Mud Packs Research Articles

Efficacy of Mruttika Lepa (Mud-Pack) in Yuvan-Pidika (Acne-Vulgaris) - A Case Study

Today, every person, whether young or old wants to look attractive and flawless skin. Acne vulgaris is a follicular disorder affecting susceptible pilosebaceous follicles primarily of the face, neck and upper trunk. Characterized by comedones, papules, nodules and cysts. Acharya Sushruta was the first and foremost who described Yuvan-Pidika disease under the heading of “Kshudra Roga” According to Acharya Sushrut Yuvan-Pidika is caused by vitiation of Kapha, Vata and Rakta. Characterized by Shalmali thorn like eruptions, Kandu, Shoola, Ghana, Medogarbha, Daha, Strava, Vivarnata. In Naturopathy, Mud therapy is a famous and cost-effective treatment modality. Mud is capable of absorbing toxins from the body also useful for prevention and treatment of many diseases. Acharya Sushrut has defined anti-toxic effect of black soil. It is indicated as Lepa in Shotha, Arunshika, and mainly in Kapha, Pitta, Raktaj Vikara. This case study is of a 17 years old female patient who came to hospital complaining of eruptions over her face with mild pain since 11 months. The patient was given a mud pack to apply on the face for the period of 45 days daily in the morning. Patient was successfully treated without any complication within 45 days proving it is a safe, simple and cheap method in Yuvan Pidika.

Efficacy of balneotherapy on pain, function, and sleep quality in patients with chronic low-back pain: a prospective observational study.

The aim of this prospective observational study was to evaluate the efficacy of a cycle of sulfate-arsenical-ferruginous mud bath therapy on pain, function, and sleep quality in patients with chronic low-back pain (CLBP). One hundred twenty-three patients treated at Levico Spa Center (Italy) with 12 daily local mud packs and generalized thermal baths were included in this experience. General medical assessments were performed before starting the therapy, at the end of the treatment, and 3months later. Pain intensity and stiffness were measured by a 0 to 10cm visual analogue scale (VAS); the range of mobility of the lumbar spine was evaluated using the Schober test and functional disability by the Roland-Morris Disability Questionnaire (RMDI). The Pittsburgh Sleep Quality Index (PSQI) was used to assess the sleep quality. The VAS score for pain and stiffness showed a significant reduction (p < 0.0001) at the end of the treatment persisting for 3months of follow-up. Similarly, a significant improvement was found for the Schober test and RMDQ. Finally, we showed a significant decrease of PSQI score at the end of the cycle of mud bath and at 3months of follow-up. The Spearman analysis showed a significant positive correlation between the score of PSQI and VAS pain, VAS stiffness, and RMDQ. In conclusion, this preliminary study confirms the beneficial and long-term efficacy of balneotherapy on pain and function and, for the first one, shows the positive effect on quality of sleep in patients with CLBP treated with a cycle of mud bath therapy.

Immediate effect of mud pack on resting cardiovascular parameters in hypertensive individuals – A single-arm pilot study

Immediate effect of mud pack on resting cardiovascular parameters in hypertensive individuals – A single-arm pilot study

Unveiling the Therapeutic Potential and Healthcare Applications of Marine Therapy: A Systematic Review with Meta-Analysis and Meta-Regression.

This study was conducted to estimate the effectiveness of marine-derived resources for treating specific diseases, as well as identify the most effective methods for applying such resources in therapeutic applications. Bibliographic databases (PubMed, Embase, and Cochrane) were searched from their inception until May 2023 using Medical Subject Headings terms and text keywords related to seawater, mineral water, or ocean therapy. Fifteen eligible studies were included, involving 1325 participants aged 42.7-63.0 years. In the subgroup analysis based on treatment type, the mean difference was -1.581 (95% CI: -1.889, -1.274) for seawater with sun exposure and -1.210 (95% CI: -1.417, -1.002) for seawater with sun exposure, mud pack application, and sulfur pool therapy. The pooled standardized mean difference was calculated for different outcomes; the results were -1.110 (95% CI: -3.028, 0.806) for osteoarthritis severity, -0.795 (95% CI: -0.982, -0.607) for arthritis pain, -1.623 (95% CI: -2.036, -1.209) for fibromyalgia pain, and -1.498 (95% CI: -1.888, -1.108) for quality of life. Marine therapy is, therefore, promising for treating chronic skin issues, easing musculoskeletal discomfort, and enhancing the quality of life among patients with musculoskeletal pain.

