Hip Pain or Aching Hips at Night
What Causes Sore Or Aching Hips At Night?
Outer hip pain or pain on the ‘lateral’ part of the hip is a significant cause of hip pain that commonly occurs at night. This blog will talk you through the most common causes of pain on the side of hip and most importantly what can be done for hip pain relief.
Traditionally most outer hip pain has been diagnosed a “bursitis”, implying that there is inflammation to the bursa on the side of the hip and hence a cortisone injection into the bursa will provide the magic solution and all will be resolved. Patients are often left frustrated as to why this solution has only a very short term benefit, if any benefit at all.
Radiological and surgical studies however, have now shown that any involvement of the bursa is almost always secondary to a primary pathology of the muscle tendons that it is closely associated with, that is the gluteus medius or minimus tendons. (Bird et al. 2001, Kong et al. 2007, Pfirrmann et al. 2005, Woodley et al. 2008).
In fact gluteal tendinopathy has been reported to be as high as 20% in those having hip joint pain and up to 35% in people with low back pain. This condition can occur across all ages, but it is more common in females rather than males and peaks in the perimenopausal period. It may also occur in young athletes however, particularly runners.
Physiotherapy for hip joint pain.
Tendons often become painful or sensitised when they are compressed under other soft tissue structures around the hip or when the hip joint is placed into positions that will compress these tendons. The amount of compressive loading that can accumulate over a 24 hr period can be substantial, so implementing some basic but very effective tendon decompressive strategies is very important in managing your outer hip pain.
How To Manage Hip Pain At Night
Here are six simple simple rules to get you started:
1) Avoid low chairs, car seats and sofas. Many car seats and soft sofas slope down towards the back part of the chair and this winds and compresses the tendons making it very painful not only to get out of that position but also starting to walk. Higher seats and simply using a sitting wedge can be very beneficial as an affordable solution to sitting with your hips higher than your knees.
2) Avoid leg crossing in sitting.
3) Avoid ‘hanging’ off your sore hip in standing, that is, don’t allow more weight through that leg with the hip thrust out to the side. This is a very common posture to hold when carrying a toddler for example on one hip.
4) Hip pain at night lying on your side is very common in this condition. As you can imagine, that close to 8 hours will be spent directly lying on the sore side (directly compressing the lateral hip against the bed) or lying with the sore hip up but draped across and resting on the bed which adds to the compressive load. Sleeping on your back with pillows under the knees to offload your back and hips is a better position, however if it is difficult to sleep whilst lying on your back, try placing a firm pillow between the knees and ankles and aim to have a horizontal position of the top leg. Using a piece of eggshell foam on the mattress directly where your hips lie, is also a very useful tip to reduce the direct compression through the lateral hip when side-lying.
5) Often patients with lateral hip pain do have tight muscles around that region and are given stretches to do that in fact will increase compressive loads and actually aggravate the situation! It is best to stop stretches and look at other ways to address the muscle tightness such as massage, trigger point release or dry needling that will not increase compressive loads.
6) Finally, patients are often given exercises in side-lying such as the ‘clam’ or straight leg lifts to the side, in either lying or standing, that can again increase compression and aggravate your pain.
Hip pain treatment.
Here at Keilor Road Physiotherapy, we believe a targeted and individualised approach to lateral hip pain can be a very effective way to manage this common condition. Led by Specialist Hip Musculoskeletal Physiotherapist, Australian College of Physiotherapy Fellow and University and Post-Graduate educator Jenny Hynes, the team here at KRP offers an outstanding evidence based approach to help the management of your lateral hip pain.
Long-term positive outcomes can be achieved by the team here at KRP. Our physiotherapists are experts at identifying and managing predisposing factors, poor postural and movement patterns and identifying and correcting muscle dysfunction. Once we know the cause, you’ll then be started on targeted self -management strategies that aim to take the pain away from sensitised tissue and improve your load tolerance through the lateral hip, to get you back where you want to be in no time.
Don’t put up with lateral hip pain when we have the solutions for you. Servicing Niddrie, Essendon, Airport West, Moonee Ponds, Oak Park, Keilor & the Northern suburbs for over 40 years, you can book with one of our Post Graduate trained hip pain team below or call 93794557 to speak to one of our admin superstars.
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Article by
Jenny Hynes | Clinical Director
Specialist Musculoskeletal Physiotherapist
Jenny has over 20 years of experience in the treatment of the musculoskeletal conditions, holding a Masters degree in musculoskeletal physiotherapy and post graduate training in Osteopathy. She is a lecturer at Latrobe University and has specialized expertise in the management of low back, pelvic girdle and hip pain.
Jenny sat extensive examinations to be inducted as a fellow into the Australian College of Physiotherapy in 2009 and gain the title of Specialist Musculoskeletal Physiotherapist, one of only a few physiotherapists in the state to have done so.