Abstract
Background: Chronic Low back pain (LBP) is among the most prevalent conditions distressing the adult population worldwide. The use of complementary and alternative medicinal (CAM) therapies for the management of LBP have rapidly gained popularity, where Yoga is being widely used as mind-body CAM therapy for relieving back pain. The aim is to assess the effectiveness of Sphinx Yoga Pose (Salamba Bhujangasana), in managing CLBP and to measure the variations in the disability index, quality of life, and stress scores.
 Methodology: A randomized controlled clinical trial will be conducted including the Nurses and midwives. Numerical Pain Rating (NPR) Scale, Roland Morris Disability Questionnaire, Fear Avoidance Beliefs Questionnaire (FABQ) will be used for initial screening. Subjects meeting inclusion criteria will be randomly assigned to either of the study group i.e. Group A (Experimental) and Group B (Control). The Group A subjects will be assigned with Sphinx Yoga therapy for 12 weeks while group B subjects will be assigned to usual care. Pre and post samples will be collected for Substance P (SP), Beta Endorphins (β-Endorphin), and Cortisol. Moreover, Oswestry Low Back Pain Disability index, World Health Organization Quality of Life (WHOQOL) and Sadaf Stress Scale (SSS), will be used at baseline and after 12 weeks follow-up (post-intervention).
 Discussion: Offering a 12-week Yoga therapy to the subjects with CLBP might give an insight into its application and efficacy. To be precise, the findings of this research will support the wider implementation of Sphinx Yoga as a lifestyle intervention.
 Trial registration: The trial was registered with ClinicalTrials.gov (NCT04721639).
Highlights
Low back pain (LBP) has become the most frequently reported musculoskeletal complaint resulting in wide-scale disability compared to any other medical condition[1]
Literature suggests that offering yoga therapy to chronic low back pain (CLBP) subjects improves low back functionality and overall quality of life[13,14]
A randomized controlled trial conducted by Tilbrook et al comparing the effectiveness of yoga and usual care for CLBP showed that the yoga therapy resulted in enhanced back functionality and reduced the disability index as compared to usual care[14]
Summary
Low back pain (LBP) has become the most frequently reported musculoskeletal complaint resulting in wide-scale disability compared to any other medical condition[1]. It is considered as the major reason behind the restricted activity and work absenteeism globally, imposing a high economic burden[1]. Even among cases where a specific radiological diagnosis has been achieved, the underlying pain mechanism often remains concealed. It has multifactorial etiology; the causative factors may be genetic, lifestyle associated, or symptom of a comorbid condition. We aim to conduct a trial determining whether yoga therapy is effective for CLBP and to understand the underlying physiology
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