Hip Pain During Pregnancy Why It Gets Worse at Night

You are doing everything right. The pain is not your fault. Here is what your body is actually going through.

NuAligno Health Team

Sleep and Pain Wellness

| June 2025 5 min read

Pregnancy hip pain almost always gets worse at night. There is a specific reason for that — and it is not just because you are tired.

If you are lying awake at 2AM with an aching outer hip, you are not imagining it. Something very specific is happening while you sleep.

Why pregnancy changes everything below the waist.

From around 10 to 12 weeks your body begins producing a hormone called relaxin. Its job is to loosen the ligaments of your pelvis so your baby has room to grow and your body can open during birth. It does this job extremely well.

The problem is that relaxin does not only loosen the ligaments you need loosened. It affects all the connective tissue in the pelvic region — including the sacroiliac joints, the pubic symphysis and the hip joints. Structures that would normally hold your pelvis stable become more mobile. More vulnerable. More sensitive to sustained pressure.

Add to this the fact that your centre of gravity shifts forward as your bump grows — which changes how load is distributed through your hips and lower back — and you have a body that is working much harder than usual just to stay comfortable.

Relaxin does not know which ligaments you need loosened. It loosens all of them.

Why it is always worse at night.

During the day you are upright and moving. Movement distributes load, warms the muscles and keeps the joints from staying in one position for too long. Even when you are tired and uncomfortable, your body is constantly making small adjustments.

When you lie down, all of that stops. Your muscles relax. Your pelvis stays in one position, with gravity acting on it, for hours. And because your ligaments are looser than they would normally be, the pelvis is less supported in that position than it would be outside of pregnancy.

For side sleepers — which is the recommended sleep position during pregnancy — the top knee gradually drops toward the mattress as you fall into deep sleep. That knee drop rotates the pelvis, compresses the sacroiliac joint and places sustained pressure on the outer hip structures that are already sensitised by relaxin. By 3AM that pressure has been building for hours. Which is exactly when most pregnant women wake up.

💡 Worth knowing

The pain being worse on the side you are sleeping on is a key sign that positional pressure is contributing. If you roll over and the pain shifts to the other hip, that confirms it — the issue is sustained load on whichever side is bearing your weight during sleep.

What actually helps.

There is no single fix for pregnancy hip pain — it is a complex picture involving hormones, biomechanics and a body that is doing something extraordinary. But there are things that make a meaningful difference to how comfortable your nights are.

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Support between your knees

Keeps the top knee from dropping — which stops the pelvic rotation before it starts. The key is keeping it in place when you roll over, which a regular pillow cannot always do.

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Alternate sides during the night

No single hip should bear all the load. Switching sides even once or twice significantly reduces sustained pressure overnight.

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Evening hip stretches

A seated figure four or gentle lying spinal twist for 30 to 45 seconds each side before bed reduces the tension your pelvis carries into sleep.

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Physio and osteopathy

If pain is affecting your sleep or daily function this is the most important step. Pelvic girdle pain responds very well to targeted professional treatment.

⚠️ When to seek help promptly

If pain is severe, you have difficulty walking, it radiates into your groin or leg, or you feel clicking in your pelvis — speak to your midwife, obstetrician or GP. These can be signs of pelvic girdle pain or symphysis pubis dysfunction that needs assessment.

It does get better.

For most women the pain improves significantly after birth as relaxin levels fall.

In the meantime the right support and a few small changes to your sleep setup can make a real difference to how you feel every morning.

🛏 From NuAligno

KneeRest Pro — designed to stay in position when you roll over

The adjustable leg strap keeps KneeRest Pro between your knees even as you move during sleep — which is what makes it different from a regular pillow. Contoured memory foam, pregnancy-safe materials, and a 30-night comfort guarantee.

Shop KneeRest Pro