Hand Osteoarthritis: Is Balneotherapy Useful? Bridging the Gap in the Literature with a Scoping Review of Randomized Controlled Trials

Hand osteoarthritis (HOA) represents a common presentation of osteoarthritis, significantly affecting patients’ quality of life and daily activities. The 2018 EULAR recommendations underline the importance of a multidisciplinary approach, combining non-pharmacological and pharmacological treatments. Yet, the role of balneotherapy (BT) in the HOA therapeutic regimen remains unclear. This review seeks to bridge the gap by exploring recent randomized controlled trials (RCTs) that investigate the potential benefits of BT as a complementary intervention for managing HOA. This scoping review investigates original research articles published between January 2003 and August 2023 through a comprehensive search across MEDLINE (PubMed), Google Scholar, and Web of Science. The findings from this scoping review contribute to the growing corpus of evidence indicating that BT, particularly when employing specific methods like mud packs and mineral-rich baths, presents a promising role in reducing pain and enhancing functionality and quality of life, particularly in the initial phases of the condition. These findings highlight the potential therapeutic efficacy of BT interventions and support their inclusion as a complementary approach in managing HOA and preventing its progression. However, further research and the undertaking of larger-scale trials are imperative to validate these preliminary findings.

Electrical Bioimpedance Analysis for Evaluating the Effect of Pelotherapy on the Human Skin: Methodology and Experiments.

Pelotherapy is the traditional procedure of applying curative muds on the skin's surface-shown to have a positive effect on the human body and cure illnesses. The effect of pelotherapy is complex, functioning through several mechanisms, and depends on the skin's functional condition. The current research objective was to develop a methodology and electrodes to assess the passage of the chemical and biologically active compounds of curative mud through human skin by performing electrical bioimpedance (EBI) analysis. The methodology included local area mud pack and simultaneous tap water compress application on the forearms with the comparison to the measurements of the dry skin. A custom-designed small-area gold-plated electrode on a rigid printed circuit board, in a tetrapolar configuration, was designed. A pilot study experiment with ten volunteers was performed. Our results indicated the presence of an effect of pelotherapy, manifested by the varying electrical properties of the skin. Distinguishable difference in the measured real part of impedance (R) emerged, showing a very strong correlation between the dry and tap-water-treated skin (r = 0.941), while a poor correlation between the dry and mud-pack-treated skin (r = 0.166) appeared. The findings emerged exclusively in the frequency interval of 10 kHz …1 MHz and only for R. EBI provides a promising tool for monitoring the variations in the electrical properties of the skin, including the skin barrier. We foresee developing smart devices for promoting the exploitation of spa therapies.

Assessment of barium diffusion from therapeutic mud wrapped in micro-perforated polyethylene bags towards the human organism

Barium is present within the clay-derived therapeutic mud packs deposed on the patient's skin for treating some rheumatologic conditions. We studied in twenty-four young healthy volunteers the diffusion of Ba from mud wrapped in micro-perforated polyethylene bags and soaked in mineral water. No significant systematic increase in plasma or urine Ba levels was evidenced when comparing pre- and post-treatment samples using inductively-coupled plasma mass spectrometry. These levels were markedly inferior to the recommended thresholds in nearly all the participants. Noticeably variability in blood and especially urine Ba concentrations was large and mainly explained by environmental exposure (alimentation). Interestingly, we evidenced an intense Ba accumulation within the therapeutic mud at the end of the regimen. Because we chose a clay with one of the highest Ba content available in France for medical therapy and participants with an optimal transcutaneous diffusion capacity (young individuals with low-fat mass), we conclude unambiguously that there is no risk of Ba overexposure in patients receiving pelotherapy according to the procedure used in French medical spas.

