The effect of Neydharting mud-pack therapy on knee osteoarthritis: a randomized, controlled, double-blind follow-up pilot study
Key Findings
- Double-blind RCT comparing Neydharting mud packs vs. physically similar control packs for knee OA (n=53)
- WOMAC pain, stiffness, and function all improved significantly (p<0.001) in both groups — heat effect confirmed
- Medication need decreased significantly ONLY in mud group (p<0.001) vs. control (p=0.106) — chemical effect demonstrated
- Mud group showed continuous downward trend in medication need through 12-week follow-up, becoming significant at Week 12 (p=0.016)
- Control group showed only temporary, non-significant medication decrease
- First properly double-blinded and controlled mud therapy RCT — previous studies had methodological weaknesses
First rigorously double-blinded, controlled RCT of mud-pack therapy for knee osteoarthritis. Used Neydharting moor mud (lowland peat peloid, pH 6.4, 32.56% humic acid in organic matter) vs. a physically matched control pack (zinc oxide, talc, glycerol, activated carbon — similar viscosity, color, and thermal properties but no bioactive compounds).
Design
- n=53 (27 mud, 26 control), randomized 1:1
- Treatment: 10 sessions over 2 weeks, 42°C packs on affected knee
- Blinding: Separated treatment rooms, independent assessor, patients could not distinguish treatments
- Follow-up: Weeks 0, 2, 6, and 12
Results
| Parameter | Mud group | Control group |
|---|---|---|
| WOMAC total (baseline → Week 12) | 51.4 → 27.6 (p<0.001) | 49.8 → 32.3 (p<0.001) |
| EQ-5D (baseline → Week 12) | 0.49 → 0.72 (p<0.001) | 0.56 → 0.66 (p<0.001) |
| Medication need change | Significant decrease (p<0.001) | Non-significant (p=0.106) |
| Between-group difference | Consistent trend favoring mud but not statistically significant (underpowered) |
Key Interpretation
Both groups improved significantly — confirming the thermal effect of heated packs. However, the medication reduction was significant ONLY in the mud group, suggesting an additional “chemical effect” from the bioactive compounds. The authors note the study was likely underpowered to detect between-group differences and recommend larger trials.
Neydharting Mud Composition
Lowland moor turf mud, pH 6.4, 83.2% water, 16.77% dry weight, of which 12.05% organic material. 32.56% of organic material is humic acid (considered high). Inorganic material 4.72%.