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Effectiveness of peloid therapy in patients with chronic low back pain: a single-blind controlled study

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Abstract

The aim of this study was to compare peloid therapy in addition to home exercise with home exercise alone in terms of pain, function, quality of life, and depression in patients with chronic low back pain (cLBP). A total of 106 cLBP patients were divided into two equal groups as treatment and control. The peloid therapy group had peloid therapy (with a total of 15 sessions on 5 days per week for 3 weeks duration with 45 °C temperature lasting 30 min/day) + home exercise program. The control group was only given a home exercise program. Patients completed the visual analog scale-pain (VAS-pain), patient and physician global assessments (VAS-PGA and VAS-PhGA), revised Oswestry disability index (rODI) for functional status, the short form-36 (SF-36) for quality of life, and Beck Depression Inventory (BDI) for depression three times as before treatment, after treatment (3rd week), and 1 month after the end of treatment. Assessments in the 3rd week at the end of treatment revealed statistically significant improvements for rODI (p = 0.013), VAS-pain (p = 0.039), and VAS-PhGA (p = 0.002) parameters in the peloid therapy group compared to the control group. Assessments in the 1st month after the end of treatment revealed statistically significant improvements in rODI (p < 0.001), VAS-pain (p < 0.001), VAS-PGA (p = 0.002), VAS-PhGA (p < 0.001), and SF-36VE (p = 0.022) parameters in the peloid therapy group compared to the control group. Peloid therapy + home exercise was statistically significantly superior to home exercise alone in improving pain and function in patients with cLBP. Peloid therapy may be recommended as a non-pharmacological treatment for cLBP patients. There is a need for randomized studies with longer follow-up including biochemical parameters to verify the beneficial effects observed in this study and elaborate the mechanisms of action.

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References

  • Abu-Shakra M, Mayer A, Friger M, Harari M (2014) Dead Sea mud packs for chronic low back pain. Isr Med Assoc J 16:574–577

    Google Scholar 

  • Alleva J, Hudgins T, Belous J, Kristin Oligemes A (2016) Chronic low back pain. Dis Mon 62(9):330–333

    Article  Google Scholar 

  • Angioni MM, Denotti A, Pinna S, Sanna C, Montisci F, Dessole G, Loi A, Cauli A (2019) Spa therapy induces clinical improvement and protein changes in patients with chronic back pain. Reumatismo 71(3):119–131

    Article  CAS  Google Scholar 

  • Bai R, Li C, Xiao Y, Sharma M, Zhang F, Zhao Y (2019) Effectiveness of spa therapy for patients with chronic low back pain: an updated systematic review and meta-analysis. Medicine (Baltimore) 98(37):e17092. https://doi.org/10.1097/MD.0000000000017092

    Article  Google Scholar 

  • Bağdatlı AO, Donmez A, Eröksüz R, Bahadır G, Turan M, Erdoğan N (2015) Does addition of ‘mud-pack and hot pool treatment’ to patient education make a difference in fibromyalgia patients? A randomized controlled single blind study. Int J Biometeorol 59(12):1905–1911

    Article  Google Scholar 

  • Beer AM, Junginger HE, Lukanov J, Sagorchev P (2003) Evaluation of the permeation of peat substances through human skin in vitro. Int J Pharm 253:169–175

    Article  CAS  Google Scholar 

  • Bronfort G, Maiers MJ, Evans RL, Schulz CA, Bracha Y, Svendsen KH, Grimm RH Jr, Owens EF Jr, Garvey TA, Transfeldt EE (2011) Supervised exercise, spinal manipulation, and home exercise for chronic low back pain: a randomized clinical trial. Spine J 11(7):585–598

    Article  Google Scholar 

  • Bunzli S, Smith A, Schütze R, Lin I, O’Sullivan P (2017) Making sense of low back pain and pain-related fear. J Orthop Sports Phys Ther 47(9):628–636

    Article  Google Scholar 

  • Cheleschi S, Gallo I, Tenti S (2020) A comprehensive analysis to understand the mechanism of action of balneotherapy: why, how, and where they can be used? Evidence from in vitro studies performed on human and animal samples. Int J Biometeorol 64(7):1247–1261. https://doi.org/10.1007/s00484-020-01890-4

