Robert Karpman, MD, is a board-certified orthopedic surgeon at Banner Estrella Medical Center.
Question: I am having pain in my hip which is worse at night and I have difficulty sleeping on that side. Is this a sign of early arthritis in my hip?
Answer: Hip arthritis is often confused with other problems that can occur around the hip joint. A thorough clinical exam with your orthopedic specialist and a simple x-ray of the hip joint can determine the presence of hip arthritis, which is a loss of the cartilage which lines the hip socket. In most instances, patients with hip arthritis complain of groin pain which can migrate down the thigh and around the inside of the knee. This pain may be confused with a hernia or other abdominal problems, but is more typically associated with hip arthritis.
The pain you describe—worse in the evening and difficulty sleeping because of pressure on one side—is most likely bursitis of the hip. Bursitis is inflammation of the bursae, or small fluid-filled sacks, that are frequently located around bony prominences such as the hip, elbow, shoulder and knee. The bursae allow for smooth motion of muscles that overlay the bony prominence. In some cases, particularly with overuse such as climbing stairs, frequent bending down or even riding a bicycle, the hip bursa becomes inflamed and this causes pain, usually at the end of the day. This pain can be worse when pressure is placed on the area, such as when you sleep on your side.
For this type of pain, treatment is fairly simple and involves using ice over the area, over the counter non-steroidal medication such as Advil, Motrin or Aleve, and stretching exercises to relieve the pressure over the bursa. A helpful hint for applying ice:
Fill paper Dixie cups with water and place them in the freezer. This provides you with something to hold on to that won’t freeze your fingers. Before applying the ice to the affected area, place a thin layer of Vaseline over the skin. Peel the paper around the cup and apply the ice directly on the tissues. The lubricant will take the sting away from the skin and allow for better absorption of the ice into the deeper tissues. By utilizing this technique, you only need 10 to 15 minutes of ice application instead of a half-hour to 45 minutes to achieve the same effect.
Try the ice and over-the-counter recommendation for a month to see if this alleviates the pain. If the problems persist, see an orthopedic specialist. Your orthopedic specialist can recommend an occasional cortisone injection into the area of involvement, which can relieve pain for up to three months after the shot.