Your hip needs cushioning and your waist needs support
Your hip and shoulder need room to sink, but your pelvis shouldn't drop below the rest of you. When you lie on your side, the hip and shoulder carry much of your weight. A hard surface presses against them; an excessively soft mattress lets your middle sink too far and twists the lower back. Buying the opposite of whatever you own sounds satisfyingly decisive, I know, but you need to work out which problem you're changing.
My rough check is where you feel sore and what happens under your waist. Soreness at the point of the hip or shoulder, with a gap beneath the waist, makes me suspect excessive firmness. If the hip feels fine but your lower back stiffens towards morning and your pelvis sinks, I suspect too little support. Use those clues to compare how you lie on different surfaces. Pain alone can't tell you which mattress to buy.
In Saini and colleagues' 2025 systematic review, side-lying was the most common sleeping posture. It was associated with less low back pain when the spine was supported in line and more when it wasn't.1 The review covered six observational studies published between 2005 and 2024. It concerned low back pain and posture, not hip pain or mattresses, and cannot establish cause and effect. It is a starting point for thinking about alignment.
Before a shopping trip, try a pillow between your knees. It helps keep the upper hip from rolling forward, so you can check whether changing position makes you more comfortable. The spare pillow finally has a job beyond looking nice. Keep your mattress and other bedding the same while you try it, so you have a clearer sense of what changed.
A deep, softer top over pocket springs is the useful combination
A deep comfort layer over a supportive pocket-spring core gives you the cushioning and support I'd look for first. The top spreads your weight over more of your body as the hip sinks into it; the core supports your middle. A plain firm mattress with a thin top is my usual suspect when a side sleeper feels pressed against the bed. You don't need a heroic spring count to understand that difference, however enthusiastically someone recites one at you.
Latex or a springy foam suits you if you want to turn without feeling deeply enclosed. Memory foam is an option if you enjoy a close hug and don't run hot. I like it for cushioning, but hot sleepers should be cautious: sinking into foam is a warm arrangement, whatever the cooling fabric is called. Compare the depth and type of the comfort layer, because a token soft finish over a hard bed gives your hip very little room.
I work from your weight first, then adjust for how you sleep. For a side sleeper with a sore hip, that means trying a step softer than I would otherwise suggest. If you're light, you need less resistance to let the hip sink. If you're heavier, keep enough support beneath the softer top to stop your pelvis dropping. This is where the one-word firmness label becomes bloody unhelpful: it tells you very little about the difference between the top and the core.
The table reflects how I narrow the choice by build and position; these are shopping rules of thumb.
| Your build and position | What to try | What to check while lying down |
|---|
| Lighter side sleeper | A softer comfort layer that compresses under your weight | Your hip sinks a little and your waist stays supported |
| Side sleeper between lighter and heavier builds | A hybrid a step softer than your usual preference | Your shoulder has room without your pelvis dropping |
| Heavier side sleeper | A yielding top over a firmer, supportive core | Your middle stays level instead of sinking deeply |
If you're a lighter side sleeper, explore soft-medium mattresses before assuming medium-firm is compulsory. Compare the feel as well as our firmness scale. Each maker uses its own firmness labels, so two mattresses called medium can feel quite different under you.
Your sleeping position deserves as much attention as the bed
Adjust how you lie before replacing an otherwise sound mattress. A pillow between the knees helps keep the upper hip from rolling forward, and a body pillow gives you a longer cushion to hold in the same position. No elaborate bedtime origami required: the useful change is keeping yourself comfortably supported.
In Desouzart and colleagues' 2015 controlled pilot, twenty physically active women in their sixties, averaging 63 years old, were split into two groups. Ten received advice on sleeping position over four weeks and ten received none.2 The advised group reported significantly fewer back-pain complaints afterwards. This was a small pilot about back pain and position advice, not hip pain or mattresses. It offers a starting point for paying attention to position.
Try alternating sides if both are comfortable, instead of insisting on the same side all night. Habit is remarkably persuasive at bedtime; you don't have to award it permanent control. Keep the pillow between your knees when you turn, and stop a position change if it makes you less comfortable.
