute bridge demonstrated on the 3D figure

3D demoGlute bridgeBeginner · No equipment

2 to 3 slow reps at a time, building to sets of 8, 2 to 3 times a day, up to 2 sets of 15 · NHS inform's exercise for outer hip pain, with its pacing

Easier: Pelvic tilt into bridge · Harder: Single-leg glute bridge

Sit squat (partial squat) demonstrated on the 3D figure

3D demoSit squat (partial squat)Beginner · No equipment

10 slow reps, once a day, knees over your toes · As in our hip bursitis guide, with no increase in outer hip pain allowed

Harder: Bodyweight squat

Supine heel slide demonstrated on the 3D figure

3D demoSupine heel slideBeginner · No equipment

10 slow reps each side, once or twice a day · The move page's dose, an editorial starting point. For stiffness from arthritis, in bed before you get up

Harder: Hip windshield wipers

Move on when: None of these raises outer hip pain, and your nights have been no worse for about a week (as in our hip bursitis guide).

Follow along: a timer, a cue and the next move, one step at a time.

Stage 2

Build: shift the load onto one leg

About weeks 2 to 6, 3 or 4 days a week: the LEAP progression to loading one leg with the pelvis level, plus NHS inform's step-up. With arthritis, add chair stands. Doses are editorial unless a source is named.

Staggered-stance bridge (offset bridge) demonstrated on the 3D figure

3D demoStaggered-stance bridge (offset bridge)Beginner · No equipment

5 slow reps each side once a day, building to 2 sets of 5 to 10 at a somewhat hard effort · The move page's dose, from the LEAP trial programme

Easier: Pelvic tilt into bridge · Harder: Single-leg glute bridge

3D demoStep-upBeginner · A step

Lead with the sore leg onto a low step: 2 to 3 reps at a time, building to sets of 8, up to 2 sets of 15 · NHS inform's step-up for outer hip pain, with its pacing. Keep the pelvis level

Easier: Low step-up · Harder: Dumbbell step-up

Single-leg stand demonstrated on the 3D figure

3D demoSingle-leg standBeginner · A wall

3 holds of 10 to 30 s, pelvis level, a hand near a support · As in our hip bursitis guide

Easier: Tandem stance and heel-to-toe walk · Harder: Single-leg reach matrix

Split squat demonstrated on the 3D figure

3D demoSplit squatIntermediate · No equipment

5 slow reps each side, short range, building to 2 sets of 5 to 10 · As in our hip bursitis guide

Easier: Bodyweight squat · Harder: Reverse lunge

Lateral band walk demonstrated on the 3D figure

3D demoLateral band walkBeginner · A band

10 to 15 steps each way with a band · As in our hip bursitis guide

Easier: Hip abduction machine · Harder: Lateral band walk, band at the feet

Sit to stand from a chair demonstrated on the 3D figure

3D demoSit to stand from a chairBeginner · A bench or box

3 sets of 8 to 12 from a lower seat, no hands, slow lowering · As in our hip arthritis guide. For arthritis

Easier: Sit to stand, pushing on the thighs · Harder: Bodyweight squat

Move on when: You can stand on the sore leg for 30 seconds with the pelvis level and no outer hip pain (as in our hip bursitis guide), and you're sleeping through most nights in your chosen position.

Follow along: a timer, a cue and the next move, one step at a time.

Stage 3

Strengthen, and sleep through

From about week 6, 2 or 3 days a week, and ongoing: heavier single-leg strength without squeezing the tendon, as the LEAP programme's heavier sessions twice a week did, while lying on the sore side comes back by the written steps below. Expect months rather than weeks: NHS inform says outer hip pain can take 6 to 12 months to settle.

