Waking up because of hip pain or struggling to find a comfortable position at night can be frustrating. For many people, nighttime hip pain can affect energy, focus, mobility, and how they feel the next day.

Two common causes of hip pain at night are arthritis and bursitis. While the symptoms can sometimes feel similar, there are important differences in where the pain shows up, what makes it worse, and how it behaves during daily activities. Orlin & Cohen’s Barbara Feehan, PT, is here to help you understand those clues to help you know what may be happening and when it’s time to get care.

Why Hip Pain Flares at Night

Hip pain often feels worse at night because your body is still for several hours. Without regular movement, joints and surrounding tissues may become stiff. Certain sleep positions can also place prolonged pressure on the hip joint or soft tissues around it, making discomfort more noticeable.

If you sleep on your side, the hip that’s pressed into the mattress can become irritated from direct pressure. Even lying on the opposite side may cause discomfort if the painful hip is unsupported and allowed to drop inward.

Hip Arthritis: What It Feels Like

Hip arthritis occurs when inflammation and wear within the joint affect how the hip moves and functions. Osteoarthritis is one of the most common forms and can develop gradually over time as cartilage in the joint wears down.

Where arthritis pain shows up

Hip arthritis pain is often felt deep in the front of the hip or groin. Some people may also experience pain along the outer hip, buttock, or back of the hip, but groin pain is one of the most common clues that the joint itself may be involved.

How arthritis behaves day to day

Arthritis-related stiffness is often most noticeable in the morning or after sitting for a long period. Many people find that symptoms improve within an hour of getting up and moving. However, weight-bearing activities such as standing, walking, and climbing stairs may cause pain to worsen throughout the day. Depending on severity, arthritis can also limit range of motion and make it harder to bend, rotate, or move the hip comfortably.

Hip Bursitis: What It Feels Like

A bursa is a small, fluid-filled sac that helps reduce friction between bones, muscles, and tendons. Hip bursitis occurs when one of these sacs becomes inflamed. At the hip, this is often referred to as greater trochanteric bursitis or greater trochanteric pain syndrome.

Where bursitis pain shows up

Unlike arthritis, which often causes deeper groin pain, bursitis typically causes pain along the outside of the hip. The area may feel tender to the touch, and pressing on the outer hip can increase discomfort.

How bursitis behaves at night

Bursitis is especially known for causing pain when lying on the affected side. The direct pressure from the mattress can irritate the inflamed tissue, making sleep difficult. Some people also feel discomfort when lying on the opposite side, particularly if the painful hip is unsupported.

During the day, bursitis pain may increase with activities that require standing on one leg, such as walking, using stairs, or stepping in and out of a car, tub, or shower.

Arthritis or Bursitis? Comparing the Clues

The biggest difference often comes down to location and triggers. Arthritis pain is more commonly felt deep in the groin and may be accompanied by morning stiffness or discomfort during prolonged walking or standing. Bursitis pain is usually more localized to the outside of the hip and often worsens with side sleeping or single-leg activities.

That said, hip pain is not always straightforward. Some patients may have more than one contributing factor, and symptoms can overlap. That’s why a proper evaluation by an orthopedic specialist is important when pain persists or begins affecting daily life.

Other Causes Worth Ruling Out            

Arthritis and bursitis are common, but they are not the only causes of nighttime hip pain. Tendon irritation, lower back issues, referred pain from the spine, muscle strain, labral problems, or other orthopedic conditions may also contribute. If pain worsens, spreads, or is accompanied by weakness, numbness, or difficulty walking, it should be evaluated.

How to Sleep More Comfortably Tonight

Small adjustments may help reduce nighttime hip pain. If you sleep on your side, try placing a pillow between your knees to keep your hips more aligned. Avoid lying directly on the painful hip if it increases discomfort. If you sleep on your back, placing a pillow under your knees may reduce strain through the hips and lower back.

When to See a Specialist              

If hip pain is persistent, worsening, or interfering with sleep and daily activities, it may be time to see an orthopedic specialist. Pain that limits walking, makes stairs difficult, or causes ongoing tenderness should not be ignored. Early evaluation can help identify the source of symptoms and guide the development of the right treatment plan.

Find Relief with an Orlin & Cohen Hip Specialist

At Orlin & Cohen, our fellowship-trained hip specialists evaluate the full picture, including where your pain is located, what activities aggravate it, and how it affects your sleep and mobility. Whether your symptoms are related to arthritis, bursitis, or another condition, our team can help create a personalized plan to improve comfort and function.

If nighttime hip pain is keeping you from getting the rest you need, schedule an appointment and take the first step toward lasting relief.