Back pain could be arising from a variety of pathological changes involving a multiple number of tissues including the bony spine itself and its surrounding muscles, nerves and vascular tissues involved. In a complex situation, back pain is still experienced in spite of serious attempts to remove the pathology or counteract the abnormal activities related. Nowadays, when conventional attempts fail to give good relief, acupuncture is commonly applied. Review of past experiences gives good support to the use of acupuncture for back pain. The theories behind the effectiveness of acupuncture remain hypothetical but the practice itself is safe and often effective. One would expect better outcome from this old traditional technique if more communication can be established between the acupuncturists the surgeons and therapists, and if puncturing practices could be standardized.