Single-leg glute bridge demonstrated on the 3D figure

3D demoSingle-leg glute bridgeIntermediate · No equipment

2 to 3 sets of 8 each side · As in our hip bursitis guide

Easier: Glute bridge · Harder: Barbell hip thrust

Side-lying leg raise demonstrated on the 3D figure

3D demoSide-lying leg raiseBeginner · No equipment

2 to 3 sets of 8 to 12, lying on the good side with a pillow between your knees · As in our hip bursitis guide and NHS inform's exercise: keep the top leg in line with the body, never dropping below level or drifting forward. Lying this way can aggravate a painful outer hip, as the move page cautions, so it comes last

Easier: Lateral band walk · Harder: Lateral band walk, band at the feet

Patrick step-down demonstrated on the 3D figure

3D demoPatrick step-downIntermediate · A step

3 sets of 8 each side · As in our hip bursitis guide

Easier: Bodyweight squat · Harder: Skater squat

Single-leg Romanian deadlift demonstrated on the 3D figure

3D demoSingle-leg Romanian deadliftAdvanced · A dumbbell

2 to 3 sets of 6 to 8 each side · As in our hip bursitis guide

Easier: Dumbbell Romanian deadlift

Knee side plank demonstrated on the 3D figure

3D demoKnee side plankBeginner · No equipment

3 holds of 15 to 30 s each side · As in our hip bursitis guide

Harder: Side plank

Dumbbell goblet squat demonstrated on the 3D figure

3D demoDumbbell goblet squatIntermediate · A dumbbell

3 sets of 8 to 10, to a box or chair · As in our hip arthritis guide

Easier: Bodyweight squat · Harder: Barbell front squat

Move on when: Our suggestion: once your nights have been settled for 2 weeks, try a few minutes on the sore side at the start of the night (the written steps below), and keep two strength days a week for the long term. If the hip wakes you more after a busy day, drop back a step for a few days.

Follow along: a timer, a cue and the next move, one step at a time.

What to change for now

How to sleep tonight (written steps)

Our 3D figure can't show these changes. They come from NHS inform, an NHS hospital and the NHS; no trial has tested a sleeping position, a pillow or a mattress topper for hip pain, and where a step is our suggestion, it says so.

1. Don't sleep on the painful side for now (NHS inform and the Royal Orthopaedic Hospital).
2. Lie on your back with a pillow under your knees, or on your good side with a pillow between your knees, so the top leg stays in line with your hip and doesn't drop across your body. One pillow may not be enough: our hip bursitis guide suggests one or two.
3. Extra cushions around the sore hip may help protect and support it (the NHS's advice for bursitis).
4. If you can only sleep on the sore side, a soft topper or a folded duvet under the hip, with a pillow between your knees, is a reasonable compromise (our suggestion, untested).
5. Arthritis: a warm bath or heat before bed, and gentle heel slides in bed before you get up, ease stiffness for some people (our suggestion).
6. The mattress: for back pain, a medium-firm mattress did better than a firm one in a trial; no trial has tested mattresses for hip pain, and the Chartered Society of Physiotherapy (CSP) says whatever feels most comfortable for you is best.
7. Pregnancy: from 28 weeks, go to sleep on your side, either side, because going to sleep on your back can double the risk of stillbirth. If you wake on your back, turn back onto your side. Support your bump with pillows and put a pillow between your knees (the NHS). In a small trial, a memory-foam mattress and pillow eased night-time pelvic girdle pain in pregnancy.

Sources 2, 6, 24, 14, 13, 30, 31, 26

By day, stop squeezing the tendon (written steps)

In the trials, advice about these positions was a big part of the benefit: everyone in the menopause trial had it, and every group improved.

1. Stand with your weight even on both feet, not "hanging" on one hip (NHS inform).
2. Don't cross your legs, and sit with your knees hip-width apart (NHS inform).
3. Avoid low chairs and low car seats; a cushion helps (the NHS and NHS inform).
4. On stairs, use a handrail (an NHS hospital's advice), and spread stair trips through the day while it's sore (our suggestion).
5. Keep moving within the pain rule: complete rest reduces the tendon's ability to take load, the hospital says.
6. Arthritis: don't carry heavy things (the NHS), and a walking stick, if you use one, goes in the hand opposite the sore hip.

Sources 2, 6, 32, 10, 22, 15

Nights come back (written steps)

No trial has tested how to return to sleeping on a painful side. These steps are our suggestion.

