Hip pain in middle of the night; dull ache that wakes me up. What could it be?

This pain can be complex. If it is Ischeal bursitis (rest (avoid sitting on it, too - perhaps "sit" on recliners that get you to zero gravity on the sit bones), ice, anti-inflammatories) is possible but you could also have some piriformis syndrome, too, (a modified form of sciatica where burning / cramping, etc. can occur; stretching will help this). Many people posting here actually sound like they have piriformis syndrome moreso than bursitis. Stretching and exercise (walking, some squats), helps but avoid overly repetitive exercises (i.e. perhaps not running, running up hills, etc. You can do squats / leg press with some weights once in the rehab phase - but avoid over repetition).

It sounds like bursitis. I have had it on and off for last 15 years, I was about your age when it started. At its worse I couldn't even dress my bottom half in the mornings and had to have steroid injections and even surgery was considered. Over the last 2 or 3 years it's got much better but I still get the pain if I lay too long on my hip and for about an hour after waking. I find if I get up when the pain starts and walk about a bit then go back to sleep it's not so bad but if I stay in bed for more than 7 hours it's terrible. Bursitis is mainly caused by uneven walking, carrying a heavy bag on one shoulder for example can cause you to walk unevenly as does cross country walking or running (the cause of mine), some people even have one leg slightly shorter. A 'bursa' of fluid develops at side of hip, mine was so bad I could actually see the bulge. If its Bursitis it will feel tender when you press on this area .

All I can say is that you kind of get used to the pain after a while and as long as you don't overdo it and keep moving it does get better.

My Doctor suggested Pilates to strengthen core.

I took vitamin D3 5000 mg and it did the trick for me. I had terrible deep achy pain in my hips and upper legs. My chiropractor recommended large doses of D3 whenever you have lower body achiness. Not sure why it works but it does for me. Also helps my mood. Best wishes for good health everyone.

Once my doctor told me to take magnesium. I took it once or twice, no hip/ leg pain for a very long time but now it is starting again. I'm going back to get more magnesium to try it again. (first bottle expired on me)