    Article  Google Scholar 

  • Chou R, Deyo R, Friedly J, Skelly A, Hashimoto R, Weimer M, Fu R, Dana T, Kraegel P, Griffin J, Grusing S, Brodt ED (2017) Nonpharmacologic therapies for low back pain: a systematic review for an American College of Physicians Clinical Practice Guideline. Ann Intern Med 166(7):493–505

    Article  Google Scholar 

  • Cozzi F, Galozzi P, Ciprian L, Zanatta E, Polito P, Oliviero F, Carrara M, Punzi L (2020) Mud-bath treatment of seronegative spondyloarthritis: experience at the Euganean Thermal Area. Int J Biometeorol 64:937–941. https://doi.org/10.1007/s00484-019-01761-7

    Article  Google Scholar 

  • Eröksüz R, Erol Forestier FB, Karaaslan F, Forestier R, İşsever H, Erdoğan N, Karagülle MZ, Dönmez A (2020) Comparison of intermittent and consecutive balneological outpatient treatment (hydrotherapy and peloidotherapy) in fibromyalgia syndrome: a randomized, single-blind, pilot study. Int J Biometeorol 64(3):513–520

    Article  Google Scholar 

  • Gálvez I, Torres-Piles S, Ortega-Rincón E (2018) Balneotherapy, immune system, and stress response: a hormetic strategy? Int J Mol Sci 19(6):1687. https://doi.org/10.3390/ijms19061687

    Article  CAS  Google Scholar 

  • Gay C, Guiguet-Auclair C, Coste N, Boisseau N, Gerbaud L, Pereira B, Coudeyre E (2020) Limited effect of a self-management exercise program added to spa therapy for increasing physical activity in patients with knee osteoarthritis: a quasi-randomized controlled trial. Ann Phys Rehabil Med 63(3):181–188

    Article  Google Scholar 

  • Golob AL, Wipf JE (2014) Low back pain. Med Clin North Am 98(3):405–428

    Article  Google Scholar 

  • 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(5):495–507

    Article  Google Scholar 

  • Hahm SC, Shin HJ, Lee MG, Lee SJ, Cho HY (2020) Mud therapy combined with core exercise for chronic nonspecific low back pain: a pilot, single blind, randomized controlled trial. Evid Based Complement Alternad Med 2020:1–8. https://doi.org/10.1155/2020/7547452

    Article  Google Scholar 

  • Hartvigsen J, Hancock MJ, Kongsted A, Lancet Low Back Pain Series Working Group et al (2018) What low back pain is and why we need to pay attention. Lancet 391(10137):2356–2367

    Article  Google Scholar 

  • Hayden JA, van Tulder MW, Malmivaara A, Koes BW (2005) Exercise therapy for treatment of non-specific low back pain. Cochrane Database Syst Rev 20(3):CD000335

    Google Scholar 

  • Hisli N (1988) A study on validity and reliability test of the Beck Depression Scale. Turk J Psychol 6:118–122

    Google Scholar 

  • Hudson-Cook N, Tomes-Nicholson K, Breen A (1989) A revised Oswestry disability questionnaire. In: Roland M, Jenner JR (eds) Back pain: new approaches to rehabilitation and education. Manchester:Manchester University Press, pp 187–204

  • Karagülle M, Karagülle MZ (2015) Effectiveness of balneotherapy and spa therapy for the treatment of chronic low back pain: a review on latest evidence. Clin Rheumatol 34(2):207–214

    Article  Google Scholar 

  • Kardeş S (2021) Public interest in spa therapy during the COVID-19 pandemic: analysis of Google Trends data among Turkey. Int J Biometeorol. https://doi.org/10.1007/s00484-021-02077-1

  • Kardeş S, Karagülle M, Geçmen İ, Adıgüzel T, Yücesoy H, Karagülle MZ (2019) Outpatient balneological treatment of osteoarthritis in older persons: a retrospective study. Z Gerontol Geriatr 52(2):164–171

