Tuesday, September 22, 2009

Sleeping with Hip Pain and Bursitis

hip pain while lying or sleeping on side
Do you suffer with lots of pain in the hip after prolonged sleeping in a side posture? You’re certainly not alone. The cause may be bursitis and this can occur either with the hip/leg on top, or the one that is pressured against the mattress. Hip bursitis can either be acute or chronic hip bursitis.

WHAT IS BURSITIS?
Bursitis is dysfunction in the fluid-filled sac (bursa) that normally provides buffering and lubrication for tendons gliding over a joint. It is often caused by new or old injuries or can be a result of lack of important nutrients to the joint. Acute Bursitis is inflammation of the sac and perhaps over-production of fluid (swelling). Chronic bursitis actually presents with dryness, lack of fluid and poor lubrication for movement of tendons.

HIP PAIN ON THE DOWNSIDE
Although there are many facets of treatment and self-care for bursitis of the hip joint, a pressure point relieving, supportive foam mattress is one very important aspect of treating it. REASONING: (1) It is important to not have pressure on the inflammed bursa while lying on that side. (2) Additional to excessive pressure, poor mattresses lack support and often sag or hammock. That places an undesirable stretch on the muscles associated with the hip on the downside, thus irritating the bursa and impeding healing. One might wake up with pain, clicking, stiffness and limited mobility which may lessen after being up and about for awhile.

HIP PAIN ON THE UPSIDE
Alternatively, your pain may occur in the hip that faces upward. I know this seems sort of odd, but it is actually quite common. REASONING: (1) In most people, their hips are wider apart than their knees. This is especially true in women. This anatomical truth can create tension on hip muscles as the knees come together and stretch such muscles. (2) Or perhaps, one stretches their leg out in front of them twisting the spine and pulling on hip muscles. In those with bursitis, this can wreck havoc with the sensitive bursa. (3) Of course, a supportive, pressure relieving mattress is advisable to prevent excessive hip rotation.(4) However, in this case it is often advisable to also utilize a nice space occupying pillow between the knees. The pillow should be soft enough to not impede circulation but substantial enough to maintain a distance between the knees perhaps equal to the width of the hips. Please note that hip bursitis often is complicated by a component of hip tendonitis which may also be alleviated with the advice of this article. Please also note that this is not the panacea of care for hip bursitis. Functional care involving nutrition, stretching, strengthening and physical medicine are advisable but beyond the scope of this article.

HELPFUL SLEEP SOLUTIONS FOR HIP BURSITIS

Mattresses to consider:
  • Nimblepedic Memory Foam Mattress
  • Pincore Latex Foam Mattress
  • Or, if your mattress is extremely firm, it likely causes pressure points and will actually bend the spine. In such cases, instead of a new mattress, one may consider a memory foam mattress overlay for firm mattresses.

Pillows to consider:

43 comments :

  1. This is really good article. My one of the friend has a problem in sleeping positions. I am searching a good article on that. Thank god finally I got very good article on this. I am going to give this article to him. I am sure it will sure help to him.

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  2. I wake through the night with terrible pain in my hip joint, after turning over I wake again with the same pain in the other hip. I have been sleeping on a so-called memory foam mattress for the past five years. My husband has no problems with the mattress. Can you please advise me.

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    1. get rid of the memory foam since i did my pain is so much better

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    2. Although we appreciate your opinion, this is not necessarily the best advise for someone with pain in the hip joint. There are multiple reasons for having hip joint pain. One must first know the etiology before one can say how much influence the mattress is having. I suppose there could be special certain circumstances as such that a quality memory foam mattress may not be viable advice; however, I cannot think of any cases of such. If her memory foam mattress was part of the problem, the quality and density of the memory foam mattress would likely be inadequate. The generalization that all memory foam mattresses should be tossed out for hip conditions is really off base. The NimblePedic Memory Foam Mattress for example has certainly played a part in resolving hip pains for hundreds of folks who have tried them. I have personally followed the results on this mattress and know this for a fact. I'm sure the well known Tempurpedic Mattress company has many testimonials related to that as well.

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    3. I am the same way. We have a memory foam mattress and I got sciatica from it which led to bursitis from limping for 7 months straight. We are investing in a new mattress.