Active Heating following Cryolipolysis Reduces Efficacy and Side Effects: A Randomized Split-Body Trial.

Cryolipolysis-a popular noninvasive technique for body contouring-has fewer side effects compared with liposuction; however, its effectiveness in terms of reducing local adipose tissue is also lower. This study is, to the authors' knowledge, the first prospective, controlled, investigator-blinded split-body trial to evaluate whether postcryolipolytic heating can increase the efficacy. Twenty-five subjects were treated with one session of cryolipolysis on the lower abdomen and a subsequent heating with a mud pack of a randomized side of the treated region (left or right). Epidemiologic, temperature, edema, erythema, hypesthesia, and pain level data were obtained. Photographs, fat layer thickness (on ultrasound, caliper, and abdominal girth), satisfaction, and side effects were documented over a follow-up period of 12 weeks. The side effects-edema, erythema, and hypesthesia-faded almost completely with heating, whereas they remained on the nonheated site. However, the mean sonographic reduction of local adipose tissue after 12 weeks was significantly lower on the heated sites than on the control sites (9.6% versus 14.1%; P = 0.0003). The overall satisfaction was high (9.2 of 10 points), even though only 44% of participants had a subjective recognition of fat loss without difference between the sites. Active heating following cryolipolysis increases bodily well-being by reducing common side effects, but it reduces the effectiveness of cryolipolysis significantly and should therefore be avoided. Further improvements are necessary to enhance the efficacy of cryolipolysis. Therapeutic, I.

Comparison of the efficacy of mud-pack and hot-pack treatments in chronic non-specific neck pain: A single-blind, randomized-controlled study.

This study aims to compare the short-term efficacy of mud-pack (MP) and hot-pack (HP) treatments with the same temperature and duration on sleep, function, depression, and quality of life for chronic non-specific neck pain (CNNP) patients. Between December 2018 and September 2019, a total of 70 patients with CNNP diagnosis (12 males, 58 females; mean age: 50.2±9.4 years; range, 24 to 65 years) were included. The patients were divided into two groups. The MP group (n=35) had a total of 15 sessions of MP for 20 min + transcutaneous electrical nerve stimulation (TENS) for 20 min + home exercise (HE) on five days per week for three weeks. The HP group (n=35) had 15 similar sessions of HP for 20 min + TENS for 20 min + HE. The patients were assessed with the Visual Analog Scale (VAS-pain), VAS physician's and patient's global assessments, modified Neck Disability Index (mNDI), Beck Depression Inventory (BDI), Pittsburgh Sleep Quality Index (PSQI), and Short Form-36 (SF-36) measures before treatment, at the end of post-treatment third week and one month later. In the MP group, there were statistically significant improvements in all parameters at the end of treatment three-week and one-month follow-up (p<0.05), apart from SF-36 Vitality/Energy (SF-36V/E) at the end of treatment and SF-36 General Health (SF-36GH) at one month. In the HP group, there were statistically significant improvements observed for all parameters (p<0.05), apart from the SF-36 Physical Role and SF-36GH at the end of treatment third week and SF-36V/E at the first-month assessment. The VAS-pain(p<0.001), mNDI (p=0.019), BDI (p=0.002), SF-36GH (p<0.001), SF-36V/E (p<0.001) and SF-36 mental health (p<0.001) showed statistically significantly superior improvements in the MP group (p<0.05). In CNNP patients, both MP and HP treatments are effective. However, MP therapy has more positive effects on pain, function, depression, and quality of life parameters. The MP treatment may be used in addition to TENS treatment for CNNP patients.

Impact of cold mud pack on abdomen and eyes on the autonomic control of heart rate

Mud therapy is a system of naturopathic medicine where treatment is given using various forms of mud. Hence, the present study aims to evaluate the physiological effects of simultaneous application cold mud pack over the abdomen and eyes by determining the cardiovascular and autonomic parameters of the study participants. 30 healthy volunteers were recruited for the study. All volunteers were subjected to two sessions of treadmill run up to 10 minutes and subsequently to supine rest. Their first session was considered under control trial, during which they were given a dry abdomen and an eye pack after the treadmill run for 20 minutes. With a gap of 15 days in between, in the experimental trial, they were given a cold mud packs to the abdomen and eyes during the supine rest after the treadmill run. HRV Assessments were done during the intervention and their BP and pulse were recorded immediately after the intervention. All HRV parameters in the time domain and HF in frequency domain remain increased during the mud pack trial.

