Five Top Uses for Mud Therapy

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For thousands of years, people all over the world have believed in the healing powers of mud and natural hot springs. Isn't it time you consider the use of mud therapies to soothe your own aches and pains?

Spas often offer specialized mud or warm mineral spring water therapies for pain and inflammation. Mud therapy can include mud packs or balneotherapies, which use warm -- about 100-degree Fahrenheit -- mineral-rich water or mud. With mud or minerals, you can immerse your whole body, soak a body part -- a hand or foot -- or pack mud around a part that's harder to soak, like a knee.

Mud and spring waters contain minerals that are useful for pain management and can successfully treat diseases from knee, hand, hip and spine osteoarthritis, chronic lower back pain and rheumatoid arthritis to degenerative inflammatory diseases like fibromyalgia, psoriatic arthritis, spondylitis and lupus to psoriasis.

Sea mud from a tidal pond in South Korea was analyzed and scientists found mud contained more than 19 different mineral components including sodium, magnesium and zinc, explaining its anti-inflammatory effects.[i]

1. Knee Osteoarthritis

Osteoarthritis (OA) is one of the most common musculoskeletal diseases in the world and results from inflammatory and degenerative processes affecting the entire joint. Knee osteoarthritis (KOA) presents in 13% of women and 10% of men aged 60 years or older.[ii]

In a meta-analysis on the efficacy of mud therapy in the treatment of KOA, 11 articles including 1,106 patients were reviewed and mud treatments led to significant improvements in visual pain scores and knee pain, stiffness and function ratings.[iii]

Researchers systematically reviewed and reevaluated the results of 12 studies. They confirmed that mud-pack therapy, balneotherapy -- bathing in mineral springs or mud -- and spa therapy are effective in the treatment and prevention of knee osteoarthritis.

These therapies markedly reduced pain, nonsteroidal anti-inflammatory drug (NSAID) consumption and functional limitations and improved quality of life of affected patients.[iv]

In a study of 53 patients with knee osteoarthritis, one group received hot mud-pack therapy, whereas the other (control) group was treated with hot packs of other substances 10 times during a two-week period.

The quality-of-life scores improved from the baseline to the end of treatment in both groups, but the need for medications for knee joint pain improved significantly only in the mud-treated group.[v]

In a systematic review of 14 trials, evidence shows that balneotherapy and spa therapy significantly improved quality of life measures for patients with KOA, reduced their drug consumption and improved all functional indexes.[vi]

In a study of 283 knee osteoarthritis patients, participants were either given a standard spa therapy -- standardized spa treatment, six days a week for three weeks -- or a spa-rehab therapy -- spa sessions three days a week for three weeks, followed by a rehabilitation program, three days a week for three weeks. Spa-rehab therapy was more effective for KOA patients.[vii]

In 120 KOA patients randomly assigned to an experimental group – three weeks of balneotherapy consisting of daily whirlpool baths, hydrokinesitherapy sessions and knee shower/massages -- or a control group treated with their usual analgesia medication. Out of 60 patients in the experimental group, 45 were found to benefit from the treatment intervention in terms of pain relief, clinically relevant improvement in symptoms and quality of life, which persisted three months after treatment.[viii]

Sixty KOA individuals were divided into two groups – three weeks of spa therapy or two weeks of spa therapy. Spa therapy had positive effects on pain, physical activity and quality of life in all KOA patients, but the three weeks of spa therapy had even stronger effects on pain compared to the two weeks group.[ix]

A meta-analysis of 34 trials documenting spa treatments -- hot mineral water baths, mud therapy, hot showers, massages and supervised water exercises -- conducted across Europe and the Middle East found these treatments to be highly effective for pain and function in KOA patients from three to nine months after their treatment.[x]

In a treatment trial of 103 patients with KOA, half were randomly assigned to receive a cycle of mud-bath therapy with standard treatment over a period of two weeks and the other half just continued their standard treatment alone.

