Hip pain that becomes worse when you lie on one side is very common.

You may notice:

• Pain directly over the outside of the hip
• Pain that wakes you when you roll onto that side
• Aching down the outside of the thigh
• Pain when climbing stairs
• Pain after longer walks
• Pain when getting up from a chair
• Difficulty finding a comfortable sleeping position

When the pain is mainly on the outer side of the hip, the problem is often related to the soft tissues around the hip rather than the hip joint itself.

Mayo Clinic notes that pain over the outer hip, upper thigh or outer buttock is more commonly associated with surrounding muscles, tendons, ligaments or bursae, whereas pain in the groin or inner hip is more suggestive of a problem inside the hip joint.

Why Does My Hip Hurt When I Sleep on My Side?

Lying on one side places direct pressure on the outer part of the hip.

If the tissues around this area are already irritated, that pressure can make symptoms significantly worse.

Common possibilities include:

• Gluteal tendon irritation
• Trochanteric bursitis
• Other soft-tissue problems
• Less commonly, pain referred from the lower back

Mayo Clinic describes trochanteric bursitis as causing pain over the point of the hip that can spread down the outer thigh and become worse at night or when lying directly on the affected side.

What Is Trochanteric Bursitis?

A bursa is a small fluid-filled sac that helps reduce friction between tissues.

The greater trochanter is the prominent bone on the outside of the hip.

A bursa around this area can become irritated and painful.

Symptoms may include:

• Outer hip pain
• Tenderness when pressing the side of the hip
• Pain lying on the affected side
• Pain walking longer distances
• Pain climbing stairs
• Pain when standing from a chair

The NHS lists bursitis as a possible cause of hip pain that may spread into the thigh and become worse with movement or when lying on the affected side.

Is All Outer Hip Pain Bursitis?

No.

Many cases of outer hip pain involve the gluteal tendons as well as, or instead of, the bursa.

These tendons connect important hip muscles to the outer hip.

If they become irritated, symptoms may include:

• Pain over the outer hip
• Pain lying on that side
• Pain walking
• Pain climbing stairs
• Pain standing on one leg

This is why simply calling every case “bursitis” may oversimplify the problem.

Why Does the Pain Go Down the Outside of My Thigh?

Pain from tissues around the outer hip can spread down the outside of the thigh.

Mayo Clinic notes that trochanteric-region pain may extend down the outer thigh.

This does not automatically mean that the pain is coming from a nerve.

However, pain that continues farther down the leg or is associated with:

• Tingling
• Numbness
• Burning
• Shooting pain

may require assessment of the lower back and nerves as well.

Could the Pain Actually Be Coming From My Back?

Yes.

Lower-back problems can sometimes cause pain felt around the:

• Buttock
• Outer hip
• Thigh

Mayo Clinic specifically notes that hip-region pain can sometimes be referred from the lower back.

This becomes more important when you also have:

• Lower-back pain
• Pain below the knee
• Tingling
• Numbness
• Burning or electric pain

What if the Pain Is in My Groin Instead of the Outside of My Hip?

Groin pain is more suggestive of a problem within the hip joint itself.

Possible causes include:

• Osteoarthritis
• Labral injury
• Other joint-related problems

Mayo Clinic notes that pain in the inner hip or groin more commonly points toward structures inside the hip joint.

This distinction can help determine whether an X-ray, MRI or another investigation may be more appropriate.

Why Does My Hip Hurt on Both Sides When I Sleep?

Pain on both sides can occur if both outer hip regions are sensitive.

Other possibilities include:

• Sleeping position
• Mattress pressure
• Hip tendon problems on both sides
• Referred pain from the lower back

Bilateral pain does not automatically mean there is a problem inside both hip joints.

A physical examination can help determine where the pain is actually coming from.

Can My Mattress Cause Hip Pain?

It may contribute.

A very firm surface can increase direct pressure over the outer hip.

A very soft mattress may allow the pelvis to sink into a position that some people find uncomfortable.

However, repeatedly changing mattresses may not solve symptoms caused by an underlying tendon, joint or spinal problem.

If you have persistent hip pain every night, it is worth considering more than the mattress alone.

Should I Stop Sleeping on the Painful Side?

Temporarily avoiding direct pressure on the painful side is reasonable.

Mayo Clinic specifically recommends avoiding sleeping on the affected side when dealing with minor hip pain.

You might try:

• Sleeping on the opposite side
• Sleeping on your back
• Using a pillow between the knees

The goal is to reduce pressure while the irritated structures recover.

Will a Pillow Between My Knees Help?

Some people find it more comfortable.

A pillow between the knees can help support the upper leg and reduce twisting through the pelvis.

It may not treat the underlying cause, but it can make sleep more comfortable.

