Efficacy of Balneotherapy and Mud Therapy in Patients with Knee Osteoarthritis: A Systematic Literature Review
Key Findings
- Systematic review of thermal mineral water and mud therapy for knee OA
- WOMAC used as primary outcome measure across studies
- Evidence supports efficacy of both balneotherapy and mud therapy for pain and function in knee OA
Systematic literature review published in Aktuelle Rheumatologie (2021) by researchers from Lithuanian University of Health Sciences, examining balneotherapy and mud therapy specifically for knee osteoarthritis. Uses WOMAC as the primary outcome measure across studies — a consistent metric that makes cross-study comparison meaningful.
What It Reviewed
The review focused on knee OA specifically, excluding other joint conditions that also appear in the balneotherapy literature. This narrower focus improves the reliability of conclusions: pooling osteoarthritis of the knee with OA of the hand or hip would mix anatomically and mechanically distinct conditions. Thermal mineral water (balneotherapy) and mud therapy were examined as related but distinct interventions.
What It Found
Evidence supports the efficacy of both balneotherapy and mud therapy for pain reduction and functional improvement in knee OA, with WOMAC as the primary measured outcome. The review is consistent with the earlier Bender 2013 meta-analysis and the individual RCTs by Karagülle 2007 and Evcik 2007. The geographic diversity of the included studies — conducted across multiple countries with different peloid types — adds weight to the conclusion that the benefit is not specific to one peat source or climate.
Place in the Literature
Raza 2021 is a mid-evidence-hierarchy reference: not a single RCT with raw data, not a meta-analysis with pooled statistics, but a structured systematic review that qualifies and synthesises available trials. Together with Keilani 2025 and Bender 2013, it forms a converging body of reviews all pointing to the same conclusion for knee OA.