Hip Pain When Sleeping on Your Side? What It May Mean
Updated: Aug 18
Does the outside of your hip hurt when you sleep on your side, walk, climb stairs, or stand on one leg?
One possible cause is greater trochanteric pain syndrome (GTPS) — a common condition affecting the outside of the hip.
It is often called hip bursitis, but current research suggests that the gluteal tendons are frequently involved as well.
At OsteopathyNearMe in Etobicoke, we start with an assessment to understand what may be contributing to your hip pain and whether the symptoms are actually coming from the hip.
What Causes Hip Pain When Sleeping on Side?
Hip pain when sleeping on side is often related to irritation or sensitivity of the muscles and tendons around the outside of the hip.
Common symptoms may include:
Pain on the outside of the hip
Pain when sleeping on the affected side
Discomfort with stairs or longer walks
Pain when standing on one leg
Symptoms after increasing running or exercise
Aching down the outside of the thigh
However, similar symptoms can sometimes come from the lower back, hip joint, or other structures, which is why assessment is important.
Is It Really Hip Bursitis?
Not always.
The term trochanteric bursitis is still commonly used, but lateral hip pain can involve the gluteus medius and gluteus minimus tendons, the bursa, and surrounding tissues.
This is why simply treating inflammation may not address everything contributing to the problem.
How Is Lateral Hip Pain Assessed?
An assessment may include:
Hip movement
Tenderness around the outside of the hip
Hip muscle strength
Walking and single-leg control
Lower-back movement
Movements that reproduce your symptoms
Research supports using a combination of clinical tests rather than relying on one test alone.
An MRI is therefore not automatically necessary. Imaging may be considered when the diagnosis is unclear, a significant injury is suspected, or symptoms are not progressing as expected.
What Treatment Has the Best Evidence?
Current research provides the strongest support for education and progressive exercise in people with gluteal tendinopathy.
Treatment often focuses on gradually improving the hip’s ability to tolerate everyday activities such as walking, stairs, exercise and prolonged standing.
Complete rest is usually not the goal.
Instead, activity may be temporarily modified and then progressively increased as symptoms allow.
Can Osteopathy Help With Hip Pain?
Osteopathic manual treatment may be used as one part of a broader management plan when appropriate.
Depending on your assessment, care may include:
Hands-on treatment
Movement and activity advice
Mobility work
Progressive exercises
Strategies to reduce aggravating positions
Importantly, research currently provides stronger direct evidence for education and exercise in gluteal tendinopathy than for manual therapy alone.
Our goal is therefore not simply to repeatedly treat the painful area, but to help improve movement, function and your ability to tolerate activity.
What Can I Do at Home?
While waiting for an assessment, you may try:
Avoiding prolonged pressure directly on the painful hip
Sleeping on the opposite side with a pillow between your knees
Reducing activities that significantly aggravate symptoms
Continuing comfortable daily movement rather than complete rest
Avoid aggressively stretching or strengthening the hip if you are unsure what is causing the pain.
When Should Hip Pain Be Investigated?
Seek appropriate medical assessment if hip pain follows significant trauma, you suddenly cannot bear weight, symptoms are severe or rapidly worsening, or you develop significant neurological or systemic symptoms.
Most uncomplicated lateral hip pain can initially be assessed conservatively.
Hip Pain Treatment in Etobicoke
If hip pain is interfering with sleep, walking, exercise or everyday activities, an assessment can help determine what may be contributing to your symptoms.
At OsteopathyNearMe Health Studio in Etobicoke, we assess the hip together with relevant muscle function, movement and surrounding areas before developing an individualized treatment plan.
Frequently Asked Questions
Why does my hip hurt when I sleep on my side?
Direct pressure can irritate sensitive tissues around the outside of the hip. GTPS and gluteal tendinopathy are possible causes, although other conditions can produce similar symptoms.
Is outer hip pain always bursitis?
No. The gluteal tendons and other surrounding tissues may also contribute to lateral hip pain.
Should I stop walking?
Usually not completely. The amount of walking may need to be temporarily adjusted if it significantly aggravates symptoms.
Should I stretch my IT band?
Not necessarily. Some positions may increase compression around sensitive lateral hip tissues. Exercise should ideally be based on your individual assessment.
Do I need an MRI?
Not always. Many cases can initially be assessed clinically. Imaging may be considered when the diagnosis is uncertain or the result would change management.
References
Bremer T, Nicklen P, Fearon A, Morrissey D. The efficacy of gluteal tendinopathy treatments: a systematic review. Clinical Rehabilitation. 2025;39(5):600–617. DOI: 10.1177/02692155251327298.
Kjeldsen T, Hvidt KJ, Bohn MB, et al. Exercise compared to a control condition or other conservative treatment options in patients with Greater Trochanteric Pain Syndrome: a systematic review and meta-analysis. Physiotherapy. 2024;123:69–80. DOI: 10.1016/j.physio.2024.01.001.
Kinsella R, Semciw AI, Hawke LJ, et al. Diagnostic Accuracy of Clinical Tests for Assessing Greater Trochanteric Pain Syndrome: A Systematic Review With Meta-analysis. J Orthop Sports Phys Ther. 2024;54(1):26–49. DOI: 10.2519/jospt.2023.11890.
Mellor R, Bennell K, Grimaldi A, et al. Education plus exercise versus corticosteroid injection versus a wait and see approach for gluteal tendinopathy. BMJ. 2018;361:k1662. DOI: 10.1136/bmj.k1662.
Comments