Objective: Lumbar muscle strains and sprains (LS) are the most common causes of acute low back pain. Current treatments for LS include drug, physical, and acupuncture treatments but they are not effective in all cases. This case study describes the application of acupuncture and active movement for LS. Clinical features: Two patients presented with acute LS caused by physical injury and did not respond to drug treatments. Both patients had reduced ranges of motions and pain affecting qualities of life. Intervention and outcome measurements: We developed a treatment based on LI3 (Sanjian) point acupuncture combined with active movement. Two treatment sessions were performed in one week. Evaluations were conducted at baseline, after the second session, and 2 months after the final treatment using the Visual Analogue Scale (VAS) and the Roland-Morris Disability Questionnaire (RMDQ). The patients reported less pain after treatment and had no pain at follow-up. No adverse effects were observed. Conclusion: The combination of acupuncture with active motion may reduce pain perception and facilitate movement in LS patients. The described treatment could be safe, simple, and cost-effective for LS patients who do not respond to drug treatments. Larger studies are needed to extend beyond these two cases.