scales are not the preferred indicator for this research study. Evidence from registry study will be an important supplement to the RCTs. Through the acupuncture registry study for CLBP, we will at least benefit in the following aspects. Firstly, gaining more practical and reliable evidence for acupoint selections and guideline modifications. Secondly, to explore potential confounding factors of acupuncture implementation and provide ideas for high-quality RCTs in the future. Thirdly, through the accumulation of potential acupuncture adverse reactions and excavation of big data, it will be helpful to scientifically choose an individual, safe, and efficient acupuncture style. Characteristics of acupuncture ineffective cases will be identified, avoiding waste of medical resources or delay the patient’s condition. Fourthly, the registration organization will help recruit excellent professional acupuncture teams for the treatment of CLBP, providing a better and standardized acupuncture program for the treatment of CLBP. Therefore, our evidence from a large sample, real-world settings and consistent with the characteristics of acupuncture will be indispensable. Strengths of study As far as we know, there are very few registries for acupuncture, which is our biggest innovation. We can obtain responsibly data that relatively high-quality and characterized by acupuncture through structured, standardized, and electronic data collection. Furthermore, prospective data come from real-world will be more convincing than retrospective data. Our registry projects will provide an applicable paradigm for research of complementary and alternative medicine. Limitations of study In the initial stage, center selection bias maybe be inevitably affected by real recruitment results, we will promote geographical representation by expanding recruitment. Lacking the pre-defined comparable group will be the inevitable limitation, as well as selection bias. Although we will adopt the method of propensity score matching to implement post hoc randomization and conduct stratification analysis, hidden, unknown confounding factors will still exist. Perhaps, in future research, we can embed pragmatic randomized controlled trials, pRCTs with long-term follow-up into the platform as a subproject, to obtain more reliable and abundant evidence [23, 56]. Conclusion This study will identify key factors that influence the effectiveness of acupuncture and explore effective acupuncture interventions with different characteristics of low back pain. Furthermore, reliable acupuncture evidence from the registry will be an important supplement to the future RCTs for the treatment of CLBP. Abbreviations CAAM: Chinese Association of Acupuncture-moxibustion; CLBP: Chronic low back pain; HIS: Hospital information system; ID: Identification; IRPAM: International Registry Platform of Acupuncture-Moxibustion; MCID: Minimal clinically important difference; MNAR: Missing not at random; NRS: Numeric rating scale; ODI: Oswestry Disability Index; RCTs: Random controlled trials; SSL: Secure Sockets Layer; STRICTA: Standards for Reporting Interventions in Clinical Trials of Acupuncture; TCM: Traditional Chinese Medicine; WFAS: World Federation of Acupuncture-Moxibustion Societies; WPRO: Western Pacific Region Office Acknowledgments We thank the dissemination and academic support of the Acupuncture Patient Registration Alliance in CAAM. Tanks are also due to the engineers from the Zhong Teng Baimai Baima Medical Technology co.LTD for network technical supporting of the electronic web-based platform. Authors’ contributions JL contributes to the concepts, design and acquired funding for the registry, HZ take responsibility for clinical administration of the registry and project, JL and HZ conceived the study protocol and implementation, XW drafted the original manuscript and contribute to specific daily management of the platform, LH guided the statistical analysis plan, and BL conceived initiative of the registry platform. XY made contributions to the registration of research, and JZ participated in the revision of the protocol. All authors contributed to revising the manuscript and approved the final version to be published. Funding This work was supported by the Tenth independent topic selection in China Academy of Chinese Medical Science (NO. z0470) and National Natural Science Foundation of China (NO. 81704189). The funding body had and will Wei et al. BMC Musculoskeletal Disorders (2019) 20:488 Page 8 of 10 not have any role in the design of the study and collection, analysis, and interpretation of the data and writing and submitting manuscripts. Availability of data and materials Data sharing is through the network platform (http://www.amreg.org/), different access rights will be set for users in the platform. Ethics approval and consent to participate The study protocol demonstrated herein was approved by the Ethical inspection committee of the Institute of Basic Research in Traditional Chinese Medicine, Academy of Chinese Medical Sciences. Every recruited patient must provide written informed consent in advance of enrolling. Consent for publication Not applicable. Competing interests The authors declare that they have no competing interests. Author details 1 College of Acupuncture