Sleeping with long-term hip pain and waking up less stiff
Dr Nicola Tik
When hip pain has been around for a while, you may know the routine well. You find a position, wake an hour later aching, shift, and repeat. Then you get up in the morning feeling stiff, as if your hip needs time to remember how to move. This guide covers your mattress, sleeping positions and a short morning routine to help you sleep better and wake up less stiff.
Long-term hip pain is often linked with osteoarthritis. That involves changes to the joint surfaces and low-grade inflammation inside the joint. Together, these can leave the hip aching after a busy day and stiff after periods of stillness, like a night in bed.
Sleep problems are common alongside this. In a large Danish study of people with hip and knee osteoarthritis, around one in five people with hip pain had insomnia, slightly more than those with knee pain. Poor sleep then makes pain feel stronger the next day, because a tired nervous system is less able to dampen pain signals.
Your mattress affects how much pressure goes through your hip, especially if you sleep on your side. A very firm mattress can press hard on the bony point at the side of your hip. A mattress that is too soft can let your hips sink, twisting your spine and pelvis.
A medium-firm mattress tends to be a good middle ground for many people. If buying a new mattress isn’t an option, a memory foam or soft topper can help spread the pressure around your hip.
Some positions take pressure off a sore hip more than others. Some options to try:
If both hips are sore, lying on your back with a pillow under your knees is often the easiest position.
After hours of lying fairly still, the joint and the muscles around it have had little movement. Joint cartilage relies on movement to circulate the fluid that keeps it nourished, so it tends to feel stiffest first thing. This kind of stiffness usually eases once you start moving, often within the first half hour or so.
Something to try once you are up, holding onto something steady if you need to:
A warm shower afterwards can help loosen things further. If you would like to follow along, VIDA has short videos of heel raises you can use as part of your routine.
Exercise is one of the most effective ways to manage long-term hip pain. In large education and exercise programmes for people with hip osteoarthritis, hip pain reduced by around a quarter on average. Stronger muscles around your hip help support the joint and share the load.
Some gentle options include sit to stands and bridges, which strengthen the muscles around your hips. If you would like to follow along, VIDA has short videos of sit to stands and bridges you can work through at your own pace. Walking regularly helps too. On tougher days, gentler movement still counts.