Sciatica is a prevalent form of neuropathic pain, affecting up to 10% of people with chronic low back pain and having a lifetime incidence of 10% to 40%, sometimes reaching as high as 70%. It is typically caused by compression or injury to the sciatic nerve, most often due to lumbar disc herniation. Other contributing factors include age, occupation, obesity, and smoking. Sciatica places a significant burden on healthcare systems, as managing it can be costly and complex. Current treatments for sciatica, such as physical therapy, nonsteroidal anti-inflammatory drugs (NSAIDs), and epidural steroid injections, aim to relieve pain and improve function. However, these methods often have limited long-term benefits and may cause side effects with prolonged use. Surgical interventions, such as lumbar discectomy and nerve ablation, are typically reserved for severe or refractory cases but carry their own risks. Recent advances in understanding the underlying mechanisms of sciatica have led to new treatment possibilities. Novel therapies include tumor necrosis factor (TNF)-alpha inhibitors, which target inflammation, phytochemicals like ferulic acid, and acetyl-L-carnitine, which show promise in protecting nerve health. Minimally invasive techniques, such as radiofrequency ablation and ultrasound-guided nerve hydrodissection, are also being explored for better pain relief. This review discusses both established and emerging treatments for sciatica, with a focus on improving outcomes while reducing side effects, paving the way for more effective management strategies in the future.