Clinical recommendation	Evidence rating	References	Comments
Patients with acute lumbar pain should be advised to stay active.	A	16	Systematic review
Nonsteroidal anti-inflammatory drugs, acetaminophen, and muscle relaxants may be effective for nonspecific low back pain, but have not been extensively studied with lumbar disk herniation pain.	B	17–20	Systematic reviews and conflicting RCTs
Systemic steroids are no better than placebo in the treatment of lumbar disk herniation pain.	A	21	Consistent RCTs
Epidural steroid injections for acute lumbar disk herniation may modestly improve pain in the short-term, but do not impact long-term outcomes.	A	22, 31	Systematic reviews
If red-flag findings are absent, a patient with sciatica should try conservative management for up to six weeks before obtaining imaging and considering surgical approaches.	A	11	Systematic review
Selected patients with lumbar disk herniation pain not improving after six weeks of conservative management may benefit from diskectomy for faster clinical relief.	A	11	Systematic review
Diskectomy has similar long-term outcomes as conservative or nonsurgical management.	A	12, 13	Consistent RCTs