Is Hip Pain at Night a Sign of Cancer?

What usually causes hip pain at night?

The most common cause is pain on the outside of the hip from the gluteal tendons and the bursa over the bony point of the hip. AAOS OrthoInfo notes that hip bursitis pain is typically worse at night, when lying on the affected hip and when getting up from a chair. Lying on that side presses the sore tissue against bone, so the pain wakes you when you roll over.

Arthritis is the second common cause. AAOS OrthoInfo explains that hip osteoarthritis pain usually develops slowly and, as it progresses, can appear more often, including during rest or at night. Arthritis night pain tends to be a deep ache in the groin or thigh with stiffness when you first get up.

Other everyday causes include a labral tear, a muscle strain that is still healing and pain referred from the lower back. Together these account for the great majority of night hip pain our team sees.

Does the pain change when you change position?

This is one of the most useful questions you can ask yourself. Pain that flares when you lie on one side and eases when you shift to your back or the other side is behaving like a mechanical problem, such as a tendon, bursa or joint issue. These problems respond to pressure and movement.

Pain from a bone tumor tends to behave differently. It is often described as a constant, deep ache that does not care how you lie, and it may wake you even when you have not moved. AAOS OrthoInfo notes that bone pain occurring without heavy activity is particularly concerning in someone with cancer.

Keep in mind that arthritis can also ache at rest in its later stages, so position alone does not settle the question. It is one clue among several, and our team looks at the whole picture, including how long the pain has been present and how quickly it is changing.

What pattern of night pain needs prompt imaging?

Mayo Clinic lists bone cancer, leukemia and cancer that has spread to bone among the possible causes of hip pain. These are uncommon, but certain features make them worth ruling out sooner rather than later. If several of the following apply to you, ask for an evaluation within days instead of weeks.

• Deep, constant pain that is present at rest and not tied to position or activity
• Pain that is steadily worse week by week
• Unexplained weight loss, fevers or night sweats
• A personal history of cancer, especially breast, lung, prostate, kidney or thyroid
• A fracture after a minor bump or fall

Why does a history of cancer matter?

Most cancers found in bone in adults did not start there. AAOS OrthoInfo explains that cancer which begins in an organ and spreads to bone is called metastatic bone disease, and that breast, lung, thyroid, kidney and prostate cancers are the ones that most often spread to the skeleton. The pelvis and the long bones of the leg are among the common sites.

AAOS OrthoInfo also notes that bone metastases are generally painful when they occur, and that a cancer patient who has new pain, especially in the back, legs or arms, should tell their doctor right away. If you have had cancer, even years ago, new hip pain is worth mentioning promptly to your oncologist and to us.

How is cancer ruled out?

For most people, the answer comes quickly. The visit starts with your history and an exam that checks the joint, the tendons and the lower back. Standing X-rays of the pelvis and hip are usually done the same day. AAOS OrthoInfo notes that X-rays show bone and some tumors well, and they also show arthritis, which often explains the pain on its own.

When the X-ray is normal and the pain pattern is concerning, an MRI is the next step. AAOS OrthoInfo explains that MRI gives detailed images of both bone and soft tissue. A normal MRI is very reassuring, and it can also reveal the tendon or labral problem that is actually causing the pain. If anything suspicious appears, our team coordinates prompt referral to the right specialists.

What can you do for night hip pain in the meantime?

For the common mechanical causes, small changes can help you sleep. Try lying on the pain-free side with a pillow between your knees, or on your back with a pillow under your knees. Avoid long periods of standing with your weight on one hip and crossing your legs during the day, since both can irritate outer hip tendons.

Over-the-counter pain relievers may help if they are safe for you. Keep a short log of when the pain happens, what position you were in and whether it changes with movement. That record is one of the fastest ways to tell a mechanical problem from one that needs further imaging.

When should you book a visit?

Book a visit if night pain is lasting more than a couple of weeks, is getting worse or is costing you sleep. Seek same-day care if night pain comes with fever, a hot swollen joint or inability to bear weight. If you are simply worried, that is a fair reason to come in too, since a clear answer often helps people sleep better on its own.

The Saturday Hip Pain Clinic at Dr. Stride Hip & Joint in Memorial City is a good place to get a clear answer quickly. New patients are usually seen within the week, and most people leave with a diagnosis, a plan and real peace of mind.

Bring any X-rays, MRIs or reports you already have, a list of your medicines and, if you have had cancer, the type and year of treatment. That information helps Dr. Stride decide right away which imaging, if any, is needed.

Questions patients ask