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Other Hip Treatments
Hip Pain at Night: Causes and Treatment in London
Hip pain that is worse at night, that wakes you or stops you settling on one side, is one of the most common and most worrying symptoms patients bring me. The reassuring truth is that it is usually caused by something ordinary and treatable, most often outer hip tendon problems or arthritis. Occasionally night pain needs closer review, and this page explains, calmly, how to tell the difference and what to do.
Why hips hurt more at night
There are simple reasons a hip complains at night. When you lie on your side you press directly on the outer hip, where the tendons and bursa sit, so gluteal tendon problems and bursitis flare. When you lie still, an arthritic joint stiffens and aches without the movement that eased it in the day. And with fewer distractions, pain you managed to ignore all day finally gets your attention. None of these means something sinister. They mean the hip has a mechanical or arthritic problem that is worth sorting out.
What night pain usually means
In the great majority of people, hip pain at night comes down to one of two things. The first is greater trochanteric pain syndrome, the outer hip tendon and bursa problem, which is classic for pain lying on that side. The second is hip arthritis, which characteristically aches at rest and stiffens overnight. Both are common, both are treatable, and neither is an emergency. You can read more on the outer hip pain and hip arthritis pages.
When night pain deserves a closer look
Let me be straightforward, because this is the fear that brings people to the internet at 2am. Most night hip pain is mechanical. But pain that is constant, unrelenting, present regardless of position, or that comes with unexplained weight loss, fevers, or feeling generally unwell, deserves prompt medical assessment rather than reassurance from a webpage. That is not to alarm you. It is to say that the right response to persistent night pain is to have it properly assessed, so you either get treated for the ordinary cause or, in the rare case, have something less ordinary caught early.
At a Glance
How I approach it
A proper assessment does two jobs at once: it works out the ordinary cause so you can be treated, and it rules out the uncommon one so you can stop worrying. That means listening to exactly how and when the pain behaves, examining the hip, and arranging the right imaging where it is needed. From there the plan follows the cause, whether that is loading work and a guided injection for a tendon problem, or a properly sequenced plan for arthritis.
The honest bottom line
If you take one thing from this page, take this. Hip pain at night is common, it is usually caused by something treatable, and it is worth getting assessed rather than lying awake guessing. The goal is a clear answer and a plan, not a scan chased in a panic and not months of worry.
Frequently Asked Questions
Usually because lying on your side presses on the outer hip tendons and bursa, or because an arthritic joint stiffens at rest. Both are common and treatable. Occasionally persistent night pain needs closer review.
In the great majority of people, no, it means an ordinary tendon or arthritis problem. Pain that is constant regardless of position, or comes with weight loss, fevers or feeling unwell, should be assessed promptly to be safe.
Most people are more comfortable off the painful side, often with a pillow between the knees to reduce pressure on the outer hip tendons. If no position helps at all, that is worth mentioning at assessment.
It depends on the cause. Outer hip tendon pain responds to loading work and, if needed, a guided injection; arthritis to a properly sequenced plan. The first step is finding out which you have.
Book a consultation and bring any imaging you have. I will work out the cause and give you an honest plan. Call 0207 859 4016 or email admin@ortholongevity.co.uk. This page is educational and is not a substitute for individual assessment; if you feel unwell or the pain is severe and constant, seek medical review promptly.
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