title: Short- and long-term effects of mud-bath treatment on hand osteoarthritis: a randomized clinical trial.
abstract: 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.
authors: Rheumatology Unit, Department of Clinical Medicine and Immunological Sciences, University of Siena, Viale Bracci,1, 53100, Siena, Italy, fioravanti7@virgilio.it.
authors: Antonella
authors: A
authors: Fioravanti
authors: Sara
authors: S
authors: Tenti
authors: Chiara
authors: C
authors: Giannitti
authors: Nicola Angelo
authors: NA
authors: Fortunati
authors: Mauro
authors: M
authors: Galeazzi
mesh_terms: D000368:Aged; D001494:Baths; D002118:Calcium / Q000627:therapeutic use; D005260:Female; D005459:Fluorides / Q000627:therapeutic use; D006225:Hand; D006801:Humans; D008274:Magnesium / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D008900:Mineral Waters / Q000627:therapeutic use*; D009094:Mud Therapy; D010003:Osteoarthritis / Q000628:therapy*; D016037:Single-Blind Method; D013431:Sulfates / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D008900:Mineral Waters; D013431:Sulfates; D008274:Magnesium; D005459:Fluorides; D002118:Calcium