Is there anything better than a cozy night cuddling with your sweetheart? Or anything worse than when you can’t find the right cuddling or sleeping positions for hip pain?

For many of us, cuddling is one of the ways we show affection to our partners and enjoy quality time together. So, what happens when your hip pain starts to interfere with that sacred time?

Whether your hip pain starts to act up just when you’re starting to snuggle in, or is interfering with your ability to sleep at night, you’ll need to know how to manage it.

No matter what the root cause of your hip pain is, knowing the best snuggling and sleeping positions for hip pain is a good starting point in your hip pain management.

That being said, implementing the best sleeping positions for hip pain is only the first step. Your body positioning is merely a reaction to a deeper issue. If you don’t find out what is causing your hip pain in the first place, then you are only putting a bandaid on the problem. And I’m a big fan of addressing the root cause of the problem.

That’s why I’ll help you understand some common reasons your hip may be hurting when cuddling or sleeping, a few of the best sleeping positions for hip pain, and how to prevent hip pain altogether.

What causes hip pain when cuddling?

Hip pain can persist throughout the day, but many people actually experience the worst of it when they’re resting or trying to sleep. So, it’s no wonder the pain can pop up when you are cuddling with your partner or relaxing at the end of the day.

There are a variety of reasons why you may have hip pain, but some of the most common causes of hip pain include:

• Arthritis and osteoarthritis
• Bursitis
• Tight iliopsoas muscles
• Tendonitis

This is certainly not an exhaustive list. There are other reasons you may be having hip pain, including a hip fracture or a labral tear.

Because hip pain is so different for many individuals, if you are experiencing discomfort or any sensation that is interfering with daily activities like sleeping, cuddling, walking, driving, etc., it is important to get an opinion from a medical professional.

This article isn’t meant to diagnose or treat hip pain. It is here merely to help you understand your hip pain better, learn a little bit about the anatomy of your hip flexors and find the best sleep positions for hip pain so you can rest easy.

Although there are quite a few relatively common reasons for hip pain, the one I want to focus on today is overly tight iliopsoas muscles (also known as your hip flexor muscles).

Tight iliopsoas muscles are a frequently overlooked factor when it comes to hip pain, but this tightness is also one of the most prevalent reasons so many people have persistent pain in their hip - sometimes spreading to their back, legs, knees and further downward.  

How tight hip flexor muscles cause hip pain

Your hip flexor muscles are one of the most used muscles in your body. During the majority of your daily activities - including sitting, walking, stepping up, lunging, squatting, kicking, running, and anything else that involves leg or trunk movement - these muscles are engaged.

The over-engagement of the iliopsoas muscles can eventually lead them to tighten.

The two separate muscles that make up the hip flexors are the iliacus and the psoas muscles. The iliacus and psoas overlap and connect, the psoas starting at your low-mid spine, and the iliacus starting inside your pelvic bone, and both inserting at the top of your thigh bone. These muscles go diagonally through your core and have the very important job of connecting your upper and lower body.

If the iliacus and psoas muscles are allowed to get too tight, they begin to pull on the structures around them. The excessive tension in the iliopsoas can pull your hip out of alignment and eventually cause pain in your hip or lower back.

The iliopsoas muscles and other surrounding pelvic muscles have the ability to create a domino effect. If one of the muscles is too tight, or a bone is misaligned, it will impact the surrounding areas. Tight iliopsoas muscles can interfere with your other muscles, interfere with your posture (all the way down your feet!), and keep creating more and more issues if the tension continues.

That’s a pretty big effect from such small muscles!

So now that you have a better understanding of your hip structure, and know at least one possible source of your hip pain, it’s time to learn how to manage that pain in the evening so you can actually relax.

Here are the best sleeping positions for hip pain that I recommend to my patients.

The 4 best cuddling & sleeping positions for hip pain

Cuddling is a great way to relieve stress, enjoy time with your partner, enjoy a strong cocktail of your self-manufactured love chemical oxytocin, and even alleviate some chronic pain symptoms. Still, if you suffer from hip pain for any reason, you may struggle to cuddle comfortably or to get a good night’s sleep.

Most of these cuddling and sleeping positions for hip pain are going to be ones that you’re already familiar with, but they include some variations to help you get comfortable and ease hip pain while you cuddle or fall asleep.

1. Be the little spoon

Spooning is a very common cuddling position for many couples, especially when they’re falling asleep together. And, if you are one of the couples who enjoy spooning then you are in luck! Spooning is one of the best sleeping positions for hip pain.

If you have hip pain even while spooning with your partner, identify which hip you’re having pain in while you spoon. If your hip pain is isolated to one hip, be sure to flip over and lie down on the hip that is not causing you pain.

If you prefer being the little spoon, put a pillow between your legs (from knee to ankle) while lying on your side. Elevating your top knee and keeping your top leg parallel to your bottom leg with the pillow, helps to change your top thigh’s angle and prevents it from dropping and tugging on the muscles surrounding your hip.

