Comparison of the efficacy of mud-pack and hot-pack treatments in chronic non-specific neck pain

Randomized controlled trial published in the Turkish Journal of Physical Medicine and Rehabilitation (2022), directly comparing mud-pack therapy to conventional hot-pack therapy for chronic non-specific neck pain. Most peloid therapy RCTs focus on knee osteoarthritis — this trial provides evidence for the cervical spine, a common but less-studied indication.

Study Design

70 patients with chronic non-specific neck pain were randomized to two groups: mud-pack plus TENS plus home exercise, or hot-pack plus TENS plus home exercise. Both groups received 15 sessions over 3 weeks (5 sessions per week), with 20 minutes of mud/hot pack followed by 20 minutes of TENS, and daily home exercise. The TENS and exercise components were identical — the mud-pack versus hot-pack difference is the only variable.

What It Measured

Pain was assessed with VAS (Visual Analogue Scale) and the Neck Disability Index (NDI), which measures how neck pain interferes with daily activities. Range of motion and functional capacity were also recorded. These are the standard outcomes for cervical spine pain trials.

What It Found

Both groups improved from baseline. The mud-pack group showed additional benefits in pain reduction and functional measures beyond what the hot-pack group achieved. This is consistent with the peloid trial literature for knee OA (Evcik 2007, Karagülle 2007) — a pattern of heat-plus-chemical outperforming heat alone.

What It Adds

Evidence for peloid therapy in neck pain is sparser than for knee OA. This trial is one of the few well-designed RCTs for the cervical spine indication. The TENS and exercise co-treatment make it more representative of real clinical settings, where peloid therapy is rarely used in isolation.