The researchers concluded that mud-bath therapy added to the usual treatment for KOA had a beneficial effect on pain and function in KOA patients and significantly increased the biomarker of C-terminal cross-linked telopeptide type II collagen called CTX-II, which explains the increase of cartilage turnover.[xi]

2. Hand, Hip and Spine Osteoarthritis

Although osteoarthritis can damage any joint, the disorder most commonly affects joints in your hands, knees, hips and spine. Over a million people are affected by this disease throughout the world.[xii]

Thirty-one patients with knee and/or hip OA of both sexes were included in the study and 31 healthy patients were the controls. All OA and healthy patients received mud pack and sulfur baths for 20 minutes a day, for six consecutive days a week, over three weeks.

The treatment by sulfur bath and mud packs led to a significant decrease of lipid peroxidation in plasma, as well as pain intensity in OA patients compared to controls. These changes were associated with changes in plasma activity and a significant increase of hemoglobin level.[xiii]

In a controlled study of 60 hand OA patients, one group of 30 was treated with 12 daily local mud packs and generalized thermal mineral baths with a sulfate-calcium-magnesium-fluoride mix. The control group of 30 continued a regular outpatient care routine -- exercise, NSAIDs and/or analgesics.

Mud and mineral hot bath therapy showed significant improvement in all the assessed parameters, regarding pain, function, quality of life and symptomatic drug consumption in hand OA patients and results lasted over six months.[xiv]

Thirty-one individuals with chronic nonspecific lower back pain were randomly allocated to either the intervention group, which was treated with a mud pack for 30 minutes and performed a core-exercise program for 50 minutes twice a day for four days, or a control group, which only did the core-exercise program. There were significant improvements in pain intensity, motor function, static balance and dynamic balance using mud therapy with core exercise for those with chronic lower back pain.[xv]

3. Rheumatoid Arthritis

There are over 100 rheumatic disorders with different underlying causes, different treatments and different outcomes. These conditions can be broadly divided into non-inflammatory diseases, of which osteoarthritis is the most important, and inflammatory conditions such as rheumatoid arthritis (RA), ankylosing spondylitis and systemic lupus erythematosus.[xvi]

Forty-five patients suffering from hand RA were studied, with 22 treated with true mud compresses (treatment group) and 23 given fake mud compresses (control group). The compresses were applied in the patients' homes five times a week during a three-week period with four follow-ups.

Treatment with true mud compresses significantly relieved pain affecting the hands and reduced the number of swollen and tender joints in the hands of patients suffering from RA as compared to the controls at the end of treatment and three months later.[xvii]

The effect of Brazilian black mud in preventing articular damage in rats induced with chronic arthritis was studied. Mud was applied daily (40 degrees Centigrade or 104 degrees Fahrenheit for 30 minutes) during the arthritis treatment and was compared with warm water and no treatment groups.

Mud treatment lowered leukocyte migration into the synovial membrane and articular cavity when compared with both control groups. An increase in collagen, the number of chondrocytes and more conserved tissue structure in the cartilage was observed in mud-treated animals.[xviii]

4. Inflammatory Degenerative Diseases

Fibromyalgia -- an inflammatory condition that causes pain all over the body -- affects about 4 million adults in the U.S., or 2% of the adult population. Fibromyalgia often co-occurs with other types of arthritis such as osteoarthritis, rheumatoid arthritis, systemic lupus erythematosus and ankylosing spondylitis.[xix]

Forty-one fibromyalgia (FM) patients -- 39 females, two males -- were studied with 21 patients receiving mud-bath treatment, while the other 20 received balneotherapy -- mineral water and thermal baths. Pain, symptoms and quality of life were improved in all patients treated with either mud-bath or balneotherapy, but the mud-bath treatment gave longer lasting results.[xx]

In a crossover clinical trial, 40 fibromyalgia patients were given either thermal baths – 14 hot mineral baths and drug treatment -- or as a control group only the drug treatment and after a washout period of three months, the group treatments were switched. Simple baths with medicinal mineral water made an improvement on the impact of fibromyalgia in both groups.[xxi]

A study including 41 patients with inflammatory rheumatic diseases (33 with rheumatoid arthritis and eight with ankylosing spondylitis) and 40 patients with degenerative diseases such as gonarthritis (knee inflammation) or coxarthritis (hip deterioration) subdivided patients into two groups. One received nine mud baths for 21 days in addition to a physical rehabilitative treatment while the control group only got the physical rehabilitative treatment.

