Rheumatology International

, Volume 33, Issue 10, pp 2569–2576 | Cite as

The effect of Neydharting mud-pack therapy on knee osteoarthritis: a randomized, controlled, double-blind follow-up pilot study

  • Ildikó Katalin Tefner
  • Ramóna Gaál
  • András Koroknai
  • Adél Ráthonyi
  • Tamás Gáti
  • Péter Monduk
  • Edit Kiss
  • Csaba Kovács
  • Géza Bálint
  • Tamás Bender
Original Article

Abstract

The aim of this study was to evaluate the effects of Neydharting mud-pack therapy on the clinical parameters and quality of life in patients with knee osteoarthritis. In this double-blind, randomized, follow-up study on 53 patients with knee osteoarthritis, one group received hot mud-pack therapy, whereas the other (control) group was treated with hot packs of a substance manufactured on 10 occasions for 2 weeks. Western Ontario and McMaster Universities Arthritis Index (WOMAC), EuroQoL-5D quality-of-life measure and need for analgesics and non-steroidal anti-inflammatory drugs were recorded before treatment, at the end of treatment (at Week 2), and at Weeks 6 and 12. The WOMAC and the EQ5D quality-of-life scores improved from the baseline to the end of treatment in both groups, and further improvement was observed during the follow-up period (p < 0.001, respectively, in both groups). The need for medications for knee joint pain improved in both groups, and these changes were significant only in the mud-treated group (p < 0.001), but not in the control group (p = 0.106) compared to baseline. The number of patients requiring medications for knee joint pain showed a continuous downward trend at the subsequent post-treatment visits by the mud-treated group, and these changes became significant by Visit 4 compared to baseline (p = 0.016). The control group showed only temporary and not significant decrease. The difference was not significant between the groups in any of the outcome parameters at any visits. The Neydharting mud pack has a favorable effect on the clinical parameters, quality of life, and need for medications in patients with knee osteoarthritis. To evaluate the chemical effect, the number of patients should be increased.

Keywords

Mud-pack therapy Peloids Osteoarthritis of the knee Neydharting Hot-pack therapy Randomized Controlled Double-blind trial 