1. Stages 1 and 2: not on the painful side; on your back with a pillow under your knees, or on the good side with one or two pillows between your knees.
2. Stage 3: once nights have been settled for 2 weeks, try a few minutes on the sore side at the start of the night, with a soft topper or folded duvet under the hip and a pillow between your knees. Roll off before it builds, and add a few minutes every few nights.
3. If the hip wakes you more after a busy day, that day's load was too much: drop the exercises back a step and spread walking and stairs through the day.
4. Flare-ups are normal: reduce the repetitions or rest for a few days, then restart (NHS inform). Keep two strength days a week for the long term.

Sources 2, 6, 3

Injections, hormones and painkillers

A steroid injection eased outer hip pain at 8 weeks but did worse than education and exercise, and at a year it was no better for pain. NHS inform offers one when painkillers aren't helping and says it may not cure the condition; an NHS hospital says the effect is usually short-lived and repeated injections are often not advised.

Hormone therapy helped only women with a BMI under 25 in one trial; decide on it for its own reasons with your doctor. For arthritis, NICE says joint injections give short-term relief and should support exercise. The NHS suggests ice for up to 20 minutes every 2 to 3 hours, and paracetamol or ibuprofen gel.

Sources 22, 2, 6, 15, 21, 32

Positions to swap, and why

Habit or position	Why it matters	Instead
Sleeping on the painful side	It presses the tendons against the bone.	On your back with a pillow under your knees, or on your good side with a pillow between your knees.
Lying on the good side with the top knee dropped	The top leg falls across the body and squeezes the tendons, as our hip bursitis guide explains.	One or two pillows between your knees so the top leg stays level.
Sitting cross-legged, or with your knees pressed together	The thigh crosses the midline and squeezes the tendons.	Knees hip-width apart, with your hips a little higher than your knees (our hip bursitis guide's advice).
Standing "hanging" on one hip	The hip drifts out sideways under your weight.	Weight even on both feet.
Low chairs and low car seats	The NHS and NHS inform say avoid them.	A higher seat or a cushion.
Iliotibial (IT) band and outer hip stretches	Drawing the leg across the body presses the gluteal tendons against the bone, as the move page says.	Load the tendons without squeezing them, with the lying hold.Try: Supine isometric hip abduction (belt press)
The knee-across-the-body stretch and lying twists	They draw the thigh across the body, which the move page says presses the gluteal tendons against the bone.	A single knee to chest, which keeps the knee in line.Try: Single knee-to-chest stretch
Reclined figure four and pigeon stretches, with outer hip pain	Our hip pain guide's stretch table advises care with them for outer hip pain, which they can provoke.	The bridge.Try: Glute bridge
Foam rolling or massaging the sore bony point	Deep pressure over the sore spot can make it worse, an NHS hospital says.	Leave it alone while it's painful.
Clamshells while the outer hip hurts at night	They're done lying on your side with the hips bent and the knees together, close to the squeezing position (our reasoning from the LEAP programme).	The lying hold now, and the side-lying leg raise with a pillow between your knees later.Try: Supine isometric hip abduction (belt press)
Resting completely until it settles	Complete rest reduces the tendon's ability to take load, an NHS hospital says.	Keep moving within the pain rule, with the stage 1 holds.
Repeated steroid injections as the plan	Their effect is usually short-lived, and education and exercise did better at 8 weeks and at a year.	Education and exercise.
Going to sleep on your back after 28 weeks of pregnancy	The NHS says it can double the risk of stillbirth.	Go to sleep on your side, either side, with pillows under your bump and between your knees.

Routines to follow

Glute workout at home

A 25-minute glute workout with bodyweight and a mini band: bridges, clamshells, band walks, kickbacks and lunges.

25 minBeginner9 movesA wall, A band

Low-impact leg workout (no jumping)

A gentle leg strength routine with no jumping: sit-to-stands, step-ups, wall sits, bridges and calf raises.

20 minBeginner7 movesA bench or box, A step

Balance exercises routine

Balance practice in 10 minutes: tandem stance, single-leg stands, marches, heel walks, tree pose and floor transfers.

10 minBeginner7 movesA wall, A bench or box

Hip mobility routine

A 15-minute hip opener: 90/90 switches, windshield wipers, CARs, Cossack squats, frog and pigeon.

