This systematic review of 15 studies on acute low back pain and sciatica found that most patients experience rapid improvement in pain, disability, and return to work within one month. Pain and disability continue to improve until about three months, after which levels remain relatively stable. Over 73% of patients had at least one recurrence within 12 months. The review highlights that while acute low back pain typically has a favorable prognosis, pain and disability often persist, and recurrences are common. The study emphasizes the importance of identifying clinically relevant prognostic factors, such as fear-avoidance behaviors, leg pain, and job satisfaction, which can influence recovery. However, the evidence for these factors is limited, and most studies have methodological weaknesses. The review also notes that the prognosis of individuals off work is different from those who are working, with higher pain and disability scores among those off work. The study concludes that while most people recover within 12 months, long-term pain and disability persist, and the prognosis of those initially off work remains unclear. The review recommends further research to better understand the long-term outcomes and prognostic factors for acute low back pain.This systematic review of 15 studies on acute low back pain and sciatica found that most patients experience rapid improvement in pain, disability, and return to work within one month. Pain and disability continue to improve until about three months, after which levels remain relatively stable. Over 73% of patients had at least one recurrence within 12 months. The review highlights that while acute low back pain typically has a favorable prognosis, pain and disability often persist, and recurrences are common. The study emphasizes the importance of identifying clinically relevant prognostic factors, such as fear-avoidance behaviors, leg pain, and job satisfaction, which can influence recovery. However, the evidence for these factors is limited, and most studies have methodological weaknesses. The review also notes that the prognosis of individuals off work is different from those who are working, with higher pain and disability scores among those off work. The study concludes that while most people recover within 12 months, long-term pain and disability persist, and the prognosis of those initially off work remains unclear. The review recommends further research to better understand the long-term outcomes and prognostic factors for acute low back pain.