In the mud bath group, there was a significant improvement in the functional parameters and a significant reduction in pain strength for both inflammatory rheumatic and degenerative diseases and increased osteoprotective and chondroprotective -- stops progressive narrowing of joint space -- effects at the molecular level as well.[xxii]

In a study of 33 patients with gonarthrosis -- a degenerative inflammatory disease of the knee joint -- the participants were divided into three groups. The group that used a two-week regime of mineral water baths and hot native mineral mud packs had the most significant improvements in knee pain and night pain and lowered drug consumption compared to the groups that only had one of the treatments.[xxiii]

In a review of 19 studies of rheumatic inflammatory diseases including fibromyalgia, ankylosing spondylitis, rheumatoid arthritis, chronic lower back pain, knee osteoarthritis and hand osteoarthritis, 16 trials indicated a persistent improvement for at least 12 weeks, in pain, analgesic and NSAID consumption, functional capacity and quality of life from spa therapies including hot-water mineral and mud baths.[xxiv]

In a clinical trial of 24 patients with spondylitis and Crohn's disease or ulcerative colitis, half were given spa mud-bath treatments -- 12 mud packs and 12 thermal baths over a period of two weeks -- and 12 were enrolled as controls with no spa treatments. A significant reduction of clinical evaluation indices of spondylitis was observed at the end of the spa mud-bath treatments. Patients with spondylitis associated with inflammatory bowel disease tolerated the treatments well and many saw improvement in spinal symptoms and function for several months.[xxv]

A total of 42 patients with psoriatic arthritis were treated at the Dead Sea for four weeks. Patients were randomly allocated into group 1 (23 patients) and group 2 (19 patients). Both groups were exposed daily to sunbathing and regular bathing at the Dead Sea. Group 1 was also treated with mud packs and sulfur baths.

Both groups had similarly statistically significant improvement for psoriasis area and severity index, morning stiffness, patient self-assessment, right and left grip, and distance from finger to floor when bending forward. For variables such as tender and swollen joints, and inflammatory neck and back pain, improvement over time was statistically more significant in the mud packs and sulfur bath therapy group.[xxvi]

5. Psoriasis

Psoriasis is a chronic disease caused by a problematic immune system, where T-cells or white blood cells attack the body's skin cells.[xxvii] Thirty psoriasis subjects -- 19 males and 11 females with an average age of 56 years -- were divided into those treated with psoriasis drugs or those treated with mud-bath therapy with water containing a chlorinate-sulphureous-bicarbonate mineral mix, both for 12 consecutive days.

The mud therapy was found to be as effective as anti-psoriasis drugs in improving psoriasis symptoms and quality of life.[xxviii]

Mud Baths or Packs as Therapeutic

Research has shown the efficacies of using mud baths with hot mineral water or mud packs as treatments for a variety of diseases and conditions that are associated with inflammation and/or persistent pain. If you would like to review more scientific evidence, please see's database on mud therapy, spa bathingbalneotherapies and chronic pain.


[i] Jung-Hyun Kim, Jongsma Lee, Hyang-Bok Lee, Jeons Hyun Shin, Eun-Ki Kim. Water-retentive and anti-inflammatory properties of organic and inorganic substances from Korean sea mud. Nat Prod Commun. 2010 Mar;5(3):395-8. PMID: 20420315

[ii] McMillan G, Nichols L. Osteoarthritis and meniscus disorders of the knee as occupational diseases of miners. Occup Environ Med. 2005 Aug;62(8):567-75. doi: 10.1136/oem.2004.017137. PMID: 16046610; PMCID: PMC1741064.

