With technology now going into mattress production advertisers tout their mattress can solve your aches and pains.  No matter their bells, whistles and gadgets technology cannot control what is happening within the body and in some case can be contributing to the pain and problems.  If hip pain is specific to sleep without pain during the day or at other times it is most likely due to a musculoskeletal or orthopedic condition irritated by your sleeping position or the sleep position altering the musculoskeletal position. As a side note for pregnant women experiencing hip pain during sleep the reviews within this article can still be applicable; however, if your pain or other signs and symptoms are not resolved with these recommendations consult your physician to rule out any circulatory or neurological conditions from your baby’s position or changes in your sleeping to accommodate your baby.

So, what causes hip pain while sleeping?

The first thing I always begin with patient and clients in discussing their pain is to look at their starting position of the joint, spine, arms and legs.  This gives me insight to existing conditions and deficits even though they only experience hip pain with sleep.  Any deficits or abnormal positions of these areas can cause pain in sleeping because of the prolonged lying down position for several hours during sleep.  Let’s review how different positions contribute to hip pain. We have all heard that sleeping on your stomach is not recommended.  While it is easy to say it may not be easy to do if you are already asleep. hip pain while sleeping2Sleeping on your stomach can cause pain or soreness in the groin or front of the hip if hip flexors are tight or shortened.  Lying on your stomach may cause these muscles to stretch especially if you have to sit throughout the day. Also, if hip flexors are short this can tilt the pelvic anteriorly towards the mattress which now changes them hip, and low back position.  This can cause pain in the buttocks from stretching the gluteal muscles of the buttocks.  Additionally, with a tilted pelvis this alters the low back position and can produce pain in the hip from the sciatic nerve being compressed through the hip. Check here the best sleeping positions for a full rest sleep. Sleeping on your back and cause pain in the groin and front of the hip for the same tight hip flexors. Tightness in the muscles on the inner or outer thigh can create pain or soreness in the groin, inner thigh or the outside of the hip.  Tightness of the inner thigh muscles can be irritated when lying down as legs roll or rotate outward. Add bending the knee, as some do during sleep, and this adds additional pull to the muscles.  Typically when the femur, (thigh bone), rotates outward the pelvis tilts anteriorly.  When the femur rotated inward the pelvis tilts posteriorly. Keeping the pelvis and/or femur in one of these positions for several hours can cause muscle soreness, pain, spasm and cramping.    In sleeping on your side the top leg will adduct and will sometimes rotate inward as well.  If the outer hip muscles or buttocks muscle, (gluteals) are tight this can pull in the groin or outer thigh.  Outer thigh pain can also be caused by compression of the bursa, (shock absorber) that is under the IT Band, (illiotibibal band), from tightness of the IT band, fascia or muscles. Lying on the bursa on the bottom leg can be a source of pain as well.  Often people will sleep in the fetal position in side lying with knees and hip in significant flexion.  This places the gluteal muscles, (and low back),in a stretched position and the groin and hip flexors in a shorted and sometimes pinched position.  There is also bursa more posteriorly in the hip and can be irritated by this position as well.

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So, what can be done for heal and prevent this pain?

1.  Decrease the pain and inflammation by icing the sore or painful area for 15- 20 minutes waiting minimum 30 minutes before reapplying ice. Repeat 2-3 times per day.  Icing will decrease the inflammation and will help break the pain cycle that can also contributes self-limiting or guarding of hip movement. DO NOT sleep with the ice on the area. 2. You need to change your behavior or positions either during the day, such as prolonged sitting and change sleeping positions to prevent positions of significant flexion at the hip.  You can also use a pillow between the thighs and knees to help maintain good hip position in side lying to keep the top hip from ‘falling in’ or rotating and can use lying on your back to keep the hip from rotating until able to do so comfortably.  Also, check how are you sleeping. Do you have too large of pillows, or an old mattress that hold you in a poor sleeping position. 3.  Get the hips ready for bed.  Perform stretches such as standing forward lunge, knee to chest, trunk rotation, sitting cross over stretch, butterfly or frog stretch and 90/90 hamstring stretch, (lying on back with hip at 90 degrees straighten leg towards ceiling stretching hamstrings).  These will help relax and loosen the muscles from the day’s activities. 4. Be in a consistent exercise program of strengthening and flexibility.  It will keep the body from becoming deconditioned making it susceptible to irritations and strains that would otherwise develop or cause problems. 5.  Be smart.  If pain has not decreased and condition not improved after a few days see your physician to rule out onset of more significant deteriorations or strains. 6. Sweet Dreams!!

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