To explore the therapeutic regimens and acupoint selection rules of acupuncture for chronic lumbar muscle strain (CLMS).

Clinical literature on acupuncture treatment for CLMS was retrieved from CNKI, Wanfang Data, SinoMed, PubMed, Embase and Web of Science, with the retrieval period from January 1, 2004 to December 31, 2024. A database was established using Microsoft Excel 2021 to analyze the literature types, therapeutic protocols and frequency of acupoints. SPSS Modeler 18.1 was adopted to conduct correlation analysis on acupoint selection in included studies.

A total of 41 articles were enrolled, involving 70 acupoint prescriptions and 45 acupoints, with a total application frequency of 229 times. Acupuncture, warm needling and fire needling ranked the top three commonly used interventions for CLMS. The top five frequently used acupoints were Shenshu (BL23), Weizhong (BL40), Ashi points, Dachangshu (BL25) and Yaoyangguan (GV3). The Bladder Meridian of Foot-Taiyang and Governor Vessel were the most frequently applied meridians, and most acupoints were distributed over the lumbodorsal region and lower extremities. Back-shu points and Five-Shu points were the top two categories of specific acupoints in terms of usage frequency. High-frequency acupoint combinations included Weizhong(BL40)-Shenshu(BL23), Shenshu(BL23)-Weizhong(BL40), Shenshu(BL23)-Ashi points, Weizhong(BL40)-Ashi points-Shenshu(BL23) and Weizhong(BL40)-Dachangshu(BL25).

Acupuncture is safe and effective for CLMS. The main interventions are conventional acupuncture, warm needling and fire needling, and Shenshu(BL23), Ashi points, Weizhong(BL40), Dachangshu(BL25) and Yaoyangguan(GV3) serve as the primary acupoints for treatment.