Hip Surgery, Orthopedic Surgery

July 26, 2021

Why Does My Hip Hurt When I Wake Up?


After a good night’s sleep, you hope to wake up feeling refreshed and pain-free.  It doesn’t always work that way.  Some people wake up with hip pain in the morning and are mystified.  They are surprised that resting all night and taking the weight off their hips leads to discomfort instead of relief.

It may be something as simple as the way you’re sleeping.  If your mattress is too soft and doesn’t correctly support and align your body, you can wake up with hip pain.  Your sleeping position can also make your hips hurt.  Sleeping on your stomach sometimes triggers hip and lower back pain.  Try sleeping on your side or back, preferably with a pillow behind or between your legs for support.

If your hip pain is mild, it will probably go away as the day progresses.  Your body releases more endorphins during the day, and moving around loosens up and warms your muscles.  If you continue to wake up with hip pain and it doesn’t subside during the day, there may be underlying conditions causing it.  Chronic hip pain can be a sign of serious problems in the joint that need to be addressed.

Bursitis is a chronic condition caused by inflammation of the fluid sacs, or bursa, in the hips.  These sacs cushion the hip joints but can cause pain when they are inflamed.  Pain can flare up after sleeping in a position that puts pressure on the bursa.  The pain can continue to flare up throughout the day.  In most cases, exercise, anti-inflammatory medications, and icing the area will help relieve bursitis pain.  In rare cases, surgeons may have to remove the bursa.

Tendonitis of the Hip

After a workout or unusual physical activity, the tendons around the hip bone can become irritated and inflamed.  As you age, this happens more frequently because tendons are less elastic and flexible.  If the hip area is red or swollen and you have trouble bending forward, tendonitis may be the culprit.  Resting the area and applying heat and ice alternately can help.  Physical therapy and anti-inflammatory medications can also bring relief.  In severe cases of hip tendonitis, surgery may be needed.


There are two forms of arthritis that cause hip pain that can worsen when you wake up in the morning—osteoarthritis and rheumatoid arthritis.  Arthritis is the deterioration of the bones and joints in the body.  It leads to the bones grinding together rather than moving freely.  Osteoarthritis is more common as you age, occurring over time due to wear and tear.  You can also develop it as a result of a joint injury or infection.  Rheumatoid arthritis is an immune disorder that attacks healthy joint tissue.

While arthritis pain normally continues through the day, it can be more severe in the morning if you’ve slept on the affected joint.  Anti-inflammatory medicine, appropriate exercise, and physical therapy are helpful.  Hip surgery may be needed if the arthritis is advanced.

Ankylosing Spondylitis

This is a form of hip arthritis as well, but over time the bones of the spine fuse together rather than developing normal wear and tear or bone spurs.  This fusion leads to pain in the back, hips, and buttocks.  Stiffness in the back and hip is another symptom of ankylosing spondylitis.  Physical therapy and medication are the most common treatment.  For advanced ankylosing spondylitis cases, your physician may prescribe interleukin inhibitors or other biologics to reduce inflammation and immune system response.  If hip damage is severe, a total hip replacement might be needed.


The sciatic nerve running from the spine down the back of the legs can cause severe hip pain in the morning if it is compressed or pinched.  This causes inflammation and a burning, stinging sensation or sharp, stabbing pain that runs down the leg.  It can flare up throughout the day.  If the pain is mild to moderate, pain medications, hot and cold packs, and gentle exercises can help.  For severe pain, steroid injections may help reduce swelling and pain.

Treatment Options for Morning Hip Pain

The first line of treatment for hip pain is usually anti-inflammatory pain medications such as Ibuprofen.  If over-the-counter formulas aren’t effective, talk to your doctor about a prescription strength.  Physical therapy, exercise, and gentle stretching can loosen up the hip joint and improve the range of motion.  If none of this brings relief, you may need to consult a surgeon at Arkansas Surgical Hospital to discuss your options.  In some cases, surgery is the best option for relieving severe pain and resolving mobility issues.


A hip bursectomy is the draining or removal of the inflamed bursa in the hip joint.  A bursectomy is most often laparoscopic surgery, but open surgery is used in some complex situations.


Hip osteotomy involves cutting and reorienting the hip joint’s bones to alleviate excess pressure on the joints caused by arthritis or injury.  During the surgery, healthy cartilage is put in place, and the joint is placed in a stronger, more comfortable position to prevent future problems.

Hip Resurfacing

If your hip pain is due to excessive wearing of the cartilage in the hip socket, hip resurfacing may help.  During resurfacing, a surgeon replaces the damaged cartilage and bone by covering the ball of the femur bone with a metal cap and lining the socket’s interior with a metal cup.  This works best for people who plan to remain physically active.  It isn’t appropriate for those with osteoporosis who may have delicate bone tissue.

Total Hip Replacement

Replacing the hip joint is sometimes the best or only option for individuals suffering from severe hip pain due to osteoarthritis or injury.  During this operation, the ball of the thigh bone and the lining of the hip socket are replaced.  The damaged bone and cartilage are removed and replaced with metal, nylon, or ceramic parts.

If your hip pain when you wake up has lasted for several weeks or is becoming more severe, talk to your doctor.  Medication, stretching, and strengthening exercises may help.  If not, the physicians at Arkansas Surgical Hospital can determine whether pain injections or surgery will bring you relief.  Contact us to set up an appointment for an evaluation of your morning hip pain.


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