Ресурсосберегающие методики пелоидотерапии в реабилитации пациентов после микродискэктомии (Resource-saving peloidotherapy techniques in rehabilitation of patients after microdiscectomy)

Russian RCT published in the Russian Journal of Physiotherapy, Balneology and Rehabilitation (2023), testing a non-thermal peat mud application protocol for patients in rehabilitation following microdiscectomy (minimally invasive spinal disc surgery). This is a clinically important population: post-surgical patients who need rehabilitation but cannot tolerate the heat-intensive protocols designed for chronic conditions.

The Non-Thermal Approach

Standard peloid therapy uses heat (38–42°C) as a core therapeutic component. But elevated temperature is contraindicated in post-surgical patients: increased vasodilation and blood flow near a surgical site can cause complications. This trial evaluated thin-layer peat mud applications at lower temperatures — “resource-saving” because they use less peat and avoid high heat — to see whether the chemical component of peat therapy could produce benefit without the thermal component.

Study Design and Findings

74 patients (n=74) were randomised in the RCT. Non-thermal thin-layer peat applications were found to be effective for rehabilitation outcomes and were better tolerated than hot applications, with fewer contraindication-related exclusions and adverse events. This confirms that the chemical mechanisms of peat therapy — humic substance anti-inflammatory and tissue-modulating effects — operate independently of the thermal mechanism.

Significance

Most of the peloid therapy evidence base uses heated applications. Kulikov 2023 is one of the few RCTs demonstrating that non-thermal peat works — opening the indication to patient populations who cannot tolerate heat: post-surgical patients, elderly patients with cardiovascular contraindications, and patients with acute inflammation where heat would exacerbate symptoms.