Could hot mud treatments and sodium chloride mineral baths relieve the symptoms of osteoarthritis? A small scale pilot study, although limited in scope, concludes that they are worth further investigation.

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A new study examines the therapeutic benefits of mud.

Osteoarthritis (OA) is a degenerative joint condition that causes pain and stiffness in the joints.

OA can affect most joints but is more common in those of the knees, hips, and hands.

In the United States, knee OA affects 10% of men and 13% of women aged 60 or older; this makes OA the most common joint disorder in the U.S.

Currently, doctors recommend combination therapy, which includes pain medication and non-pharmaceutical interventions, such as physiotherapy.

The aim is to relieve pain, slow the progress of OA, and help people compensate for any loss of movement.

Because OA is so prevalent and there is still no cure, scientists are keen to find cost effective, drug free ways of relieving symptoms.

Recently, a group of researchers in Lithuania decided to investigate two less well known interventions: peloid therapy and balneotherapy. They published their findings in the International Journal of Biometeorology.

Peloid therapy and balneotherapy

Peloid therapy is the use of clay or mud to treat ailments. Balneotherapy is a traditional treatment that involves immersing the body in mineral water or mud that is rich in minerals.

For their study, the researchers recruited 92 participants with an average age of 64.6 years, and females represented 87% of the group. All individuals had grade 1–3 knee joint OA according to the Kellgren-Lawrence (KL) grading system.

The KL grading system runs from 1, the least severe, to 5, the most severe.

All three groups received standard physical therapy, which involved 30-minute sessions, carried out every other day for 1 month.


Alongside physical therapy, group 1 received peat mud applications on the waist and leg areas. The temperature of the mud was 36–42°C (97–108°F). The procedures lasted 20 minutes, and they took place every other day for the monthlong treatment period.

Group 2 received physical therapy plus 15-minute sodium chloride (salt) bath treatments. The temperature of the water was 36–38°C (97–100°F). Group 3 participants acted as controls; they only received physical therapy.

The researchers assessed a range of physical measures at the beginning and end of the study and 1 month after the interventions had ended.

These anthropometric measures included walking speed, range of motion, and how quickly the participants could sit down and stand up five times.

Significant benefits

Immediately after the intervention and 1 month later, the authors found that groups 1 and 2 fared significantly better, across almost all of the physical measures. The team concludes:

"Anthropometric data significantly improved, pain intensity and joint stiffness decreased, [and] physical activity increased, compared to the control group."

Each participant also completed a standardized questionnaire designed to convey how their OA impacts their life. Again, the treatment appeared to help. The authors write:

"After treatment and [...] 1 month after treatment, average percentages of symptoms, stiffness, and pain of the intervention groups [...] were significantly better than those of the control group."

Limitations, shortfalls, and hope

It is important to emphasize that the study included fewer than 100 participants and ran for only a few weeks; so, before we can conclude that these types of interventions offer benefits, scientists will need to carry out longer studies with more participants.

Some might argue that any measured benefits were not due to the minerals in the mud or water. Instead, it could have been the warmth of the mud or water on the joint, or simply the opportunity to relax for an extra 15–20 minutes every other day.

Another issue, as outlined by the authors, is that the participants had KL grades of 1–3; this means that the findings might not apply to individuals with more severe OA, with KL grades of 4 or 5.

Similarly, most of the participants were women and, therefore, the results might not be transferable to men.

To date, little high quality research has investigated these types of therapeutic techniques. However, some studies have found benefits from certain types of balneotherapy on osteoarthritis.

It must be stressed that available studies have included only small numbers of participants and run for relatively short periods.

Although these interventions have been used for centuries, there is still not adequate evidence to support their use in the treatment of OA. That said, the interventions are cost effective and unlikely to cause side effects when carried out appropriately, so further investigation is warranted.