Jenn, I found the same nightmarish pain at between 3-4 A.M. the first 3 weeks. It was, without doubt, the absolute worst. I'd break out the ice pack, take 10mg of Oxy and a 1000 mg Tylenol, walk a bit and stay up for an hour or two reading or surfing. Then, back to bed/recliner with a better wake-up a few hours later. In retrospect, maybe I should have timed my meds differently to avoid that witchin' hour pain? I dunno, but I do know it improved for me around week 3. I still woke-up, but not like that, where a chainsaw seemed like a good option.