Front sleeping is the position I would encourage you to move away from when choosing for side-sleeping comfort. Buy for the position you actually spend the night in, though, rather than the beautifully arranged position you manage for thirty seconds in a shop. Our side-sleeper mattress selection is the relevant place to compare cushioning if that's how you sleep.
If you have a diagnosis, ask your clinician about comfortable positions for your particular problem. Follow that advice when trying pillows or changing sides, and seek medical advice for new or persistent symptoms.
Test the cushioning before you commit to a new mattress
Spend a full ten minutes lying on your side in the shop, and use the home trial to judge whether the mattress suits you beyond that first impression. A quick perch in your coat is a test of sitting down. Give your hip and shoulder time to sink, then notice whether either feels pressed against a hard surface.
Check beneath your waist: you want contact and support, without a gap or a deep drop through your middle. Compare a hybrid or pocket-spring mattress with a deep comfort layer against the plain firm option. Concentrate on what your body does on each one. You don't owe the firmer mattress a second date just because someone called it orthopaedic.
Try a soft topper first if your existing mattress is firm but level and supportive. That is the cheapest way to check whether extra cushioning makes you more comfortable. A topper won't repair a sagging mattress; it follows the dip beneath it. Check the base for broken or poorly supported slats too, because a mattress needs an even foundation.
Read the returns terms before ordering. Check whether you can get a refund or only an exchange, and whether collection costs you anything. A home trial is useful only when you understand how to use it. Keep the order confirmation somewhere you can find without searching through every promotional email you've ever received.
Allow for unfamiliarity during the first fortnight, then judge the feel if your symptoms allow you to wait. Write down whether the hip feels pressed, whether your middle drops and how comfortable you are on waking. Those notes are more useful than trying to remember exactly how you felt before breakfast several days ago. Don't wait out worsening or severe pain for the sake of a mattress trial; seek medical advice.
Test the edge if you sit on the bed to dress. You need it to hold you without collapsing beneath you. Check the combined mattress and base height as well: sit with your feet flat and see whether you can get up comfortably, without dropping into a low bed or hauling yourself out of it.
Avoid buying extra firmness because your hip hurts
Skip the automatic upgrade to a harder bed. I think "orthopaedic" is an especially unhelpful shopping shortcut: it is an unregulated label, usually attached to firmness, and tells you nothing useful about how far your hip will sink. The impressive lettering is free; getting the wrong feel is considerably more inconvenient.
- A firm or "orthopaedic" mattress chosen solely because your hip hurts. If your existing surface is already too hard, extra firmness presses against the hip more.
- A soft mattress throughout for a heavier side sleeper. A yielding comfort layer still needs enough support beneath it to keep the pelvis from dropping.
- A firm topper as the cushioning fix. Choose a softer top when the problem is pressure from a hard surface; adding another firm layer doesn't provide that cushioning.
- A decision based only on the first three nights. A new feel takes adjustment, so use the first fortnight to observe comfort where symptoms allow, within the returns terms.
- A mattress purchase as your response to diagnosed or sudden pain. Get medical advice before assuming that changing the bed is the appropriate next step.
When hip pain needs a GP, not a mattress
Some hip pain needs medical assessment rather than a different bed. NHS guidance on hip pain in adults says to see a GP if hip pain is stopping you doing normal activities or affecting your sleep, if the pain is getting worse or keeps coming back, if it has not improved after treating it at home for 2 weeks, or if you have hip stiffness for more than 30 minutes after waking up.
Ask for an urgent GP appointment or get help from NHS 111 if you have severe hip pain that started suddenly but you've not had a fall or injured your hip, if your hip is swollen and feels hot, if the skin around your hip has changed colour, or if you have hip pain, feel generally unwell and have a high temperature (or feel hot, cold or shivery).
Call 999 or go to A&E if you have severe hip pain after a fall or injury, if you are unable to walk or put weight on your leg, or if you have any tingling or loss of feeling in your hip or leg after an injury.