Immediate effect of cold mud pack therapy on autonomic variables in primary hypertensive individuals: a randomized trial.

Mud pack or compress is an easily accessible, cost-effective, efficient treatment modality used in naturopathy to manage and prevent various chronic illnesses. This study sought to elucidate the effectiveness of cold spinal mud packs on improving neuro-cardiac parameters among hypertensive individuals. A total of 100 hypertensive subjects aged 30-50 years were randomly allocated into two groups: Cold spinal mud pack (CSMP) and prone rest. Blood Pressure (BP) and Heart Rate Variability (HRV) were assessed at three-time points: Baseline, After 20min (T1), After 60min (T2). This single-blinded randomized controlled trial was registered in the Clinical Trials Registry-India (CTRI/2019/12/022492). After 20min of CSMP showed a statistically significant reduction (p<0.01) in mean values of Systolic BP, Diastolic BP, and in HRV attained statistically significant change (p<0.01) in mean score in the frequency domain except for Very low-frequency power (VLF) and a significant difference found in the mean score of time-domain values (p<0.01) when compared to control group and 95% confidence interval (CI) will be provided for each effect. CSMP reduces the sympathetic tone and shifts the sympathovagal balance in favor of parasympathetic dominance, contributing to a decrease in BP and effective changes in components of HRV.

Clinical Evaluation of Selected Naturopathic Therapeutic Procedures in Individuals with Low Back-pain

Background: The understanding of back-pain as one of the commonest clinical presentations, made the path to the present study. More than three-quarters of the world’s population experience back-pain at some time in their lives Purpose: The present study has evaluated the selected Naturopathic therapeutic procedures on individuals with low back-pain. Methods: Thirteen patients were selected for the study and randomly divided into two groups, viz., Group A, Naturopathic group and Group B, Control group. One patient discontinued. Naturopathic group was treated with mud pack, aromatherapy massage with Eucalyptus oil, acupressure, steam, wet trunk pack, exercises, relaxation and breathing exercises. Advice for life style and diet was given for patients of both the groups. The effect of the therapy was assessed subjectively and objectively. Particular scores drawn for Naturopathic group and control group were indi vidually analyzed before and after treatment and the values were compared using standard statistical protocols. Results: Naturopathic intervention revealed 100% relief in both subjective and objective parameters (i.e., 6 out of 14 parameters showed statistically highly significant P < 0.01 results, while 8 showed significant results P < 0.05). Conclusion: Statis tically highly significant results of this study point out the successful management of the multi factorial low back-pain with a multi focused Naturopathic treatment approach. Such encouraging results may pave the way for a future study on a large sample in a longer duration incorporating clinical investigations.

Pozitivni efekti četvoronedeljnog rehabilitacionog banjskog programa na kvalitet života bolesnika sa ankilozirajućim spondilitisom

This is an open uncontrolled study about the positive effects of a four-week rehabilitation spa program on the quality of life of 74 patients with ankylosing spondylitis. We assessed the following health status parameters on admission and discharge from the Institute Igalo, Montenegro: BASFI, BASDAI, ASDAS-CRP, ASAS 20 improvement criteria and SF-36 questionnaire. It was a "test-retest study". All the patients had six days of spa physical therapy per week during the four-week rehabilitation program, which made 24 therapy days in total. Therapy sets included the exercise program in gym and pool with mineral water, breathing exercises, massage therapy, balneotherapy (mud packs of baths, mineral and pearl baths, underwater massages), electrotherapy, sonotherapy, as well as thalassotherapy. Physiotherapy was prescribed by physician individually according to general health status and eventual contraindications. In all the observed parameters, statistical analysis showed that there was a highly significant improvement (p &lt; 0.01). After four weeks of spa rehabilitation, ASAS 20 improvement index was achieved in 74.3% of patients with ankylosing spondylitis. Conclusions were that four weeks of complex spa physical therapy program in Institute Igalo led to a significant improvement of assessed parameters of disease activity, functional status and in domains of quality of life.

