inside south St. Dongchen District, Beijing 100700, People’s Republic of China Full list of author information is available at the end of the article Wei et al. BMC Musculoskeletal Disorders (2019) 20:488 https://doi.org/10.1186/s12891-019-2894-4 Background As a consequence of the acceleration of global aging, sedentary lifestyle increasing and average weight gain, chronic low back pain (CLBP) has become a global condition with high incidence. Although disability and financial burden attributed to chronic low back pain is substantially different between countries, the incremental impact of the worldwide health care system predicted to tremendously in the coming decades [1]. According to 2015 global statistics, low back pain accounts for 7.3% point prevalence of activity-limiting illnesses, affected 5.4 billion people at all ages [2]. CLBP accounts for a significant portion of the $100 billion spent annually on treatment in the United States [3]. In China, back pain kept the top one disorder that causes of years lived with disability(YLDs) from 1990 to 2010 [4]. Therefore, effective and safe treatment is especially crucial in overcoming low back pain and disability related to the chronic condition. In a variety of treatment options devoted to backrelated disability and chronic pain consequence, noninvasive treatment therapies captured more attention. Changes can be verified in recent guidelines for low back pain [5–7]. Interventional procedure and operation are limited to recommend in guidelines, as well as the pharmacotherapy, in consideration of efficacity, safety and accessibility. Moreover, nonpharmacological intervention was recommended as first-line treatment, which included acupuncture, massage, spinal manipulation, and yoga [6]. As a characteristic non-pharmaceutical option against the opioid crisis, acupuncture captured particularly concerning in pain relief. On account of safety and the actual effect, acupuncture is widely accepted in the management of chronic low back pain [8, 9]. Low back pain was the top 1 frequently treated indication in US’s acupuncture clinic according to a cross-sectional study [10]. However, there is a lack of basic dataset on the use of acupuncture to treat CLBP in China and abroad, including the effective population characteristics, reasonable acupuncture session, preferred acupuncture protocol and acupuncture implementation details, etc. Durable efficacy of acupuncture was reported to improve function and alleviate pain for CLBP patients at the individual level [11]. Nonetheless, contradictory results are subsistent [12, 13], that acupuncture efficacy was no better than comforting acupuncture or sham acupuncture [14–16]. Despite negative outcomes of acupuncture for CLBP is not uncommon to discover [13, 14, 17], controversy, and doubting exist in methodological, research environment, unreasonable comparison, multiple acupuncture interventions and study population [18–20]. Firstly, as a complex intervention featured with specific and nonspecific factors [21], acupuncture is not suiting RCT research paradigm that was initiated more appropriately for drug and biomedically-oriented interventions [20]. RCTs is usually limited to strictly selected patients, highly controlled conditions and using a sham intervention so that results are poorly generalizable to real clinical practice [22, 23]. Secondly, very little evidence for CLBP in the special populations such as elder or some subtype of CLBP [24]. Obviously, under real clinical settings, older adults have a higher incidence of CLBP and are likely to suffer more complications [24, 25]. Furthermore, not only the acupuncture style or type, implementation details, treatment duration and frequency of acupuncture can affect outcomes, but also the experience of the operator, the individual conditions that lead to CLBP and the combined treatment too [26, 27]. The lacking of acupuncture experience and perception in the social context may reduce the effectiveness of acupuncture. Most of RCTs was conducted under noneastern culture, recruited patients lacking acupuncture experience, De Qi perception or cognition were inevitable [28]. Doubtlessly, new research models need to provide more practical details to bridge the gap between rigorous controlled circumstances and real-world practice. Therefore, we intend to conduct a registry of acupuncture therapy for CLBP through a network platform rooted in the reality of diverse form and operations of acupuncture. This is a prospective, multi-center, registry study. The current status of the study is in recruiting. The objectives of the study: To develop an international registration platform of CLBP for acupuncture therapy; To identify the key factors affecting the clinical effectiveness of acupuncture in treating CLBP from the perspective of acupuncture implementation and physicians; To analyze population characteristics and subtypes of CLBP suitable for acupuncture. Methods Study setting The Registry project of Acupuncture was firstly proposed and inspired at 8th World Conference on Acupuncture WFAS SYDNEY 2013 [29]. According to the principles and framework demonstrated by the Agency for Healthcare Research and Quality [30]. China Association of Acupuncture-Moxibustion (CAAM) had established an Acupuncture Patient Registration Alliance and initiated a network database platform-International Registry Platform of