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    4. Michele, if you got sciatica as a result of sleeping on a memory foam mattress, one of two things are likely: (1) the mattress you purchased was not of the right density and quality to properly support your body. (2) you did not sleep in the right position that best fits the needs of your particular body shape. Good quality memory foam mattresses do not cause sciatica without other causative factors being involved.

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  3. Regarding the hip pain issues for the lady in the previously posted comment...

    Well, I should start by saying that women inherently have more hip problems while side-sleeping because the anatomy of a woman is such that her hips are usually quite a bit wider than her waist. The greater degree of discrepancy creates more issues with such. That may explain why your husband is just fine. That being said, I good quality memory foam mattress like Nimblepedic or Tempurpedic should help resolve the pressure issues associated with such. Perhaps you do not have one of these brands, or the brand you have is now worn out after 5 years. I'm assuming since you mention that you have suffered for a few months, that prior to that you were not having such symptoms. I am also assuming that these hip pains are worse at night, resulting from sleep position or mattress and that upon awakening, symptoms improve throughout the day. If this is not the case, the symptoms may not have anything to do with your mattress. On the other hand, if my assumption about such is correct, you either need to update your mattress, improve the quality of your your memory foam mattress, and/or examine the exact positioning of you your sleep position. You may need to add a thick, but pressure reducing pillow between you calves and knees to space your knees apart so that the outside of your thighs in line with the width of your hips. I would suggest our Nimblepedic Comfort pillow that you can order here: http://www.backbenimble.com/memory-foam-pillows.htm#comfort

    Trying this may be the best thing to do initially. However, ultimately, if this does not work you likely need to replace your mattress with one that is still relieving the pressure points. Again, I would recommend our Nimblepedic Mattress at:
    http://www.backbenimble.com/nimblepedic-mattress.htm

    I hope this is helpful info for you

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  4. I have problems sleeping on my right side. My right hip hurts constantly. If I sleep on my left side, the right side hurts but not as much. I used to sleep on a memory foam mattress for years and I had no pain, but then the mattress starting sagging and sleeping on either side was painful. Six months ago we bought a new mattress a Prana and the pain is still there at night. We paid an arm and a leg for this mattress and I really do not know what to do. We did not buy the firmest or the softest, but one in the middle. I take two Aleve at night to help with the inflamation and yet still feel the pain. Do you think it is the mattress?

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  5. DEAR ANONYMOUS FROM JAN 29TH
    Sounds like you are suffering from one of two following conditions:
    1st and most likely: "Trochanteric Tendonitis/Bursitis"

    2nd: Sacro-iliac Joint Dysfunction

    With the wrong mattress or wrong sleep postures, both of these conditions may very likely cause discomfort, whether you sleep on your right or left side. When the right side is down, the pressure on the right S/I joint and/or hip joint will elicit pain. When lying on your left side, the tension and stretch placed on the tendons, bursa and gluteal muscles will exhibit less pain, but pain of a different type nonetheless.

    From what I know the core of the Prana mattress is latex foam and the cover has only a negligible amount of memory foam. Although latex does have some pressure relieving qualities, it is not as great as that of memory foam and probably Prana wasn't the best choice for your particular problem. That is not to say it is not good for back problems, but may not have the pressure reduction necessary for your hip condition. I would suggest you take a look at a "memory foam topper made for comfort and pressure point relief". I usually recommend the Nimblepedic brand, simply because I developed it and know the quality, but any similar one should help resolve your issues. Now, that being said, it does not solve what happens when you sleep with your left side down. For that you need to sleep with a fluffy, soft, pillow placed between your knees while you are sleeping. This will take the pressure off the right hip or s/i joint by keeping your knees apart, reducing the tension on the abducter muscles, TFL and gluteal muscles. Hope this advice is helpful to you.

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  6. Could weight be a factor in hip pain also? I used to get hip pain in bed when I was pregnant, and now a year and a half later I am getting it again. I'm definately not as big as when I was pregnant, but I was just curious if it is the extra pounds I put on. Also, my siactic nerve hurts sometimes as well. Is that related? Thanks!

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    1. @Anonymous(February 4, 2012). Pregnancy can be one of the reasons why you encounter hip pain. The added weight of your baby could add pressure to your hips while you're standing. Another thing, your hips muscles probably don't have enough exercise, that's why it can't handle too much pressure anymore.

