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. doi: 10.1007/s00484-012-0627-6. Epub 2013 Jan 14.


The aim of this study was to evaluate both the short-term and the long-term effectiveness of spa therapy in patients with primary hand osteoarthritis (OA). This was a prospective randomized, single blind controlled trial. Sixty outpatients with primary bilateral hand OA were included in the study and randomized to one of two groups. One group (n = 30) was treated with 12 daily local mud packs and generalized thermal baths with a sulfate-calcium-magnesium-fluorides mineral water added to usual treatment. The control group (n = 30) continued regular outpatient care routine (exercise, NSAIDs and/or analgesics). Each patient was examined at baseline, after 2 weeks, and after 3, 6, 9 and 12 months. Primary outcome measures were global spontaneous hand pain on a visual analogue scale (VAS) and the functional index for hand osteoarthritis (FIHOA) score; secondary outcomes were health assessment questionnaire (HAQ), duration of morning stiffness, medical outcomes study 36-item short form (SF-36) and symptomatic drugs consumption. Our results demonstrated that the efficacy of spa therapy was significant in all the assessed parameters, both at the end of therapy and after 3 months; the values of FIHOA, HAQ and drugs consumption continued to be significantly better after 6 months in comparison with baseline. There were no significant modifications of the parameters throughout the follow-up in the control group. Differences between the two groups were significant for all parameters at the 15th day and at 3 months follow-up; regarding FIHOA, HAQ, and symptomatic drugs consumption, the difference between the two groups persisted and was significant at 6month follow-up. Tolerability of spa therapy seemed to be good. In conclusion, our results confirm that the beneficial effects of spa therapy in patients with hand OA last over time.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Aged
  • Baths
  • Calcium / therapeutic use
  • Female
  • Fluorides / therapeutic use
  • Hand
  • Humans
  • Magnesium / therapeutic use
  • Male
  • Middle Aged
  • Mineral Waters / therapeutic use*
  • Mud Therapy*
  • Osteoarthritis / therapy*
  • Single-Blind Method
  • Sulfates / therapeutic use
  • Treatment Outcome


  • Mineral Waters
  • Sulfates
  • Magnesium
  • Fluorides
  • Calcium