A Review: Honey and Its Nutritional Composition

Honey is one of the historical natural products produced by honey bees. Humans used it as medicine and protection against some infectious diseases, a honey quale is dependent in its classification of the honey bee. The most famous accomplished honey bees in the world are Africanized honey bee (Apis mellıfera .l), Western honey bee or European honey bee (Apis mellifera), Eastern honey bee (Apis cerana), Philippine honey bee (Apis nigrocincta), Koschevnikovs honey bee (A. koschevnikovi), Giant Honeybees (Apis dorsata), Dwarf Honeybees (Apis andreniformis). This study collected the health effect, quality and usage of honey in several industries; also argue about the nutritious value of honey that the most important parts are protein, carbohydrates, vitamin, and minerals.&#x0D; Honey is not only a nutrient it also plays a major role in many other products, uses of honey in cosmetics as a protective and softener of skin, it is used up to 22% in paste masks and mud packs (which are considered rinse-off formulations). Uses of honey in Ayurveda for prevention of irritation, cough, healthy teeth, gums, and boons. &#x0D; Production of honey has been compared in 2013 to 2018, in 2013 the world production of honey was 1,664 thousand tones with an increase of 1/3 in just two decades. China, where manufacturing amounted to 466.3 thousand tons, i.e. approximately 29% of the global volume of output, these are showing that China was the biggest producer of honey in the world but it gets a decrease in 2018 as well as Brazil, America, Russia, Ethiopia, and Iran. And it increases in Turkey, Argentine, India, Mexico, and Poland.

Mud Pack With Menthol and Arnica Montana Accelerates Recovery Following a High-Volume Resistance Training Session for Lower Body in Trained Men.

Bartolomei, S, Nigro, F, D'Amico, A, Cortesi, M, and Di Michele, R. Mud pack with menthol and Arnica montana accelerates recovery following a high-volume resistance training session for lower body in trained men. J Strength Cond Res 36(7): 1909-1915, 2022-The aim of this study was to compare the effects of a mud pack, containing menthol and Arnica montana, on the recovery responses following a high-volume resistance protocol. Ten resistance-trained men (mean ± SD: age = 25.3 ± 6.1 years; body mass = 79.1 ± 10.6 kg; height = 178.9 ± 7.5 cm) performed a high-volume resistance workout for lower body squat and leg extension, (5 sets of 10 reps at 70% of one repetition maximum for both exercises). All the subject used mud (MUD) or a placebo (PL) in randomized counterbalanced crossover design. MUD or PL were applied 4 times: 3, 19, 27, and 45 hours after the workout, on the skin surface above the quadriceps muscle of both legs. Muscle performance (countermovement jump power [CMJP], isokinetic leg press at 75 cm·s-1 and 25 cm·s-1 [ISOK75 and ISOK25, respectively], isometric squat [ISQ]), and morphology (muscle thickness of vastus lateralis [VLMT]), were measured before exercise (baseline [BL]), and 15 minutes (15P), 24 hours (24P), and 48 hours (48P) postexercise. In addition, muscle soreness was assessed at the same time points using a visual analog scale (VAS). No significant interactions (p > 0.05) between the trials were detected for CMJP, ISOK75, ISQ, and VLMT. A significant interaction between trials was noted for ISOK25 (p = 0.022) and for VAS (p = 0.001). ISOK25 was significantly (p < 0.01) reduced from BL at 15P, 24P and 48P in PL, whereas changes were significant (p < 0.05) at 15P and 24P only in MUD. The present findings indicate that MUD may enhance the recovery rate of strength and reduce muscle soreness after high-volume exercise. Muscle morphology do not seem to be influenced by mud packs.

