A meta-analysis of the effectiveness of mud-bath therapy on knee osteoarthritis
V. 172 N. 4 (2021), Systematic review
V. 172 N. 4 (2021)

A meta-analysis of the effectiveness of mud-bath therapy on knee osteoarthritis: doi: 10.7417/CT.2021.2343

Systematic review
Pubblicato 2021-07-11
G. Mennuni
UOC Internal Medicine, Medical Therapy and Thermal Medicine - Specialization School in Thermal Medicine, Department of Clinical Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, Umberto I Polyclinic University Hospital, Rome
M. Fontana
UOC Internal Medicine, Medical Therapy and Thermal Medicine - Specialization School in Thermal Medicine, Department of Clinical Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, Umberto I Polyclinic University Hospital, Rome
C. Perricone
Rheumatology Section - Department of Medicine, University of Perugia
S. Nocchi
UOC Internal Medicine, Medical Therapy and Thermal Medicine - Specialization School in Thermal Medicine, Department of Clinical Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, Umberto I Polyclinic University Hospital, Rome
R. Rosso
UOC Internal Medicine, Medical Therapy and Thermal Medicine - Specialization School in Thermal Medicine, Department of Clinical Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, Umberto I Polyclinic University Hospital, Rome
F. Ceccarelli
UOC Rheumatology - Department of Clinical Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, Policlinico Umberto I University Hospital, Rome, Italy
A. Fraioli
UOC Rheumatology - Department of Clinical Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, Policlinico Umberto I University Hospital, Rome, Italy
PDF

Parole chiave

knee osteoarthritis
meta-analysis
mineral waters
mud-bath therapy
osteoarthritis
spa-therapy

Abstract

Objective

OA results from loss of cartilage integrity in association with changes to the structure of the entire joint. Treatment of OA is based on different pharmaceutical and no pharmaceutical approaches and the latter include the use of SPA-therapy. The biological effects of mud-bath therapy are mainly secondary to heat stimulation and to physic-chemical properties of mineral waters and mud-packs. Mud-bath therapy likely exerts its effects modulating several cytokines and other molecules involved in inflammation and cartilage degradation. Our aim was to perform an updated meta-analysis of the effectiveness of the mud-bath therapy on knee osteoarthritis and briefly to discuss the mechanisms of action of Spa-therapy.

Materials and Methods    

A MEDLINE on Pub Med for articles on knee OA and spa therapy published from 1995 through up to April 2019 was performed. Then, we checked the Cochrane Central Register of Controlled Trials to find additional references included up to April 2019. Articles were included if in accordance with the eligibility criteria. Sample size and effect sizes were processed with the MedCalc software package.

Results

Twenty one studies met the inclusion criteria and were included in meta-analysis. We examined Index WOMAC and VAS pain. We found significant improvements in function scores and painful symptoms  after mud-bath therapy in patients with knee joint osteoarthritis.

Conclusions

SPA therapy is a non-drug treatment modalities, non invasive, complication-free, and cost-effective alternative modality for the conservative treatment of knee osteoarthritis. It cannot substitute for conventional therapy but can integrated or alternated to it. Treatment with mud-bath therapy may relieve pain, stiffness and improve functional status in patients with knee OA.

PDF