    Article  Google Scholar 

  • Kardeş S, Karagülle M (2020) Pathophysiological mechanisms of balneotherapy with potential implications for Central Asian spas and sanatoriums. Cent Asian J Med Hypotheses Ethics 1:131–135. https://doi.org/10.47316/cajmhe.2020.1.2.05

    Article  Google Scholar 

  • Koçyiğit H, Aydemir Ö, Fişek G, Ölmez N, Memiş A (1999) Kısa Form-36 (KF-36)’nın Türkçe versiyonunun Güvenirliliği ve Geçerliliği İlaç ve Tedavi Dergisi. 12(2):102–106

  • Koçyiğit BF, Gür A, Altındağ Ö, Akyol A, Gürsoy S (2016) Comparison of education and balneotherapy efficacy in patients with fibromyalgia syndrome: a randomized, controlled clinical study. Agri 28(2):72–78. https://doi.org/10.5505/agri.2015.77699

    Article  Google Scholar 

  • Main CJ, Foster N, Buchbinder R (2010) How important are back pain beliefs and expectations for satisfactory recovery from back pain? Best Pract Res Clin Rheumatol 24(2):205–217

    Article  Google Scholar 

  • Malanga GA, Yan N, Stark J (2015) Mechanisms and efficacy of heat and cold therapies for musculoskeletal injury. Postgrad Med 127(1):57–65

    Article  Google Scholar 

  • Masiero S, Litwocenko S, Agostini F, On behalf section of Rehabilitation in Environmental Thermal for Italian Society of Physical Medicine and Rehabilitation (2020) Rehabilitation in an Italian thermal setting: a new therapeutic strategy for patients with musculoskeletal disability-the results of an Italian survey. Int J Biometeorol 64(6):951–954. https://doi.org/10.1007/s00484-019-01765-3

    Article  Google Scholar 

  • Misra DP, Zimba O, Gasparyan AY (2021) Statistical data presentation: a primer for rheumatology researchers. Rheumatol Int 41:43–55. https://doi.org/10.1007/s00296-020-04740-z

    Article  Google Scholar 

  • Morer C, Roques FC, Françon A, Forestier R, Maraver F (2017) The role of mineral elements and other chemical compounds used in balneology: data from double-blind randomized clinical trials. Int J Biometeorol 61(12):2159–2173

    Article  Google Scholar 

  • 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(5):559–565

    Article  Google Scholar 

  • Özay P, Karagülle M, Kardeş S, Karagülle MZ (2020) Chemical and mineralogical characteristics of peloids in Turkey. Environ Monit Assess 192:805. https://doi.org/10.1007/s10661-020-08777-2

    Article  CAS  Google Scholar 

  • Özkuk K, Gürdal H, Karagülle M, Barut Y, Eröksüz R, Karagülle MZ (2017) Balneological outpatient treatment for patients with knee osteoarthritis: an effective non-drug therapy option in daily routine? Int J Biometeorol 61(4):719–728

    Article  Google Scholar 

  • Price DD, McGrath PA, Rafii A, Buckingham B (1983) The validation of visual analogue scales as ratio scale measures for chronic and experimental pain. Pain 17:45–56

    Article  Google Scholar 

  • Russo M, Deckers K, Eldabe S, Kiesel K, Gilligan C, Vieceli J, Crosby P (2018) Muscle control and non-specific chronic low back pain. Neuromodulation 21:1–9

    Article  Google Scholar 

  • Searle A, Spink M, Ho A, Chuter V (2015) Exercise interventions for the treatment of chronic low back pain: a systematic review and meta-analysis of randomised controlled trial. Clin Rehabil 29(12):1155–1167

    Article  Google Scholar 

  • Şen U, Karagülle MZ, Karagülle M, Erkorkmaz Ü (2008) The efficacy of peloidotherapy on the patients with chronic low back pain. Türk Klinikleri J Med Sci 28(1):5–11