[iii] Chengzhi Hou, Long Liang, Xuelei Chu, Weikai Qin, Yongyao Li, Yong Zhao. The short-term efficacy of mud therapy for knee osteoarthritis: A meta-analysis. Medicine (Baltimore). 2020 Apr ;99(17):e19761. PMID: 32332614

[iv] Antonio Fraioli, Gioacchino Mennuni, Mario Fontana, Silvia Nocchi, Fulvia Ceccarelli, Carlo Perricone, Angelo Serio. Efficacy of Spa Therapy, Mud-Pack Therapy, Balneotherapy, and Mud-Bath Therapy in the Management of Knee Osteoarthritis. A Systematic Review. Biomed Res Int. 2018 ;2018:1042576. Epub 2018 Jun 25. doi: 10.1155/2018/1042576, PMID: 30046586

[v] Ildikó Katalin Tefner, Ramóna Gaál, András Koroknai, Adél Ráthonyi, Tamás Gáti, Péter Monduk, Edit Kiss, Csaba Kovács, Géza Bálint, Tamás Bender. The effect of Neydharting mud-pack therapy on knee osteoarthritis: a randomized, controlled, double-blind follow-up pilot study. Rheumatol Int. 2013 Oct ;33(10):2569-76. Epub 2013 May 21. PMID: 23689969

[vi] Michele Antonelli, Davide Donelli, Antonella Fioravanti. Effects of balneotherapy and spa therapy on quality of life of patients with knee osteoarthritis: a systematic review and meta-analysis. Rheumatol Int. 2018 Oct ;38(10):1807-1824. Epub 2018 Jun 12. PMID: 29947999

[vii] Anne-Christine Rat, Damien Loeuille, Amandine Vallata, Lorraine Bernard, Emmanuel Spitz, Alexandra Desvignes, Michel Boulange, Jean Paysant, Francis Guillemin, Isabelle Chary-Valckenaere. Spa therapy with physical rehabilitation is an alternative to usual spa therapy protocol in symptomatic knee osteoarthritis. Sci Rep. 2020 Jul 3 ;10(1):11004. Epub 2020 Jul 3. PMID: 32620866

[viii] Pedro Cantista, Francisco Maraver. Balneotherapy for knee osteoarthritis in S. Jorge: a randomized controlled trial. Int J Biometeorol. 2020 Jun ;64(6):1027-1038. Epub 2020 Apr 18. PMID: 32306085

[ix] Kağan Özkuk, Bilal Uysal. Is the Duration of Spa Cure Treatment Important in Knee Osteoarthritis? A Randomized Controlled Study. Complement Med Res. 2019 ;26(4):258-264. Epub 2019 Mar 27. PMID: 30921795

[x] Romain Forestier, Fatma Begüm Erol Forestier, Alain Francon. Spa therapy and knee osteoarthritis: A systematic review. Ann Phys Rehabil Med. 2016 Jun ;59(3):216-226. Epub 2016 Mar 17. PMID: 26996955

[xi] Nicola A Pascarelli, Sara Cheleschi, Giovanni Bacaro, Giacomo M Guidelli, Mauro Galeazzi, Antonella Fioravanti. Effect of Mud-Bath Therapy on Serum Biomarkers in Patients with Knee Osteoarthritis: Results from a Randomized Controlled Trial. Isr Med Assoc J. 2016 Mar-Apr;18(3-4):232-7. PMID: 27228651

[xii] Mayo Clinic, Diseases-Conditions, Osteoarthritis, Symptoms and Causes

[xiii] Aleksandar Jokić, Nikola Sremcević, Zeki Karagülle, Tatjana Pekmezović, Vukosava Davidović. Oxidative stress, hemoglobin content, superoxide dismutase and catalase activity influenced by sulphur baths and mud packs in patients with osteoarthritis. Vojnosanit Pregl. 2010 Jul;67(7):573-8. PMID: 20707053

[xiv] Antonella Fioravanti, Sara Tenti, Chiara Giannitti, Nicola Angelo Fortunati, Mauro Galeazzi. Short- and long-term effects of mud-bath treatment on hand osteoarthritis: a randomized clinical trial. Int J Biometeorol. 2014 Jan ;58(1):79-86. Epub 2013 Jan 14. PMID: 23314489