References

  1. 1.
    Gutenbrunner C, Bender T, Cantista P, Karagülle Z (2010) A proposal for a worldwide definition of health resort medicine, balneology, medical hydrology and climatology. Int J Biometeorol 54:495–507PubMedCrossRefGoogle Scholar
  2. 2.
    Carretero MI (2002) Clay minerals and their beneficial effects upon human health: a review. Appl Clay Sci 21:155–163CrossRefGoogle Scholar
  3. 3.
    Carretero MI, Pozo M, Martin-Rubi JA, Pozo E, Maraver F (2010) Mobility of elements in interaction between artificial sweat and peloids used in Spanish spas. Appl Clay Sci 45:506–515CrossRefGoogle Scholar
  4. 4.
    Veniale F, Bettero A, Jobstraibizer PG, Setti M (2007) Thermal muds: perspectives of innovations. Appl Clay Sci 36:141–147CrossRefGoogle Scholar
  5. 5.
    Venialea F, Barberis E, Carcangiu G, Morandi N, Setti M, Tamanini M, Tessier D (2004) Formulation of muds for pelotherapy: effects of maturation by different mineral waters. Appl Clay Sci 25:135–148CrossRefGoogle Scholar
  6. 6.
    Espejo-Antúnez L, Cardero-Durán MA, Garrido-Ardila EM, Torres-Piles S, Caro-Puértolas B (2012) Clinical effectiveness of mud-pack therapy in knee osteoarthritis. Rheumatology (Oxford) (Epub ahead of print)Google Scholar
  7. 7.
    Galzigna L, Moretto C, Lalli A (1996) Physical and biochemical changes of thermal mud after maturation. Biomed Pharmacother 50:306–308PubMedCrossRefGoogle Scholar
  8. 8.
    Tolomio C, Ceschi-Berrini C, Moschin E, Galzigna L (1999) Colonization by diatoms and antirheumatic activity of thermal mud. Cell Biochem Funct 17:29–33PubMedCrossRefGoogle Scholar
  9. 9.
    Bijlsma JW, Knahr K (2007) Strategies for the prevention and management of osteoarthritis of the hip and knee. Best Pract Res Clin Rheumatol 21:59–76PubMedCrossRefGoogle Scholar
  10. 10.
    Jordan KM, Arden NK, Doherty M, Bannwarth B, Bijlsma JWs et al (2003) EULAR Recommendations 2003: an evidence based approach to the management of knee osteoarthritis: report of Task Force of the Standing Committee for International Clinical Studies Including Therapeutic Trials (ESCISIT). Ann Rheum Dis 62:1145–1155PubMedCrossRefGoogle Scholar
  11. 11.
    Smalley WE, Griffin MR, Fought RL, Ray WA (1996) Excess costs from gastrointestinal disease associated with nonsteroidal anti-inflammatory drugs. J Gen Intern Med 11:461–469PubMedCrossRefGoogle Scholar
  12. 12.
    Mahboob N, Sousan K, Shirzad A, Amir G, Mohammad V, Reza M, Mansour VA, Hadi V (2009) The efficacy of a topical gel prepared using Lake Urmia mud in patients with knee osteoarthritis. J Altern Complement Med 15:1239–1242PubMedCrossRefGoogle Scholar
  13. 13.
    Odabasi E, Turan M, Erdem H, Tekbas F (2008) Does mud-pack treatment have any chemical effect? A randomized controlled clinical study. J Altern Complement Med 14:559–565PubMedCrossRefGoogle Scholar
  14. 14.
    Bostan B, Sen U, Güneş T, Sahin SA, Sen C, Erdem M, Erkorkmaz U (2010) Comparison of intra-articular hyaluronic acid injections and mud-pack therapy in the treatment of knee osteoarthritis. Acta Orthop Traumatol Turc 44:42–47PubMedCrossRefGoogle Scholar
  15. 15.
    Evcik D, Kavuncu V, Yeter A, Yigit I (2007) The efficacy of balneotherapy and mud-pack therapy in patients with knee osteoarthritis. Joint Bone Spine 74:60–65PubMedCrossRefGoogle Scholar
  16. 16.
    Flusser D, Abu-Shakra M, Friger M, Codish S, Sukenik S (2002) Therapy with mud compresses for knee osteoarthritis: comparison of natural mud preparations with mineral-depleted mud. J Clin Rheumatol 8:197–203PubMedCrossRefGoogle Scholar
  17. 17.
    Sarsan A, Akkaya N, Ozgen M, Yildiz N, Atalay NS, Ardic F (2012) Comparing the efficacy of mature mud-pack and hot-pack treatments for knee osteoarthritis. J Back Musculoskelet Rehabil 25:193–199PubMedGoogle Scholar
  18. 18.
    Güngen G, Ardic F, Fιndıkoğlu G, Rota S (2011) The effect of mud-pack therapy on serum YKL-40 and hsCRP levels in patients with knee osteoarthritis. Rheumatol Int 32:1235–1244PubMedCrossRefGoogle Scholar
  19. 19.
    Fioravanti A, Iacoponi F, Bellisai B, Cantarini L, Galeazzi M (2010) Short- and long-term effects of spa therapy in knee osteoarthritis. Am J Phys Med Rehabil 89:125–132PubMedCrossRefGoogle Scholar
  20. 20.
    Wigler I, Elkayam O, Paran D, Yaron M (1995) Spa therapy for gonarthrosis: a prospective study. Rheumatol Int 15:65–68PubMedCrossRefGoogle Scholar
  21. 21.
    Cantarini L, Leo G, Giannitti C, Cevenini G, Barberini P, Fioravanti A (2007) Therapeutic effect of spa therapy and short wave therapy in knee osteoarthritis: a randomized, single blind, controlled trial. Rheumatol Int 27:523–529PubMedCrossRefGoogle Scholar
  22. 22.
    Fraioli A, Serio A, Mennuni G, Ceccarelli F, Petraccia L, Fontana M, Grassi M, Valesini G (2011) A study on the efficacy of treatment with mud packs and baths with Sillene mineral water (Chianciano Spa Italy) in patients suffering from knee osteoarthritis. Rheumatol Int 31:1333–1340PubMedCrossRefGoogle Scholar
  23. 23.
