Skip to main content
SpringerLink
Log in

Mud-bath treatment of seronegative spondyloarthritis: experience at the Euganean Thermal Area

  • Special Issue: Balneology
  • Published:
International Journal of Biometeorology Aims and scope Submit manuscript

Abstract

Mud-bath therapy (MBT) has been used as a treatment for rheumatic diseases and musculoskeletal complaints in the Euganean Thermal Area (near Padova, Italy) since ancient time. There is no consensus about the use of MBT in patients with inflammatory rheumatic diseases, although experimental studies have suggested a beneficial effect of MBT on chronic articular inflammation. To evaluate the effects of MBT in patients affected by seronegative spondyloarthritis, very common chronic inflammatory rheumatic diseases, randomized controlled trials (RCT) performed in the Euganean Thermal Area have been reviewed. A significant improvement of spondylitis parameters was observed in enteropathic spondylitis, without bowel symptom exacerbation. A long-term amelioration of clinical evaluation indices was found in ankylosing spondylitis. A significant improvement of cutaneous lesions, arthritis activity, and patient’s functional ability was observed in psoriatic arthritis. MBT was usually well tolerated and adverse side effects were rarely reported. The review of the RCT suggests that MBT may exert additional beneficial effects in patients with seronegative spondyloarthritis treated with pharmacological therapy.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  • Altan L, Bingol U, Aslan M, Yurtkuran M (2006) The effect of balneotherapy on patients with ankylosing spondylitis. Scand J Rheumatol 35:283–289

    Article  CAS  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 59:1905–1911

    Article  Google Scholar 

  • Bellometti S, Poletto M, Gregotti C, Richelmi P, Bertè F (2000) Mud bath therapy influences nitric oxide, myeloperoxidase and glutathione peroxidase serum levels in arthritic patients. Int J Clin Pharmacol Res 20:69–80

    CAS  Google Scholar 

  • Berczi I, Chalmers IM, Nagy E, Warrington RJ (1996) The immune effects of neuropeptides. Baillieres Clin Rheumatol 10:227–257

    Article  CAS  Google Scholar 

  • Britschka ZMN, Teodoro WR, Velosa APP, de Mello SBV (2007) The effect of Brazilian black mud treatment in chronic experimental arthritis. Rheumatol Int 28:39–45

    Article  Google Scholar 

  • Cima L, Giusti P, Tinello A, Cozzi F, Menozzi L, Todesco S (1992) Risposte neuroendocrine all'applicazione di fanghi di diversa maturazione del Bacino Termale Euganeo. Clin Term 45:77–81

    Google Scholar 

  • Ciprian L, Lo Nigro A, Rizzo M, Gava A, Ramonda R, Punzi L, Cozzi F (2013) The effects of Spa therapy and rehabilitation on patients with ankylosing spondylitis being treated with TNF inhibitors. Rheumatol Int 33:241–245

    Article  Google Scholar 

  • Cozzi F, Punzi L (2006) Il trattamento con la fango-balneoterapia delle artriti croniche. Reumatismo 58:123–126

    Google Scholar 

  • Cozzi F, Todesco S (1992) Il Termalismo Euganeo verso il suo quarto millennio. Clin Ter 45:3–7

    Google Scholar 

  • Cozzi F, Lazzarin P, Todesco S, Cima L (1995) Hypothalamic-pituitary-adrenal axis dysregulation in healthy subjects undergoing mud-bath applications. Arthritis Rheum 38:724–725

    Article  CAS  Google Scholar 

  • Cozzi F, Carrara M, Sfriso P, Todesco S, Cima L (2004) Anti-inflammatory effect of mud-bath applications on adjuvant arthritis in rats. Clin Exp Rheumatol 22:763–766

    CAS  Google Scholar 

  • Cozzi F, Podswiadek M, Cardinale G, Oliviero F, Dani L, Sfriso P, Punzi L (2007) Mud-bath treatment in spondylitis associated with inflammatory bowel disease – a pilot randomised clinical trial. Joint Bone Spine 74:436–439