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  7. Hip Pain and Your Weight:
    Certainly, carrying extra weight plays a huge factor in problems with all weight-bearing joints, of which the hip joint qualifies. However, it is probably not the only cause of the issues; and so further diagnostic measures should be employed to prevent further advancement of the condition.

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  8. For the past several years I've been waking up several times during the night with extreme hip pain. I added a thick memory foam matress pad to my bed two years ago and I was still suffering from hip pain. I came across this article and got a small between the knee pillow for Christmas. This magical little pillow has solved my hip issues - so far I've been able to sleep pain free.

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    1. I'm so glad to be able to help you with my recommendations. Be Well!

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  9. Hello,
    I have sever hip pain in both hips while sleeping on that side. Two years we bought a double sided pillow matters top of the line! I've used pillows between my knees for years.
    Is there no medication to help this pain from coming? I hate to take strong pain medication but it's the only thing that allows me to sleep.
    Thanks

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  10. Bilateral severe hip pain that occurs mainly while side sleeping is usually related to one of three origins:
    1)hip bursitis defined as inflammation of the sac associated with the joint that houses and supplies lubricating fluid for the gliding of tendons over the bone. Tendonitis, or inflammation of the tendons is almost always coincidental with the bursitis.
    2)tightness of the ilio-tibial band, a fascia running up and down the outside of thigh from pelvis to knee that helps provide weight-bearing support and good structural foundation for the performance of the muscles supporting the knee.
    3)Sacro-iliac joint dysfunction, a joint between the pelvic and base of the spine that when compromised can refer pain to the hips and/or buttocks.

    A fourth possibility would be a "Piriformis Syndrome" or imbalance in tone of a muscle crossing over your sciatic nerve and attaching to your hip. Usually, with this one you would also have nerve-like symptoms of pain running down the back of your thigh

    Although there may be a cross over of some aspects of an appropriate treatment for all these conditions, you must first see a chiropractor or orthopedic physician that can properly differentially diagnose your condition and hopefully follow-up with the right treatment. Alternatively, if you want to try it, you might benefit from the work of a rolfer or neuro-muscular massage therapist that can provide postural re-training of soft tissues and muscles, associated with all 3 of the conditions I described. It won't likely be covered by insurance, and can be somewhat expensive, but I suspect you may benefit greatly. If you decide to do such, expect a series of about 10 treatments to get favorable results.

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  11. We had a memory foam bed . By lower back was killing me . I figured it was the bed. We finally went and got a new bed and after 2 nights the pain is all in my o.e hip . I knew I wouldn't be pain free overnight but the pain is worse. Before I could get around and after being up for a few hours I was ok . Now I can't stand or roll over . The muscles are spasming and shooting pain down my leg and up my back .

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    1. Sounds like you have some pretty troubling issues with sciatica, that may be resulting from a lower lumbar condition, a sacro-iliac problem, or what is called a Piriformis Syndrome. My first suggestion would be to checkout the following other 2 articles I have written:
      1) http://backbenimble.blogspot.com/2009/07/sciatica-real-pain-in-butt.html
      2)http://backbenimble.blogspot.com/search?q=piriformis

      You haven't really given me enough information to be able to know what is wrong with you. You need a definitive diagnosis as to what is the actual problem before it can be determined what is the best mode of treatment. In any event, I suspect that you did not have a good enough quality (3" top layer of 5.3lb foam with about a 13 ILD factor) memory foam mattress and/or you are sleeping in a compromising position for your particular condition. You need to at least feel better in the morning than when you did when you went to bed. The only exception to that would be with certain types of arthritis or circulatory problems

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    2. Hello, I am suffering from acute hip pain in whichever hip I am sleeping on. I am over 6 months pregnant, so hip sleeping is the best for my baby. I have never experienced it before now, so assume it may have something to do with relaxin. My matress is quite firm, and we are currently looking for a foam topper. However, in the mean time, is there any position I can lie in (either physically or with the aid of pillows) to help assist a comfortable night sleep? Thank you!

