Acute low back pain (LBP) with associated sciatica is a common problem leading patients to see a physician. It is usually a benign and self-limited disorder. Radicular pain in the distribution of the sciatic nerve, resulting from herniation of one or more lumbar intervertebral discs, is a common and painful event. The lifetime incidence of this situation is expected to be between 13% and 40%. Compression of a lumbar nerve root by a herniated intervertebral disc is a common cause of sciatica. Non-discogenic causes of sciatica include benign and malignant tumors, infections including epidural abscess and discitis, vascular compression, bony compression due to spinal stenosis, epidural adhesions, Piriformis syndrome, or compression by gynecological structures (i.e. uterine fibroid, pelvic endometriosis).The evidence suggests that a multifactorial interaction of inflammatory, immunological, and pressure-related processes may play a role in the pathophysiology of sciatica neuralgia. Sciatica is a clinical diagnosis. The history and physical examination can frequently reveal the etiology..Imaging studies including MRI or CT myelograms may help with the diagnosis and in selecting specific treatment plans. Several conservative and surgical therapeutic options are available for management of discogenic sciatica. Physical therapy, activity modification, nonsteroidal anti-inflammatory drugs and analgesics are the most commonly prescribed treatment. While commonly used, physical therapy, epidural steroid injections, systemic glucocorticoid therapy, trigger point injectionsspinal manipulation, bracing, and traction have little support in the literature. Different types of electro-acupuncture stimulation have had mixed results in sciatica patients. Further clinical trials are necessary to confirm their efficacy. Chemonucleolysis is the last step of conservative management in patients without extruded disk material. Allergic reactions are a possible severe complication and plans should be in place to deal with any reaction that might occur. There is limited scientific data supporting this treatment. This procedure does not affect the outcome of the later surgery if necessary. Surgical discectomy may be considered for selected patients with sciatica due to lumbar disc herniations that fail to resolve with the conservative management or in patients with severe paralysis or a cauda equina syndrome. To prevent complications, an appropriate pre-operative work up including neuroimaging is necessary, especially when there is a lack of correlation between the history, physical examination, or radiologic examination. Surgery has been shown to be highly effective, shortening the time to recovery by about 50% compared to nonsurgical treatment. Whether one specific surgical procedure is better than others remains uncertain. Methodological limitations of studies evaluating the efficacy of percutaneous methods prevent ultimate conclusions. Post-operative complications occur in 1% to 3% of cases. If patients were appropriately selected, failures happen in less than 10% of cases, which are primarily due to recurrent disc herniation or fibrosis. After pain is controlled, a multidisciplinary approach including physical, psychological, socioeconomic, and self-management techniques is recommended.