15 minIntermediate8 movesA wall

More moves for this area

Questions people ask

Why does my hip hurt at night?

The commonest reasons are lying on a sore outer hip, which presses on the gluteal tendons, or lying on the other side with the top knee dropped, which squeezes them. Arthritis in the hip joint also often aches at night, at every stage. Pain that doesn't change whatever position you lie in, with a fever, weight loss or a history of cancer, is different and needs checking.

Why does my hip hurt when I lie on my side?

If it's the bony point on the outside of the hip, it's usually gluteal tendon pain, often called bursitis: lying on it presses the tendons against the bone. It's common, especially in women from mid-life, and about 15% of women aged 50 to 79 have it on one side. Lying on your back, or on the other side with a pillow between your knees, is the NHS advice.

What is the best sleeping position for hip pain?

On your back with a pillow under your knees, or on your good side with a pillow between your knees so the top leg stays level with your hip. Avoid lying on the sore side for now. From 28 weeks of pregnancy, go to sleep on your side, not your back.

Does a pillow between my knees help?

It stops the top leg dropping across your body, which squeezes the outer hip tendons, and NHS inform and an NHS hospital recommend it. One pillow may not keep the leg level, so try two. It hasn't been tested in a trial.

Is hip pain at night a sign of cancer?

Rarely. Night pain is common with arthritis and tendon pain, and on its own it's a poor warning sign. See a GP if bone pain is constant or worse at night, or comes with a lump, weight loss, a fever, tiredness or a past cancer; NICE asks GPs to offer blood tests for myeloma in people 60 and over with persistent bone pain.

Why does my hip hurt at night in menopause?

Outer hip tendon pain is commonest in women from mid-life, and NHS inform says hormone changes may play a part. In a trial in postmenopausal women, advice on avoiding squeezing positions plus exercise helped every group, and hormone therapy added benefit only in women with a BMI under 25. Decide on hormone therapy for its own reasons with your doctor.

How should I sleep with hip pain in pregnancy?

On your side, with pillows supporting your bump and between your knees. From 28 weeks, going to sleep on your back can double the risk of stillbirth, so turn back onto your side if you wake on your back. Call your midwife or GP if pelvic pain makes it hard to move around, turn over in bed or use the stairs.

Will a mattress topper help hip pain?

It hasn't been tested for hip pain. A softer surface or extra cushions under the hip may ease pressure if you can only sleep on the sore side, and a medium-firm mattress did better than a firm one for back pain. How you lie matters more than the mattress (our view).

Is it bursitis or arthritis?

Pain over the bony point on the outside of the hip, worse lying on it, on stairs and standing on one leg, points to the tendons. A deep ache in the groin or buttock, with stiffness and trouble with socks or getting out of a car, from 45, points to the joint. A GP or physiotherapist can usually tell them apart without a scan.

What exercises help hip pain at night?

For outer hip pain, the LEAP programme of education plus exercise succeeded for 51 of 66 people at 8 weeks, against 38 of 65 after a steroid injection and 20 of 68 who waited. It starts with gentle holds and builds to single-leg strength without squeezing the tendon. For arthritis, strengthening and walking help a little and are a core treatment in NICE's guideline.

How long does outer hip pain take to go?

Often months: NHS inform says it can take 6 to 12 months of rehabilitation to settle, with flare-ups along the way, and in the LEAP trial education and exercise got more people better sooner than waiting. Talk to a professional if it isn't improving after 6 weeks. No one can promise a date.

Do I need a scan for hip pain at night?

Usually not: simple tests in the clinic identify outer hip tendon pain well, and NICE diagnoses hip arthritis without imaging from 45. A scan is for the warning signs, a possible stress fracture, or pain that isn't settling with risk factors for avascular necrosis.

Related exercise guides

Other pain guides

Sources

Exercise education, not a diagnosis or treatment plan. It is written from the guidelines and studies listed above; review by a clinician is pending. If your pain follows an injury, is severe, is getting worse, or comes with any warning sign listed on this page, get it assessed. Health disclaimer.