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    3. Yes, almost definitely your issues are being complicated by the hormone "relaxin". It serves to relax the ligaments to allow birth canal expansion and in the process causes laxity in the ligaments of the sacro-iliac joints. These are the joints that the base of your spine (sacrum) makes with your pelvic bones. The most common symptom is pain in the hips and buttocks. Top quality memory foam is the key to facilitating comfort by reducing the shear and compressive stresses to those joints. The memory foam must be about 4.5 lbs to 5.5 lb. density and of premium quality, with the support of a highly resilient foam or very firm mattress underneath. You won't find this type at big box stores or Bed, Bath and Beyond. You need to look at either Nimblepedic or Tempurpedic brands. They are both of Swedish design and the only ones I know of that actually work. If your current mattress is very firm, you can add a 3 inch thick overlay of one of these brands of memory foam. If you currently have a soft mattress, you will need to replace it. The next best mattress alternative would be latex foam and you can do a Google search for "Talalay Latex mattresses pin-core process" to find the real quality latex mattresses. You will likely want "regular firmness" for your situation. One more suggestion is that you look for a Nimblepedic Comfort Touch Pillow to place between your knees while you sleep. Such a pillow is perfect for taking the stress off of your sore sacro-iliac joints.

      Lastly, but not least important, a chiropractor that often works with pregnant ladies can work wonders in putting these joints back into place for you. There are light force techniques used for pregnant woman and being that none of the medical treatments can be utilized during your pregnancy it is really the only health care practitioner to consider right now.

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    4. Thank you so much for the prompt reply - I'll hunt down those brands!

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  12. Sleep can help people who are suffering from anxiety and traumatic stress disorders, so choose a better mattress.. we all need to have a better sleep so we need a mattress that makes us comfortable when we sleep and won't give us backaches..

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  13. I just recently started having pain in my hip while sleeping. I have tried pillows between my legs, but it doesn't work. And I have also increased the setting on my sleep number bed. Any suggestions?

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    1. Regarding your hip pain while sleeping, I have a few questions before I can offer any advise. (1) where exactly is the pain?
      (2) how long have you had the sleep number bed? Does it have a memory foam top?
      (3) Does the pain coincide with when you got the bed?
      (4) Have you been examined and your doctors given a diagnosis for your hip pain?
      (5) Any previous problems or old injuries to the area?

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    2. The pain is on my outer hip, best described as kind of like a burning sensation. It happens on both hips. It also occurs if I lay on the couch. We have had the sleep number bed for a couple of years, no memory foam top. The pain just started 2 weeks ago. No previous injuries. I have not been to the doctor yet.

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    3. Sounds like it might not be hip bursitis and you might need to have definitive diagnosis if you are going to make the best decisions relative to your condition. Being that the pain is a burning sensation, you need to rule out referred pain from internal issues and blood sugar problems like diabetes. The next thing I would want to know is if the pain occurs in both hips at the same time or whether it involves only the side that is either up or down. If in both hips at the same time, I would still be puzzled at this point. Depending on your answer, I might have further discussion.

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    4. It starts in the hip that I am laying on. Once I switch to my other side, the sensation fades within 5 minutes.
      Thank you for your advice.

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    5. Sounds like it could be either bursitis, sacro-iliac joint dysfunction or ilio-tibial band syndrome. In any event, it is obvious that in your case, changes to the mattress exclusively, will likely not resolve the issue. You need a diagnosis and a more comprehensive approach to treatment. Still, a soft fluffy pillow between the knees is necessary and if you do need mattress modification I would suggest the "Nimblepedic Mattress Overlay" to remove pressure from the bursa and sensory nerves. It works well on top of the Sleep Number Bed.

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  14. I have had hip pain for years in both hips. I was diagnosed with Fibromyalgia last June which is what I thought was the cause of my pain (the outer hips are Fibro hot spots). Which made total sense to me. But after reading this article I think that I may have Bursitis in my hips. That or it could be a combination of the two!?! I have had surgery on my right shoulder due to an injury and they had removed Bursitis during the surgery and still to this day I have chronic pain. My shoulder surgery was almost 7 years ago.