If you don’t prop your leg up with a pillow and it drops, it can impact the soft tissues (such as your muscles) around your hip and pelvis. This can trigger pain. By separating the top and bottom leg, even just slightly, you can take away some of the stress on those muscles.

If you don’t have an extra pillow to use, or you find sleeping that way uncomfortable, you can instead try angling ever so slightly onto your stomach so that your top knee rests in front of your bottom leg and your hip angle is altered.

2. Be the big spoon

If you are the big spoon through and through, there are some helpful sleeping positions for hip pain for you too. In fact, as the big spoon, you won’t need a pillow at all - you can substitute your partner for one!

While being the big spoon, simply rest your upper leg on top of your partner’s leg. Make sure you are actually relaxing while doing this. This position will help to relieve some of the tension in your leg and will ease your hip pain as well.

3. Try half-spooning

The half spoon is another one of the best sleeping positions for hip pain. If you aren’t sure what I am referring to, don’t worry. I’m here to explain it!

One partner will be lying on their back to perform this cuddling position, and the other one will be on their side facing their partner, similar to a traditional spooning position.

The partner lying on their side will rest their head on the crook of the other partner’s arm, and can rest their own arm on their partner’s chest.

The partner lying on their back can wrap their arm around their partner and lie in whatever position is comfortable for them.

If lying on your side doesn’t work, even with modifications, then choose to be the partner lying on their back.

If you still have hip pain on your back, then try putting a pillow or two under the back of your knees to lift your legs slightly and release some tension on the hip flexor muscles.

If you are the partner that is lying on your side, then just make sure you are lying on the hip that does not cause you pain. Then, drape your top leg across your partner’s body. Just like in the examples above, this will elevate your upper leg enough to relieve some of the pull on the soft tissues in your hip.

4. Rest your head on your partner’s chest

Resting your head on your partner’s chest while they are lying on their back is one of the most comfortable cuddling or sleeping positions for hip pain. Much like in the half-spoon cuddling position, one partner will lie on their side and the other will lie on their back.

The partner on their back can choose a position that works well for them, and if you struggle with hip pain when lying on your side, it will work best for you to be in this position.

The partner lying with their head on their partner’s chest will essentially be in the half-spoon position, but will be slightly lower so that their head rests on their partner’s chest instead of their partner’s arm.

This position allows you to also elevate your top leg by laying your leg across the top of your partner’s legs.

So there you have it! You can be the big spoon, little spoon, or a combination of the two (a human spork?) - and still find a comfortable sleeping position for hip pain.

As I mentioned before, however, simply managing your hip pain at night or while cuddling will not correct the cause of your hip pain in the first place.

Don’t just react to hip pain - prevent it

Chronic hip pain doesn’t have to last forever. While finding the best cuddling and sleeping positions for hip pain can help relieve your pain (or at least make you comfortable enough to fall asleep and enjoy cuddling with your partner) it is only a temporary solution.

One of the most effective ways to address hip pain when cuddling or sleeping is to find the cause of that pain and manage it. Often, there is a common root cause to hip, back and knee pain: tight hip flexor muscles. Fortunately, if that’s the case, there are several easy things that you can do to address the issue.

First, you should get an evaluation from a medical professional, like a physical therapist, to help come up with a treatment plan that fits your needs. Within that treatment plan, they may recommend that you begin to implement some hip flexor stretches to target tight iliopsoas muscles as well as muscle release techniques.

Some stretching techniques can be beneficial to tight hip flexor muscles, but the best way to release your iliacus or psoas muscles is to use targeted muscle release, involving direct, prolonged pressure. Unfortunately, the iliacus and psoas are hard muscles to reach.

While your physical therapist can reach your iliacus and psoas muscles to apply pressure to them during a session, your muscles need more attention between appointments if you want to see results.

Most standard massage or muscle release tools can’t access the iliacus or psoas muscles. That’s why I invented the Hip Hook - a psoas release and iliacus release tool.

Paying careful attention to the tightness of your hip flexor muscles is one of the best preventative measures anyone can take to ensure that they can enjoy cuddling and sleeping without hip pain. Because relaxing with another human really is the good stuff.

Keeping your hip flexors muscles healthy and happy is a long-term journey, and it’s completely worth it. If you need some relief in the meantime, my list of the best sleeping positions for hip pain should help you find it.

FAQs about hip pain when sleeping

Can a body pillow help with hip pain?

It can, and a human body pillow works just as well! If you’re a side sleeper, spooning another human (or a body pillow) allows you to keep your top leg elevated, reducing muscle tension on your top hip joint and compression on your bottom hip joint. But at some point, you may want to address the root cause of that hip pain and look at what you’re with your body during waking, non-cuddling hours.

How do I stop my hip from hurting when I sleep on my side?

One way is by using pillows to adjust the positioning of your body, allowing for more natural alignment. However, addressing any underlying muscle tension during the day may address the root cause of hip pain at night and lead to longer-lasting results.