Why Does My Hip Hurt When I Get Out of Bed?

Several hours without much movement can contribute to stiffness.

You may notice:

• Pain during the first few steps
• Stiffness that gradually eases
• Pain after getting up from a chair

If pain also occurs during walking and there is significant groin stiffness, hip arthritis becomes more important to consider.

If the pain is mainly on the outside and is tender to touch, soft-tissue causes may be more likely.

Does Hip Arthritis Cause Pain When Sleeping on Your Side?

It can cause night pain, but hip arthritis more commonly produces symptoms such as:

• Groin pain
• Pain while walking
• Joint stiffness
• Reduced hip movement

Outer hip pain specifically triggered by direct pressure is more suggestive of surrounding soft tissues.

That said, people can have more than one condition at the same time.

Can Physiotherapy Help?

Yes, depending on the cause.

Physiotherapy for outer hip pain may focus on:

• Gluteal strengthening
• Hip strength
• Movement control
• Gradual increase in walking tolerance
• Reducing activities that excessively compress the painful tissues

The programme should be progressed according to symptoms rather than simply repeating painful exercises.

Should I Stretch the Outer Hip?

Aggressive stretching is not always helpful.

Some stretches may increase compression around the painful outer hip.

If a stretch repeatedly produces significant worsening, it may need to be modified.

A physiotherapist can help determine which exercises are appropriate for the suspected problem.

Should I Stop Walking?

Usually not completely.

If walking clearly aggravates symptoms, you may temporarily reduce:

• Distance
• Hills
• Stairs
• High-impact activity

Mayo Clinic advises avoiding activities that significantly aggravate minor hip pain while continuing appropriate self-care.

The longer-term goal is generally to restore activity gradually.

What if Physiotherapy Is Not Helping?

Persistent outer hip pain despite appropriate rehabilitation may justify reassessment.

Questions include:

• Is the diagnosis correct?
• Is the pain actually coming from the lower back?
• Is there significant tendon damage?
• Is arthritis present?
• Would imaging change treatment?

The answer is not always to continue doing exactly the same exercises indefinitely.

Should I Get an X-Ray?

An X-ray is particularly useful when the clinical question involves:

• Hip arthritis
• Bone abnormalities
• Fracture

It is less useful for directly assessing:

• Gluteal tendons
• Bursa
• Labrum
• Other soft tissues

The choice of scan should follow the suspected diagnosis.

Is Ultrasound Useful for Outer Hip Pain?

Yes, in selected cases.

Musculoskeletal ultrasound can assess:

• Gluteal tendons
• Bursa
• Other superficial soft tissues

It may be useful when a tendon or bursal problem is strongly suspected.

When Is MRI Useful?

Hip MRI provides detailed images of:

• Tendons
• Muscles
• Bursa
• Cartilage
• Labrum
• Bone marrow
• Joint structures

RadiologyInfo notes that hip MRI can be used to investigate hip pain or stiffness, bursitis, tendonitis, cartilage or labral injury and fractures that may not be visible on X-ray.

MRI becomes more useful when:

• Symptoms persist despite treatment
• The diagnosis remains uncertain
• Significant tendon injury is suspected
• There may be more than one cause
• X-rays do not explain the symptoms

MRI vs Ultrasound for Outer Hip Pain

Both can be useful.

Ultrasound May Be Useful For:

• Gluteal tendons
• Bursa
• Focused soft-tissue assessment

MRI May Be Useful For:

• More comprehensive assessment
• Tendon injury
• Labrum
• Cartilage
• Bone marrow
• Hidden fractures
• Multiple possible causes

The correct investigation depends on the clinical question.

Does Hip MRI Use Radiation?

No.

MRI does not use ionising radiation.

Does Everyone With Night Hip Pain Need MRI?

No.

Imaging is usually unnecessary when symptoms are mild, short-lived and clearly improving.

MRI becomes more useful when:

• Pain persists
• Treatment has not helped
• The diagnosis is uncertain
• Significant structural injury is suspected
• Imaging would change the treatment plan

Can an Injection Help?

Selected patients with significant outer hip pain may sometimes be considered for an injection around the painful region.

Mayo Clinic notes that steroid injections can be used in some cases of trochanteric bursitis when simpler measures are insufficient.

However, an injection is not necessarily the first or only treatment.

It is useful to first determine whether the problem is:

• Bursa-related
• Tendon-related
• Joint-related
• Referred from elsewhere

When Should I See a Doctor?

Arrange an assessment if:

• Pain repeatedly wakes you at night
• You cannot sleep comfortably on either side
• Walking is becoming difficult
• Symptoms keep returning
• Pain persists despite physiotherapy
• Pain is getting worse

Mayo Clinic advises medical review when self-care measures do not improve hip pain.