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    1. It certainly doesn't surprise me that removing the bursa left you with chronic pain in the shoulder. There are more conservative methods that work. Let's start by leaving your hip bursae in there. As a Fibromyalgia sufferer you certainly could be suffering from hotspots in the hips. Then again, like you mention you could indeed have bursitis. How about I suggest a natural approach that would benefit both in the long run. It will take time, but can do a lot to suppress the symptoms of fibromyalgia as well as pretty much overcome most bursitis issues. It is important to control your weight and to exercise smartly on a regular basis. That being said, what follows is a rather good comprehensive dietary and nutritional approach. Keep in mind that both conditions tend to get worse in an acid environment in the body. Meat and dairy and lots of animal protein create acid, particularly without lots of green veggies like spinach, kale, collard greens, celery, etc. A diet high in animal proteins also tends to cause autoimmune issues whereby the body will attack its own soft tissues and joints. So, here we go with a plan:

      -Multi-vitamin -natural and comprehensive
      -CoQ10 (ubiquinol form) 100mg 2 times per day
      -Vitamin D3 - 5000 IU per day with largest meal of day
      -Krill Oil with at least 1mg of Asthaxanthin (1 gel cap 2 times per day)
      -SAMe 400mg - 2 times per day
      -2 oz. of organic Tart Cherry Juice (w/o added sugar) every evening 30 minutes before bed
      -200mg of L-Theanine (SunTheanine version) taken with Tart Cherry Juice
      -Curcumin (BCM95® type) 400mg one time per day with meals. -- DO NOT TAKE IF YOU HAVE GALL BLADDER ISSUES.
      -5 grams of D-Ribose powder 2 times per day
      -B12 sublingual (unless provided in multivitamin)
      -Magnesium-L-threonate: 140 mg daily
      -A good probiotic

      DIET
      --Distilled water (at least 80 oz per day)
      --avoid red meat and dairy (with the exception of raw goat's milk cheeses, goat's milk yogurt or organic greek yogurt)
      --eat 8-10 servings of organic fruits and veggies every day (raw in salads are better than cooked so eat at least 50% in raw form)
      --make the majority of your meals vegetarian. Eat organic cage-free sourced eggs but don't overdo it.
      --ACV - put 2 tsps of Bragg Apple Cider Vinegar in 10 oz of distilled water and drink 2 times per day
      --eat all the colors of the Rainbow but I don't mean "Fruit Loops".

      Follow this advise for 90 days and I bet you will start to feel quite a bit better.

      -- Be Well

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  15. Nice read... and thanks backdoc for additional information. I had bursitis three years ago and have gone through stem cell treatment (recommended by my tennis buddy who had tendonitis). My stem cell therapy took 6 weeks and I had it with Dr Grossman. I am happy that I don't feel pain up to this day...

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    1. That's fantastic Michael,

      Neat, that you have had such good success with the stem cell approach. That is coming on strong in many avenues in medicine. Be Well!

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  16. Great information on your blog, thank you for taking the time to share with us.

    Total knee surgery

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  17. A lot of this info sounds familiar. My left hip has been sore for about a month and 1/2.It seems to be worse when I lay on that side. Lately, I've been waking up at night with the dull, aching pain. We recently went on a trip where I walked a lot and it's been worse since we got back. But it still hurts when I'm sitting or standing or sleeping. The odd time, I can get into a comfortable sitting position where it doesn't hurt as much. My job requires me to be on my feet the entire time and I tend to have a bad habit of standing a lot at home which I'm trying to reduce! I've been trying to sleep on the opposite side and the pillow between the legs does seem to help a bit. I just started taking ibuprofen periodically as well. My knee and my shoulder on that same side ache just a little too?
    Our mattress is about 3 years old...pillow top and was expensive. Also, i had a little trouble with it last summer too, so I'm trying to where sneakers at work more instead of sandles etc. What can I do to help?

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    1. Sounds like you do definitely have some hip dysfunction, whether it be bursitis or multiple issues. Being that you have shoulder and knee pain on the same side, you like have some pelvic imbalances or leg length discrepancies. Shoes with good heel counter and arch support are important but foot orthotics and extensive deep tissue massage and/or physical therapy will likely be necessary. The first step is to have a thorough evaluation by a competent physician with standing X-rays showing the hip joints and pelvis. Once the whole picture can be clearly defined, a well thought out and comprehensive treatment plan can be established. It should definitely include a good series of progressive exercises for you to do; first with guidance and then continuing at home.

