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Low back pain is the leading cause of disability worldwide, and sciatica, a radicular pain syndrome, affects a considerable minority of adults. Ayurveda describes Gridhrasi as a Vata (or Vata-Kapha) disorder in which pain radiates from the lower back (Sphik) to the posterior thigh, calf and foot, with a characteristic gait disturbance resembling a vulture. Panchakarma therapies for Gridhrasi and Katishoola include Snehana, Swedana, Basti, Siravedha, Agnikarma and local procedures such as Kati Basti. This review summarises the classical concepts, modern understanding of sciatica and low back pain, therapeutic procedures, evidence from related musculoskeletal trials, safety and a practical integrated pathway. Guidelines favour non-pharmacological measures including heat, massage and exercise as first-line options, which aligns with several Panchakarma components.