    Google Scholar 

  • Tenti S, Manica P, Cheleshi S, Fiorovanti A (2020) Sulfurous-arsenical-ferruginous balneotherapy for osteoarthritis of the hand: results from a retrospective observational study. Int J Biometeorol 64(9):1561–1569

    Article  Google Scholar 

  • Van Middelkoop M, Rubinstein SM, Kuijpers T, Verhagen AP, Ostelo R, Koes BW, van Tulder MW (2011) A systematic review on the effectiveness of physical and rehabilitation interventions for chronic non-specific low back pain. Eur Spine J 20(1):19–39

    Article  Google Scholar 

  • Van Middelkoop M, Rubinstein SM, Verhagen AP, Ostelo RW, Koes BW, van Tulder MW (2010) Exercise therapy for chronic nonspecific low-back pain. Best Pract Res Clin Rheumatol 24(2):193–204

    Article  Google Scholar 

  • Vanti C, Andreatta S, Borghi S, Guccione AA, Pillastrini P, Bertozzi L (2019) The effectiveness of walking versus exercise on pain and function in chronic low back pain: a systematic review and meta-analysis of randomized trials. Disabil Rehabil 41(6):622–632. https://doi.org/10.1080/09638288.2017.1410730

    Article  Google Scholar 

  • Varzaityte L, Kubilius R, Rapoliene L, Bartuseviciute R, Balcius A, Ramanauskas K, Nedzelskiene I (2020) The effect of balneotherapy and peloid therapy on changes in the functional state of patients with knee joint osteoarthritis: a randomized, controlled, single-blind pilot study. Int J Biometeorol 64(6):955–964. https://doi.org/10.1007/s00484-019-01785-z

    Article  Google Scholar 

  • Wang X, Ji X (2020) Sample size estimation in clinical research: from randomized controlled trials to observational studies. Chest 158(1S):S12–S20. https://doi.org/10.1016/j.chest.2020.03.010

    Article  Google Scholar 

  • Will JS, Bury DC, Miller JA (2018) Mechanical low back pain. Am Fam Physician 98(7):421–428

    Google Scholar 

  • Yakut E, Düger T, Öksüz C, Yörükan S, Ureten K, Turan D et al (2004) Validation of the Turkish version of the Oswestry disability index for patients with low back. Spine 29(5):581–585

    Article  Google Scholar 

  • Yücesoy H, Geçmen İ, Adıgüzel T, Karagülle M, Karagülle MZ (2019) Efficacy of balneological outpatient treatment (hydrotherapy and peloidotherapy) for the management of chronic low back pain: a retrospective study. Int J Biometeorol 63(3):351–357

    Article  Google Scholar 

  • Yücesoy H, Dönmez A, Atmaca-Aydın E, Yentür SP, Saruhan-Direskeneli G, Ankaralı H, Erdoğan N, Karagülle MZ (2021) Effects of balneological outpatient treatment on clinical parameters and serum cytokine levels in patients with chronic low back pain: a single-blind randomized controlled trial. Int J Biometeorol. https://doi.org/10.1007/s00484-021-02109-w

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Authors and Affiliations

  1. Department of Medical Ecology and Hydroclimatology, Gülhane Faculty of Medicine, University of Health Sciences, Ankara, Turkey

    Fatih Karaarslan

  2. Department of Physical Medicine and Rehabilitation, Konya Training and Research Hospital, University of Health Sciences, Konya, Turkey

    Halim Yılmaz, Halil Ekrem Akkurt & Süleyman Gül

  3. Department of Medical Ecology and Hydroclimatology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey

    Sinan Kardeş

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  1. Fatih Karaarslan
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  2. Halim Yılmaz
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  4. Süleyman Gül
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Correspondence to Fatih Karaarslan.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee (ethics committee decision number: 2017/365) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Karaarslan, F., Yılmaz, H., Akkurt, H.E. et al. Effectiveness of peloid therapy in patients with chronic low back pain: a single-blind controlled study. Int J Biometeorol 65, 1799–1809 (2021). https://doi.org/10.1007/s00484-021-02137-6

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  • DOI: https://doi.org/10.1007/s00484-021-02137-6

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