[xv] Suk-Chan Hahm, Ho-Jin Shin, Min-Goo Lee, Sung Jae Lee, Hwi-Young Cho. Mud Therapy Combined with Core Exercise for Chronic Nonspecific Low Back Pain: A Pilot, Single-Blind, Randomized Controlled Trial. Evid Based Complement Alternat Med. 2020 ;2020:7547452. Epub 2020 Apr 3. PMID: 32328139

[xvi] Clinical, Chapter 32: Biochemistry of Articular Disorders,

[xvii] Shlomi Codish, Mahmoud Abu-Shakra, Daniel Flusser, Michael Friger, Shaul Sukenik. Mud compress therapy for the hands of patients with rheumatoid arthritis. Biologics. 2008 Mar;2(1):143-9. PMID: 14618372

[xviii] Zélia Maria Nogueira Britschka, Walcy Rosolia Teodoro, Ana Paula Pereira Velosa, Suzana Beatriz Veríssimo de Mello. The efficacy of Brazilian black mud treatment in chronic experimental arthritis. Rheumatol Int. 2007 Nov;28(1):39-45. Epub 2007 Jun 12. PMID: 17562044

[xix] CDC, Arthritis, Basics, Fibromyalgia,

[xx] Laura Bazzichi, Ylenia Da Valle, Alessandra Rossi, Camillo Giacomelli, Francesca Sernissi, Gino Giannaccini, Laura Betti, Federica Ciregia, Laura Giusti, Pietro Scarpellini, Liliana Dell'Osso, Donatella Marazziti, Stefano Bombardieri, Antonio Lucacchini. A multidisciplinary approach to study the effects of balneotherapy and mud-bath therapy treatments on fibromyalgia. Clin Exp Rheumatol. 2013 Nov-Dec;31(6 Suppl 79):S111-20. Epub 2013 Dec 18. PMID: 24373369

[xxi] María Reyes Pérez-Fernández, Natalia Calvo-Ayuso, Cristina Martínez-Reglero, Ángel Salgado-Barreira, José Luis Muiño López-Álvarez. Efficacy of baths with mineral-medicinal water in patients with fibromyalgia: a randomized clinical trial. Int J Biometeorol. 2019 Sep ;63(9):1161-1170. Epub 2019 Jun 3. PMID: 31161236

[xxii] G Dischereit, J-E Goronzy, U Müller-Ladner, S Fetaj, U Lange. Effects of serial mud baths on inflammatory rheumatic and degenerative diseases. Z Rheumatol. 2019 Mar ;78(2):143-154., doi: 10.1007/s00393-018-0582-7, PMID: 30627845.

[xxiii] I Wigler, O Elkayam, D Paran, M Yaron. Spa therapy for gonarthrosis: a prospective study. Rheumatol Int. 1995;15(2):65-8. PMID: 7481482

[xxv] Franco Cozzi, Marta Podswiadek, Gabriella Cardinale, Francesca Oliviero, Lara Dani, Paolo Sfriso, Leonardo Punzi. Mud-bath treatment in spondylitis associated with inflammatory bowel disease--a pilot randomised clinical trial. Joint Bone Spine. 2007 Oct;74(5):436-9. Epub 2007 May 30. PMID: 17590368

[xxvi] O Elkayam, J Ophir, S Brener, D Paran, I Wigler, D Efron, Z Even-Paz, Y Politi, M Yaron. Immediate and delayed effects of treatment at the Dead Sea in patients with psoriatic arthritis. Rheumatol Int. 2000;19(3):77-82. PMID: 10776684

[xxvii] American Academy of Dermatology –, Public, Diseases, Psoriasis, What, Causes,

[xxviii] M Costantino, E Lampa. Psoriasis and mud bath therapy: clinical-experimental study. Clin Ter. 2005 Jul-Aug;156(4):145-9. PMID: 16342515.

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