When Is Hip Pain Urgent?

Seek prompt medical attention if:

• You cannot walk or bear weight after an injury
• The hip looks deformed
• You cannot move the leg
• There is sudden major swelling
• The hip is hot and swollen with fever

The NHS identifies inability to walk after injury and a hot, swollen hip with fever among situations requiring urgent assessment.

How Much Does a Hip MRI Cost in Singapore?

For many patients arranging a hip MRI through The Pain Relief Clinic, the current price is approximately:

S$1,000

This generally includes:

• MRI examination
• MRI images
• Formal radiologist’s report

Eligible outpatient diagnostic scans may qualify for up to:

S$600 per patient per year from MediSave

subject to prevailing requirements and the patient’s remaining annual limit.

How Quickly Can I Get a Hip MRI?

When MRI is medically appropriate, The Pain Relief Clinic can often arrange hip imaging:

Within one working day

subject to:

• MRI safety screening
• Correct imaging protocol
• Appointment availability

Frequently Asked Questions About Hip Pain When Sleeping on Your Side

Why does my outer hip hurt when I lie on it?

Direct pressure can aggravate irritated gluteal tendons or the bursa around the outer hip. Trochanteric-region pain is commonly worse at night when lying on the affected side.

Is outer hip pain usually arthritis?

Not necessarily. Arthritis more commonly causes pain in the groin or inside of the hip, while outer hip pain is more often related to surrounding soft tissues.

Should I avoid sleeping on the painful side?

Temporarily avoiding direct pressure is reasonable and is recommended as a simple self-care measure for minor hip pain.

Could the pain come from my lower back?

Yes. Lower-back problems can refer pain around the hip and buttock.

Is ultrasound useful?

Ultrasound can help assess superficial tendon and bursal problems.

Do I need an MRI?

Not automatically. MRI becomes more useful when symptoms persist, the diagnosis is unclear or deeper structural problems need to be assessed.

Does hip MRI use radiation?

No. MRI does not use ionising radiation.

How much does a hip MRI cost?

A hip MRI arranged through The Pain Relief Clinic is currently approximately S$1,000, including images and a formal radiologist’s report.

Hip Pain Keeping You Awake When You Sleep on Your Side?

If outer hip pain repeatedly wakes you at night, it may be useful to determine whether the problem is coming from:

• Gluteal tendons
• Bursa
• The hip joint
• The lower back
• Another structure

At The Pain Relief Clinic, we can assess:

• The exact location of your hip pain
• Hip movement
• Strength
• Whether the lower back may be contributing
• Whether X-ray, ultrasound, MRI or no imaging is most appropriate
• Whether physiotherapy or another non-surgical treatment may be suitable

When MRI is medically indicated, hip imaging can often be arranged within one working day.

Hip pain assessment through The Pain Relief Clinic

• Medical assessment by a licensed medical doctor
• In-house physiotherapy
• Assessment of hip and lower-back causes
• Fast access to imaging where appropriate
• Hip MRI often available within one working day
• Approximately S$1,000 for many hip MRI examinations
• Up to S$600 MediSave for eligible outpatient diagnostic scans
• Formal radiologist’s report
• Non-surgical treatment options where appropriate
• Specialist referral when appropriate

Arrange a Hip Pain Assessment

The Pain Relief Clinic

Call / WhatsApp: +65 9068 9605

If hip pain is repeatedly preventing you from sleeping comfortably on one side, especially if it also affects walking or has not improved with physiotherapy, contact us for an assessment.

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References

1. Mayo Clinic — Hip Pain: Causes, 22 December 2025.
2. Mayo Clinic — Hip Pain: When to See a Doctor.
3. Mayo Clinic Primary Care — My Hip Hurts: What Do I Do?
4. Mayo Clinic — Trochanteric Bursitis.
5. NHS — Hip Pain in Adults.
6. RadiologyInfo.org, American College of Radiology and Radiological Society of North America — Hip MRI, reviewed 15 June 2026.

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Important Medical Information

This article provides general educational information and does not replace an individual medical consultation.

Pain when sleeping on the side can arise from hip tendons, bursae, the hip joint, the lower back or other causes. Pain location and sleeping position can provide useful clues but cannot establish a diagnosis by themselves.

Imaging is not required for every case of hip pain. The appropriate investigation depends on symptoms, examination findings, trauma history, duration, response to treatment and whether the result would change management.

Seek urgent medical attention for inability to walk or bear weight after injury, major loss of hip movement, visible deformity, sudden severe swelling, or a hot and swollen hip associated with fever.

Reviewed by Dr Terence Tan, Founder of The Pain Relief Clinic — 18 September 2026