This study aimed to compare the efficacy of acupuncture needling and 0.5% lidocaine injection of trigger points in chronic low back pain. Sixty participants with chronic low back pain were randomized to treatment with either acupuncture needling (n=30) at specific points or 0.5% lidocaine injection (n=30) at 2-3 trigger points twice weekly for 4 weeks. Pain scores, pressure pain intensity and depression were measured up to eight weeks from the first treatment. The results revealed that both groups improved, but there was no significant difference in reduction of pain in the two groups at any time point. Changes in depression showed only trends. The study concluded that there was improvement in both group in low back pain, and no significant difference between acupuncture needling and 0.5% lidocaine injection of trigger points for treating chronic low back pain.