Serial Mud Packs Induce Anti-inflammatory Effects in Knee Osteoarthritis – A Randomized, Prospective Clinical Study

Abstract Background Mud bath and pack have been used to treat musculoskeletal disorders since ancient times. However, the actual mechanisms of action of mud therapy on the inflammatory processes are complex and still not clarified. Methods Therefore, the clinical effects of serial mud packs in patients with knee osteoarthritis were investigated on the molecular level. A total of 52 patients were recruited from an in-patient rheumatology clinic. The participants were randomized in 2 groups: the intervention group (IG, n=26) underwent 9 mud packs in 21 days and a standardized multimodal physical therapy in an in-patient setting, whereas the control group (CG, n=26) only received the multimodal physical therapy. Primary outcome parameters were changes in the serum levels of interleukin(IL)-1ß and IL-10. Secondary outcome parameters were changes of the C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), Western Ontario and Mc Master Universities Arthritis (WOMAC) index and pain (visual analog scale - VAS). Results The IG presented after the serial mud packs significantly decreased pro-inflammatory IL-1ß levels and significantly increased anti-inflammatory IL-10 levels, whereas the CG showed no changes of the 2 cytokines. CRP and ESR remained within in the normal range in both groups without significant changes. Furthermore, the IG presented a significant decrease of the WOMAC index and pain (VAS). Conclusions The results suggest an additive anti-inflammatory effect of serial mud packs within a multimodal physical therapy concept in patients with knee osteoarthritis and could explain the beneficial clinical effects.

Sulfurous-arsenical-ferruginous balneotherapy for osteoarthritis of the hand: results from a retrospective observational study.

Balneotherapy (BT) is a complementary therapy widely used in several rheumatic conditions, however, the evidence in hand osteoarthritis (HOA) is still scarce. The aim of this preliminary study is to retrospectively evaluate the symptomatic effects of a cycle of mud-bath therapy in HOA patients. Two hundred twelve outpatients with primary bilateral HOA treated with 12 daily local mud packs and generalized thermal baths with a sulfurous-arsenical-ferruginous mineral water added to usual treatment were included in the study. Each patient was examined at baseline and at the end of thermal therapy (2weeks). Primary outcome measures were global spontaneous hand pain on a Visual Analogue Scale (VAS) and the Functional Index for Hand Osteoarthritis (FIHOA) score; secondary outcomes were handgrip strength, duration of morning stiffness, Health Assessment Questionnaire (HAQ), Short Form Health Survey (SF-12), tolerability and patients' and physicians' global impression of treatment efficacy and tolerability. Our results demonstrated that the efficacy of mud-bath therapy was significant in all the assessed parameters at the end of therapy, except for the physical component score of SF-12. The thermal treatment was well tolerated. The patient's and the physician's global assessments showed a high level of satisfaction in terms of efficacy and safety. In conclusion, our results may suggest a short-term effectiveness of mud-bath therapy in controlling pain and improving functionality in HOA patients, supporting the role of this treatment as a complementary strategy in the management of HOA; however, further randomized controlled trials with a long-term follow-up are needed.

Usual care including home exercise with versus without spa therapy for chronic low back pain: protocol for the LOMBATHERM\u2019 study, a multicentric randomised controlled trial

BackgroundLow back pain is highly prevalent and a major source of disability worldwide. Spa therapy is frequently used to treat low back pain, but the associated level of evidence for efficacy is insufficient. To fill this knowledge gap, this protocol proposes an appropriately powered, prospective, evaluator-blinded, multi-centre, two-parallel-arm, randomised (1:1), controlled trial that will compare spa therapy in addition to usual care including home exercise (UCHE) versus UCHE alone for the treatment of chronic low back pain.MethodsEligible patients (anticipated sample size of 358) will have had low back pain for more than 3 months and scores for pain greater than 40 mm on a visual analogue scale (VAS). Following initial consent for UCHE and baseline evaluations, patients are randomised (1:1) to UCHE alone, or UCHE plus spa therapy (18 days of mud packs, underwater massages, showers and water exercises under medical supervision). Patients in the latter arm will be requested to sign an additional consent form as per Zelen randomisation. Follow-up visits will occur at approximately months 1, 6 and 12 and (along with baseline assessments) will cover changes over time in VAS pain scores, the impact of lower back pain on daily life (the Rolland and Morris Disability Questionnaire (RMDQ)), inappropriate fears and beliefs about lower back pain (the fear, avoidance, belief questionnaire (FABQ)), general quality of life (the Euroqol Group 5 dimension, 5 level questionnaire (EQ-5D-5 L)), Patient Acceptable Symptom State (PASS), consumption of analgesic drugs and nonsteroidal anti-inflammatory drugs (NSAIDs), and overall state of health. Health resource use and days of sick leave (and subsequently the associated costs) will also be recorded. The primary outcome is the presence/absence of a clinically relevant change (improvement of at least 30%) in the VAS score for pain at 6 months.DiscussionDespite the fact that previous, rather dated recommendations encourage spa therapy for the treatment of low back pain, the current literary corpus is methodologically poor. This protocol has been designed to provide results spanning a thorough range of outcomes at the highest evidence level possible.Trial registrationClinicalTrials.gov: NCT03910023. Registered on 10 April 2019.

