Here is what happens to a sciatica patient every single night, in the hours when every treatment they've ever received is completely offline.
When you lie on your side, your top leg is unsupported. It weighs somewhere between eight and twelve pounds. As sleep takes hold and your muscles release, gravity pulls that leg forward toward the mattress.
That dropping motion rotates the pelvis. Gradually, incrementally, across the full length of the night.
That pelvic rotation compresses the sciatic nerve from an angle it never faces during the day — when you're upright, when you're moving, when every treatment you're receiving is working on your body.
Pressure accumulates through each sleep cycle, roughly ninety minutes. Your body's own anti-inflammatory cortisol hits its lowest point of the entire day in the small hours. Lying still means no circulation to help clear the inflammation.
By 1am, the accumulated pressure crosses a threshold. Your brain, doing exactly what it's designed to do, fires a wake-up signal so you'll shift positions and relieve the compression.
You flip to the other side. Brief relief. Fall back asleep.
Ninety minutes later: same thing.
And every treatment you received during the previous day — the physical therapy, the adjustment, the injection — has just been undone.