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  18. Thank you this is very helpful. I have very flexible joints making my right sided ankle uncomfortable when sleeping. I also have (self diagnosed) bursites on the same side. Any advise?

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    1. Assuming you are correct in your diagnosis, I would suggest that you simply follow my advise in the article. However, the first step would be to confirm the diagnosis with examination by a professional to be sure you are correct and headed in the right direction

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  19. The number of people on here that are experiencing chronic hip pain that does not respond to treatment really doesn't surprise me. Nor does it surprise me that no one has mentioned the possibility of a condition known as Femoral Acetabular Impingement, which is commonly misdiagnosed as literally all of the possible conditions mentioned in the previous comments. It's basically caused by the bones of the hip joint not being shaped right, which leads to tears and rubbing of the hip labrum. I believed for five years that I had trochanteric bursitis, until I finally got my FAI diagnosis about a year ago. Please, if you have chronic hip pain that does not respond to traditional treatment, ask your doctor about the possibility of FAI. You may need to see a specialist to be sure, but if left untreated, this condition will eventually cause you to require a total hip replacement.

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  20. Hi I have scoliosis of the thoracic and lumbar area of my spine. I was operated on to fix the thoracic area of my spine when i was a kid. The lumbar area didn't progress to such an extent that it had to be operated on, as well as the fact they said if they did operate there it would effect my movement. Anyway recently I have been having problems sleeping on my right side. I usually sleep on my right side, but recently i wake up as my hip on my right side is really painful after having slept on it for a few hours. I changed mattresses, but it is still painful. I'm worried as to what is going on.

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    1. This comment has been removed by the author.

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    2. Your hip issues could be a number of things and may or may not be related to the scoliosis. Bursitis or ilio-tibial band syndrome are likely candidates as could be sacro-iliac problems. You could also have some hip joint degeneration, perhaps related to the scoliosis. The changing of the mattress is only good if you picked the right mattress. It needs to be either "original, single-core, Talalay Latex mattress", or high quality/higher density memory foam like Tempurpedic, Nimblepedic or Serta iComfort or Isotonic. Anything else, probably not a good choice. Hopefully, you are using a nice between-the-knee-pillow to remove pressure. I recommend our Nimblepedic Comfort Touch. Also, it is important to alternate sides to maintain balance of support while sleeping. Everytime you wake up, change sides. One night start out on one side and next night, the other side.

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  21. Back doc...I have read all advice listed here... I had went to the ER twice last week with hip pain... Doctor said bursitis and tendonitis... I'm a single mom and have to work ..in a shipping dept...I am wondering what advice you can give on diet for assisting with this specifically... Also any other advice...there are evenings that I am basically unable to walk...please help...I'm due to see my PCP for a follow up in about 10 days...concerned I may not make it that long.

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    1. Hi Ms. Single Mom,
      Dietary advice for hip joint bursitis could be quite detailed and quite a change in lifestyle. Without much detail about your life, diet, medical history that is sort of beyond the scope of our blog, I will just give you some general things to consider as follows:
      1) at least 100 ounces of purified/distilled water per day from safe BPA free containers.
      2) a diet that is both "anti-inflammatory" and "alkalizing" to your system ( involves less animal protein, no beef, more organic greens, including spinach, kale and broccoli; and very little refined sugars. Do some research and studies both of these type of diets). Make sure to get sufficient essential amino acids and Vitamin B12.
      3)drink 1 tsp twice per day of "Bragg Apple Cider Vinegar" mixed in water (must be unfiltered and unpasteurized).
      4) Take "Healthy Joint Formula" with Krill Oil from Life Extension foundation (lef.org)
      5) Take 400mg of Curcumin 95 daily
      6) use extra virgin olive oil for cooking and coconut oil for baking
      7) avoid white flour, white sugar and processed foods

      You should begin "Core foam roller" therapy on your buttocks, and outside of hip and thigh.

      You should consider a "Pincore Talalay Single core Latex Mattress" for sleeping and using a pillow between your knees while sleeping.

      Where good supportive shoes and perhaps add Superfeet Orthotic Foot Insoles if you have imbalances in your feet, ankles and/or knees.

      This is the best advice I know of for things you could do on your own.

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