    Article  Google Scholar 

  • Cozzi F, Raffeiner B, Beltrame V, Ciprian L, Coran A, Botsios C, Perissinotto E, Grisan E, Ramonda R, Oliviero F, Stramare R, Punzi L (2015) Effects of mud-bath therapy in psoriatic arthritis patients treated with TNF inhibitors. Clinical evaluation and assessment of synovial inflammation by contrast-enhanced ultrasound (CEUS). Joint Bone Spine 82:104–108

    Article  Google Scholar 

  • Dönmez A, Karagülle MZ, Tercan N, Dinler M, Işsever H, Karagülle M, Turan M (2005) Spa therapy in fibromyalgia: a randomised controlled clinic study. Rheumatol Int 26:168–172

    Article  Google Scholar 

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

    Article  CAS  Google Scholar 

  • Evcik D, Kavuncu V, Yeter A, Yigit I (2007) The efficacy of balneotherapy and mud-pack therapy in patients with knee osteoarthritis. Joint Bone Spine 74:60–65

    Article  Google Scholar 

  • Fioravanti A, Perpignano G, Tirri G, Cardinale G, Gianniti C, Lanza CE, Loi A, Tirri E, Sfriso P, Cozzi F (2007) Effects of mud-bath treatment on fibromyalgia patients: a randomized clinical trial. Rheumatol Int 27:1157–1161

    Article  Google Scholar 

  • Fioravanti A, Cantarini L, Guidelli GM, Galeazzi M (2011) Mechanisms of action of spa therapies in rheumatic diseases: what scientific evidence is there? Rheumatol Int 31:1–8

    Article  Google Scholar 

  • Fioravanti A, Tenti S, Giannitti C, Fortunati NA, Galeazzi M (2014) Short- and long-term effects of mud-bath treatment on hand osteoarthritis: a randomized clinical trial. Int J Biometeorol 58:79–86

    Article  Google Scholar 

  • Fioravanti A, Bacaro G, Giannitti C, Tenti S, Cheleschi S, Gui Delli GM, Pascarelli NA, Galeazzi M (2015) One-year follow-up of mud-bath therapy in patients with bilateral knee osteoarthritis: a randomized, single-blind controlled trial. Int J Biometeorol 59:1333–1343

    Article  CAS  Google Scholar 

  • Fioravanti A, Manica P, Bortolotti R, Cevenini G, Tenti S, Paolazzi G (2018) Is balneotherapy effective for fibromyalgia? Results from a 6-month double-blind randomized clinical trial. Clin Rheumatol 37:2203–2212

    Article  Google Scholar 

  • Forestier R, Desfour H, Tessier JM, Françon A, Foote AM, Genty C, Rolland C, Roques CF, Bosson JL (2010) Spa therapy in the treatment of knee osteoarthritis: a large randomized multicentre trial. Ann Rheum Dis 69:660–665

    Article  CAS  Google Scholar 

  • Forestier R, Erol-Forestier FB, Francon A (2016) Spa therapy and knee osteoarthritis: a systematic review. Ann Phys Rehabil Med 59:216–226

    Article  Google Scholar 

  • Forestier R, Erol-Forestier FB, Francon A (2017) Current role for spa therapy in rheumatology. Joint Bone Spine 84:9–13

    Article  Google Scholar 

  • Galzigna L, Moretto C, Lalli A (1996) Physical and biochemical changes of thermal mud after maturation. Biomed Pharmacother 50:306–308

    Article  CAS  Google Scholar 

  • Giusti P, Cima L, Tinello A, Cozzi F, Targa L, Lazzarin P, Todesco S (1990) Stresshormone, freigesetzt durch Fangotherapie. ACTH- und Beta-Endorphin-Konzentrationen unter Wärmestress. Fortschr Med 108:601–604

