Acupuncture-Moxibustion (IRPAM) in 2017. Application of browser/server architecture based on cloud platform mode and Oracle database development to construct the interactive network database platform. Wei et al. BMC Musculoskeletal Disorders (2019) 20:488 Page 2 of 10 The present protocol partially referenced the guideline of the SPIRIT-PRO Extension Checklist [31] and Registries for Evaluating Patient Outcomes: A User’ guide 3th [30]. The technical roadmap is shown in Fig. 1. Eligibility criteria Requirements for recruiting physicians Acupuncture practitioners participating in the study should have the following qualifications: Engaged in acupuncture related clinical practice > for 5 years; Have a certain amount of outpatient volume of patients with CLBP; Prepare individual computer can access to the network; Volunteer to participate and sign a memorandum of understanding. Patient source Patients with CLBP were enrolled continuously to reduce selection bias. All recruited patients will be registered dynamically by the acupuncture physicians. The diagnostic criteria, inclusion criteria and exclusion criteria as follows. Diagnostic criteria Pain or muscle tension in the area below the chest and above the buttocks, with or without pain in the lower extremities, and the pain lasts for more than 12 weeks [32]. Inclusion criteria Chronic low back pain or acute onset of chronic low back pain were observed as the main objects to meet the diagnostic criteria for chronic low back pain. 16 years≤Age ≤ 80 years; The main treatment method is acupuncture. Voluntarily participate in the patient registration study and sign informed consent. Exclusion criteria Patients with severe systemic diseases, such as primary diseases of cardiovascular, liver, kidney and hematopoietic system, and severe mental disorders; Patients with backache caused by tumor, tuberculosis, cyst and other reasons. Fig. 1 Flow chart of study Wei et al. BMC Musculoskeletal Disorders (2019) 20:488 Page 3 of 10 Outcome measures Primary outcomes Considering the convenience of real-world measurements, self-reported disability and pain preferable with CLBP. Therefore, Numerical Rating scale (NRS) [33] and Oswestry Disability Index (ODI) [34] were selected as primary outcomes. These two indexes have been confirmed good validity and reliability in the aspects of back-related pain and disability [35, 36]. Numerical rating scale (NRS) Patients were asked to use the numbers 0–10 to quantify pain, with ‘0’ symbolize no pain and ‘10’ symbolize most pain. Higher the number, heavier the pain. Oswestry disability index (ODI) The ODI instrument contains 1 item on pain and 9 items on the activities of daily living (daily activities, lift weights, walk, sit, stand, sleep, and social activities, travel and sex). Each entry from 0 to 5 points to calculate, the cumulative score will be added 2 times and the total score range of 0–100 points. Higher the score, lower the back function. Effective rate Minimal clinically important difference (MCID) is an index to identify effective group, that is the NRS score decreased by 2 points or ODI score cut down 10 points [36]. The effective number divides the total number of people included in the analysis is the effective rate. Secondary indicator Adverse event Abnormal conditions in the observation period, such as needle dizziness, broken needles, bleeding and hematoma, will be recorded. The occurrence time, cessation time duration, correlation with acupuncture, the measures taken and outcomes of adverse events will be recorded too. Serious adverse events during the observation will be reported promptly. Participant timeline As a dynamic registry design, we plan to stick to the registry for at least 2 to 5 years. The tolerance range of time is 3 days around the follow-up point. If the patient does not return after the last visit, follow-up is done by phone within 1 week. At least ensure follow-up at these three time points,1 week, 4 weeks and 12 weeks. Contents of follow-up: whether there is a recurrence, whether there is back pain related surgery, whether there is any other treatment. Sample size Currently, there is no valid sample size calculation method for registry studies. According to experience, the principle of sample size estimation in multivariate analysis of variance is 5–10 times the number of variables. Our preliminary research variables are no more than 20, so the sample size of the study is 1000–2000, taking the maximum value, our sample size is set at not less than 2000. To ensure better data representation and reflect the diversity of acupuncture operations, we will recruit no less than 9 centers, at least 3 acupuncturists in each center, that is, at least 27 acupuncturists. Recruitment Through academic conferences of the World Federation of Acupuncture and Moxibustion Societies (WFAS) and Chinese Association of Acupuncture-moxibustion (CAAM), we will attract more physicians. In the recruited centers, recruitment announcements will be launched to help patients know more about the program. Moreover, recruiting more clinicians to register on the platform is an important way that can be conducted on the website (www.amreg.org). Data elements and collection methods All information will be collected through a specific network platform for acupuncture therapy and put on record in a paper version