Mud Therapy Combined with Core Exercise for Chronic Nonspecific Low Back Pain: A Pilot, Single-Blind, Randomized Controlled Trial.

Background Low back pain (LBP) is common in the elderly and an appropriate intervention for LBP management should be investigated. The aim of this study is to investigate the potential of mud-heat intervention combined with core exercise as an alternative intervention for relieving pain and improving motor function in individuals with nonspecific chronic LBP. Methods Thirty-one individuals with chronic nonspecific LBP were randomly allocated to either the intervention group (n = 16) or the control group (n = 15). The intervention group used a mud pack for 30 min and performed a core-exercise program for 50 min twice a day for 4 days (8 sessions). The control group performed the core-exercise program only, at the same time point as the intervention group. Pain intensity was assessed using a 100 mm visual analog scale and a pain pressure threshold (PPT) as the primary outcomes. The secondary outcome measures included functional disability by LBP (Oswestry Disability Index), muscle properties, and static/dynamic balance. Results There was a significant group difference in pain intensity at rest (p=0.048) and in the PPT at the two sites assessed (2 cm lateral to L3 spinous process, p=0.045; 2 cm lateral to L5 spinous process, p=0.015). No group differences were found in terms of muscle properties. Compared to core exercise only, moor-heat therapy and core exercise showed a significant improvement in static balance (p=0.026) and dynamic balance (p=0.019). Conclusion Mud therapy combined with core exercise is effective in relieving pain and improving motor function in patients with chronic nonspecific LBP. Further research is needed to underpin these preliminary results.

Comparison of intermittent and consecutive balneological outpatient treatment (hydrotherapy and peloidotherapy) in fibromyalgia syndrome: a randomized, single-blind, pilot study.

To compare the efficacy of intermittent and consecutive balneological outpatient treatment (hydrotherapy and peloidotherapy) in fibromyalgia syndrome (FMS). A parallel 1:1, single-blind, pilot study was performed. Patients were recruited from musculoskeletal disorders outpatient clinic. Eligible participants were patients aged 18-60, diagnosed as FMS according to ACR 2010 criteria. They were randomly assigned to either consecutive or intermittent treatment groups. Both groups received 20min of full body immersion in a tap water pool at 38-39°C and 30min of mud pack application on the back region at 45°C. Delivery of the treatment was five times weekly during 2weeks in consecutive group and two times weekly during 5weeks in intermittent group. The primary outcomes were pain intensity and the number of patients achieving a minimal clinically important difference (MCID) on Fibromyalgia Impact Questionnaire (FIQ) at the 1st month after the completion of the treatment. Statistical analyses were based on intention to treat method. The assessing physician was blinded. Pain intensity significantly decreased in all post-treatment evaluations of both groups (except after treatment in the intermittent group). There was no significant difference between the groups. MCID for FIQ was achieved in 6 (24%) patients in the consecutive group and 12 (48%) in the intermittent group at the 1st month. There was no statistical difference in the secondary judgment criteria. The consecutive and intermittent deliveries of balneological outpatient treatment (hydrotherapy and peloidotherapy) seem to have similar effects on the clinical status of patients with FMS.