    CAS  Google Scholar 

  • Holden W, Orchard T, Wordsworth P (2003) Enteropathic arthritis. Rheum Dis Clin N Am 29:513–530

    Article  Google Scholar 

  • Karagülle M, Kardeş S, Karagülle O, Dişçi R, Avcı A, Durak İ, Karagülle MZ (2017) Effect of spa therapy with saline balneotherapy on oxidant/antioxidant status in patients with rheumatoid arthritis: a single-blind randomized controlled trial. Int J Biometeorol 61:169–180

    Article  Google Scholar 

  • Kovács C, Pecze M, Tihanyi Á, Kovács L, Balogh S, Bender T (2012) The effect of sulphurous water in patients with osteoarthritis of hand. Double-blind, randomized, controlled follow-up study. Clin Rheumatol 31:1437–1442

    Article  Google Scholar 

  • McAlindon TE, Bannuru RR, Sullivan MC, Arden NK, Berenbaum F, Bierma-Zeinstra SM, Hawker GA, Henrotin Y, Hunter DJ, Kawaguchi H, Kwoh K, Lohmander S, Rannou F, Roos EM, Underwood M (2014) OARSI guidelines for the non-surgical management of knee osteoarthritis. Osteoarthr Cartil 22:363–388

    Article  CAS  Google Scholar 

  • Ozkurt S, Dönmez A, Zeki Karagülle M, Uzunoğlu E, Turan M, Erdoğan N (2011) Balneotherapy in fibromyalgia: a single blind randomized controlled clinical study. Rheumatol Int 32:1949–1954

    Article  Google Scholar 

  • Schmitt SK (2017) Reactive arthritis. Infect Dis Clin N Am 31:265–277

    Article  Google Scholar 

  • Sieper J, Poddubnyy D (2017) Axial spondyloarthritis. Lancet 390:73–84

    Article  Google Scholar 

  • Sukenik S, Giryes H, Halevy S, Neumann L, Flusser D, Buskila D (1994) Treatment of psoriatic arthritis at the Dead Sea. J Rheumatol 21:1305–1309

    CAS  Google Scholar 

  • Thiéfin G, Beaugerie L (2005) Toxic effects of nonsteroidal antiinflammatory drugs on the small bowel, colon, and rectum. Joint Bone Spine 72:286–294

    Article  Google Scholar 

  • Tucker LJ, Coates LC, Helliwell PS (2019) Assessing disease activity in psoriatic arthritis: a literature review. Rheumatol Ther 6:23–32

    Article  Google Scholar 

  • van Tubergen A, Landewé R, van der Heijde D, Hidding A, Wolter N, Asscher M, Falkenbach A, Genth E, Thè HG, van der Linden S (2001) Combined spa-exercise therapy is effective in patients with ankylosing spondylitis: a randomised controlled trial. Arthritis Rheum 45:430–438

    Article  Google Scholar 

  • Yurtkuran M, Ay A, Karakoc Y (2005) Improvement of the clinical outcome in ankylosing spondylitis by balneotherapy. Joint Bone Spine 72:303–308

    Article  Google Scholar 

  • Zochling J, Smith E (2010) Seronegative spondyloarthritis. Best Pract Res Clin Rheumatol 24:747–756

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Rheumatology Unit, Department of Medicine DIMED, University of Padova, Padua, Italy

    Franco Cozzi, Paola Galozzi, Luca Ciprian, Elisabetta Zanatta, Pamela Polito, Francesca Oliviero & Leonardo Punzi

  2. Department of Pharmaceutical and Pharmacological Sciences, University of Padova, Padua, Italy

    Maria Carrara

Authors
  1. Franco Cozzi
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Paola Galozzi
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Luca Ciprian
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Elisabetta Zanatta
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Pamela Polito
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Francesca Oliviero
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Maria Carrara
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Leonardo Punzi
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Franco Cozzi.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

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

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00484-019-01761-7

Keywords

Search

Navigation