Why Does My Hip Hurt at Night From a Herniated Disc?

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A herniated, or bulging, disc is a common problem that can affect any one of the intervertebral discs lining the spinal column. Although normally associated with back pain, a herniated disc can, and often does, cause pain to radiate into other parts of the body, including the hip joint and lower leg. This pain can occur at night, while lying down, or it can occur sporadically throughout the day.

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History

The spinal column is made up of several vertebrae that are separated from one another by small gel-like inserts called intervertebral discs. These discs help to cushion and stabilize the spine. A herniated, or slipped, disc is a disc that loses its normal shape and position in the spinal column and bulges outward, often pressing on nearby spinal nerves. This can cause not only back pain in the area near the herniated disc, but also referred pain down into the hip joint and lower extremities, which often increases at night when increased muscle stiffness causes additional nerve root compression.

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Significance

A series of spinal nerves run from the lumbar (lower) spinal column and extend down into the pelvis and lower legs. A herniated disc can, in many cases, irritate and inflame any number of these spinal nerves and cause pain and often numbness to radiate down into the lower extremities. Pain in or around the hip joint, as well as the knee joint, is a common symptom of a herniated disc in one of the lower lumbar spinal discs. Sleeping or lying down, especially at night, can be difficult, as pain is often aggravated by lying in a static position for long periods.

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Sciatic Nerve Irritation

The sciatic nerve is the largest and longest nerve in the body and runs from the lower spinal column down the buttocks and into the lower leg. It is common for a herniated disc in the lower lumbar spine, especially the L1 and L2 discs, to press on the nerves that branch off to form the sciatic nerve and cause pain in the hip joint. The sciatic nerve runs directly behind the hip joint, through the buttocks, and can carry pain signals to the area that get interpreted as hip pain.

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Treatment

The treatment for a herniated disc causing hip pain can vary. If the pain is mild, simple over-the-counter pain medications combined with physical therapy and activity modification may be adequate. Hip pain that occurs at night due to a herniated disc can be helped with the use of a heating pad, extra pillows under the back or legs, or postural changes. For more severe pain, nerve block injections, which consist of injecting a corticosteroid into the area around the herniated disc, can often bring substantial relief, but only temporarily. Surgery to remove the herniated disc, called a discectomy, is generally performed for severe disc herniations causing severe pain and difficulty walking.

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Prevention/Solution

A herniated disc often occurs following an accident or injury that jars or severely twists the spinal column. Thus, preventing a herniated disc can be difficult. However, many times a disc herniation can occur slowly, over time, as the result of weak back muscles, inactivity, and improper lifting mechanics. Engaging in regular exercise, including back-specific exercises and stretches, along with using proper lifting methods when lifting heavy objects can reduce the chances of developing a herniated disc.

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References

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