    Forestier R, Desfour H, Tessier JM, Françon A, Foote AM, Genty C, Rolland C, Roques CF, Bosson JL (2009) Spa therapy in the treatment of knee osteoarthritis: a large randomised multicentre trial. Ann Rheum Dis 69:660–665PubMedCrossRefGoogle Scholar
  24. 24.
    Fioravanti A, Tenti S, Giannitti C, Fortunati NA, Galeazzi M (2013) Short- and long-term effects of mud-bath treatment on hand osteoarthritis: a randomized clinical trial. Int J Biometeorol (Epub ahead of print)Google Scholar
  25. 25.
    Altman R, Asch E, Bloch D, Bole G, Borenstein D, Brandt K, Christy W, Cooke TD, Greenwald R, Hochberg M et al (1986) Development of criteria for the classification and reporting of osteoarthritis. Classification of osteoarthritis of the knee. Diagnostic and Therapeutic Criteria Committee of the American Rheumatism Association. Arthritis Rheum 29:1039–1049PubMedCrossRefGoogle Scholar
  26. 26.
    Institut Fresenius, Heilmoorbad Neydharting GmbH (2003) Peloidanalyse. Untersuchung und Begutachtung der Peloidprobe zur Eignung als Peloid für balneologische Zwecke. http://www.moor-neydharting.com/login/arzt/Peloidanalyse%202003.pdf
  27. 27.
    Bellamy N, Buchanan WW, Goldsmith CH, Campbell J, Stitt LW (1988) Validation study of WOMAC: a health status instrument for measuring clinically important patient relevant outcomes to antirheumatic drug therapy in patients with osteoarthritis of the hip or knee. J Rheumatol 15:1833–1840PubMedGoogle Scholar
  28. 28.
    Oosterveld FG, Rasker JJ (1994) Treating arthritis with locally applied heat or cold. Semin Arthritis Rheum 24:82–90PubMedCrossRefGoogle Scholar
  29. 29.
    Fioravanti A, Cantarini L, Guidelli GM, Galeazzi M (2011) Mechanisms of action of spa therapies in rheumatic diseases: what scientific evidence is there? Review. Rheumatol Int 31:1–8PubMedCrossRefGoogle Scholar
  30. 30.
    Bender T, Karagülle Z, Bálint GP, Gutenbrunner C, Bálint PV, Sukenik S (2005) Hydrotherapy, balneotherapy, and spa treatment in pain management. Rheumatol Int 25:220–224PubMedCrossRefGoogle Scholar
  31. 31.
    Melzack R, Wall PD (1965) Pain mechanism: a new theory. Science 150:971–979PubMedCrossRefGoogle Scholar
  32. 32.
    Bender T, Nagy G, Barna I, Tefner I, Kádas E, Géher P (2007) The effect of physical therapy on beta-endorphin levels. Eur J Appl Physiol 100:371–382PubMedCrossRefGoogle Scholar
  33. 33.
    Cozzi F, Lazzarin P, Todesco S, Cima L (1995) Hypothalamic-pituitary adrenal axis dysregulation in healthy subjects undergoing mud-bath application (letter). Arthritis Rheum 38:724–725PubMedCrossRefGoogle Scholar
  34. 34.
    Bellometti S, Galzigna L (1999) Function of the hypothalamic adrenal axis in patients with fibromyalgia syndrome undergoing mud-pack treatment. Int J Clin Pharmacol Res 19:27–33PubMedGoogle Scholar
  35. 35.
    Poensin D, Carpentier PH, Féchoz C, Gasparini S (2003) Effects of mud-pack treatment on skin microcirculation. Joint Bone Spine 70:367–370PubMedCrossRefGoogle Scholar
  36. 36.
    Sukenik S, Flusser D, Abu-Shakra M (1999) The role of spa therapy in various rheumatic diseases. Rheum Dis Clin North Am 25:883–897PubMedCrossRefGoogle Scholar
  37. 37.
    Bellonetti S, Galzigna L (1998) Serum levels of a prostaglandin and a leukotriene after thermal mud-pack therapy. J Investig Med 46:140–145Google Scholar
  38. 38.
    Bellonetti S, Poletto M, Gregotti C, Richelmi P, Bertè F (2000) Mud bath therapy influences nitric oxide, myeloperoxidase and glutathione peroxidase serum levels in arthritic patients. Int J Clin Pharmacol Res 20:69–80Google Scholar
  39. 39.
    Bellonetti S, Richelmi P, Tassoni T, Bertè F (2005) Production of matrix metalloproteinases and their inhibitors in osteoarthritic patients undergoing mud bath therapy. Int J Clin Pharmacol Res 25:77–94Google Scholar
  40. 40.
    Fioravanti A, Cantarini L, Bacarelli MR, de Lalla A, Ceccatelli L, Blardi P (2011) Effects of spa therapy on serum leptin and adiponectin levels in patients with knee osteoarthritis. Rheumatol Int 31:879–882PubMedCrossRefGoogle Scholar
  41. 41.
    Beer AM, Lukanov J, Sagorchev P (2003) Evaluation of the permeation of peat substances through human skin in vitro. Int J Pharm 253:169–175PubMedCrossRefGoogle Scholar
  42. 42.
    Tateo F, Ravaglioli A, Andreoli C, Bonina F, Coiro V, Degetto S, Giaretta A, Orsini AM, Puglia C, Summa V (2009) The in vitro percutaneous migration of chemical elements from a thermal mud for healing use. Appl Clay Sci 44:83–94CrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  • Ildikó Katalin Tefner
    • 1
  • Ramóna Gaál
    • 1
  • András Koroknai
    • 1
  • Adél Ráthonyi
    • 1
  • Tamás Gáti
    • 1
  • Péter Monduk
    • 1
  • Edit Kiss
    • 1
  • Csaba Kovács
    • 2
  • Géza Bálint
    • 3
  • Tamás Bender
    • 4
    • 5
  1. 1.Józsefváros Municipal Health ServiceBudapestHungary
  2. 2.Musculoskeletal Rehabilitation CenterMezőkövesdHungary
  3. 3.National Institute of Rheumatology and PhysiotherapyBudapestHungary
  4. 4.Polyclinic of Brother of St. John of God HospitalsBudapestHungary
  5. 5.Budai Irgalmasrendi KórházBudapestHungary

Personalised recommendations