Hip Pain While Sleeping During Pregnancy: Why It Happens and What to Do About It
Written and reviewed by Anna McMaster, PT, DPT, PRPC
You're exhausted, you finally get into bed, and then your hips have other ideas. Hip pain while sleeping is one of the most common and frustrating complaints during pregnancy. Research suggests that pelvic girdle and hip pain affects anywhere from 20% to 70% of pregnant women, and it's one of the leading causes of sleep disruption during pregnancy. If this is you, you are very much not alone, and there are real things you can do about it.
Why Do Your Hips Hurt When You Sleep During Pregnancy?
There are a few reasons this tends to happen, and for most women it's a combination of more than one.
First, the hormone relaxin. During pregnancy your body produces relaxin to loosen your ligaments and prepare your pelvis for birth. This is a necessary and helpful process, but it also means your joints are less stable than usual, which can make the hips more vulnerable to discomfort especially under sustained pressure like lying on your side for hours at a time.
Second, the growing weight of your baby shifts your center of gravity and increases the load on your pelvis and hips. This added pressure while lying on your side can cause strain on the hip joint, the gluteal muscles, and the surrounding pelvic structures.
Third, many women simply aren't used to side sleeping. If you weren't a dedicated side sleeper before pregnancy, your hips aren't used to the sustained pressure of being in that position all night. And even if you were a side sleeper, doing it with a significantly heavier body and looser joints is a different experience.
Finally, your mattress may be part of the problem. If you have a particularly soft bed, your hips may be sinking too far into it, causing increased strain on the muscles and tissues around the hip. A firmer mattress or mattress topper can make a meaningful difference for the remainder of your pregnancy.
Setting Up Your Pillow Fort
The single most impactful change most pregnant women can make is optimizing their pillow support. This sounds simple but the details actually matter.
The most important addition is a firm pillow between your knees. You want something that won't compress down overnight. A good way to check this: when lying on your side with the pillow between your knees, your hip and knee should be roughly in alignment. If the pillow is too flat your knee dips lower than your hip, which rotates the pelvis and strains the hip. If it's too thick your knee sits higher than your hip, which creates a different kind of strain. Getting this right can make a significant difference.
You also don't need to lie completely flat on your side. With the support of a pregnancy pillow or extra pillows, try shifting your body slightly forward or slightly back from a fully side-lying position. This can take pressure off the bony prominence on the outer hip, which is often the main source of discomfort.
A pillow or rolled blanket behind your back can also help prevent you from rolling fully onto your back during the night, and a small cushion under your bump can reduce the downward pull on your pelvis and hips.
Releasing Hip Tension Before Bed
If your hip muscles are tight and then you sleep on them for hours, that sustained pressure on already-tense tissue can worsen pain. A few minutes of gentle hip release before bed can help set you up for a more comfortable night.
A seated piriformis stretch is a great option during pregnancy: sit on a firm chair, cross one ankle over the opposite knee in a figure-4 position, keep your back straight, and gently lean forward from your hips until you feel a stretch in your glute. Hold for 30 to 60 seconds on each side. If you have a lacrosse ball or massage ball, rolling out the glutes and outer hip against a wall before bed can also help release muscle tension before you lie down.
As with any stretching during pregnancy, you should feel a gentle release rather than sharp or intense pain. If anything causes sharp discomfort stop immediately and check with your provider.
What About After Baby?
The good news is that hip pain while sleeping typically improves after delivery, as the extra weight and pressure from the baby are no longer present. As your hormone levels normalize postpartum, your ligaments will gradually return to their pre-pregnancy stability as well.
That said, your body still benefits from pillow support while sleeping postpartum. The specific setup may look different than during pregnancy, but continuing to support your hips and pelvis with a pillow between your knees as you recover is a good habit to maintain, especially in the early weeks.
When to See a PT
If you've tried optimizing your sleep setup and are still dealing with significant hip pain, it's worth seeing a pelvic floor physical therapist or a pregnancy-specialized PT. Hip pain during pregnancy is very treatable and you don't have to just push through the third trimester. A PT can assess what's driving your specific pain and give you targeted strategies to manage it.
For personalized support throughout pregnancy and postpartum, Amie offers programs designed by pelvic floor PTs for every stage of your journey.
References
Halliday L., et al. (2024). The prevalence of depression in women with pregnancy-related pelvic girdle pain: a systematic review and meta-analysis. Health Science Reports.
Vleeming A., et al. (2008). European guidelines for the diagnosis and treatment of pelvic girdle pain. European Spine Journal, 17(6), 794-819.
Bhardwaj A., Nagandla K. (2014). Musculoskeletal symptoms and orthopaedic complications in pregnancy: pathophysiology, diagnostic approaches and modern management. Postgraduate Medical Journal, 90(1066), 450-460.
American College of Obstetricians and Gynecologists. (2021). Physical Activity and Exercise During Pregnancy and the Postpartum Period. Committee Opinion No. 804.