The use of mud, especially spring mud, dates back to ancient times. In ancient Egypt, the sick were treated with mud brought by the Nile during floods. In our country, the use of mud in therapy began in the second half of the sec. XIX century in Techirghiol (sapropelic mud) and Vatra Dornei (peat mud from Copăceni and Poiana Stampei).

Prophylaxis and health improvement are the major objective of the therapeutic indication of mud in seaside resorts and different spa center or medical recovery.

As defined by the "International Society for Medical Hydrology and Climatology", sludges (peloids) are "substances formed in natural conditions under the influence of geological processes and which, in a finely divided state and mixed with water, are used in medical practice in the form of mud baths or local procedures: wrappings, poultices or onctions„.

Mud treatment is also called peloidotherapy. 

Depending on their chemical composition, therapeutic muds are classified into 3 types:

1. Sapropel sludges

• sludge sapropelic of limes and coastal lakes : Techirghiol, Eforie, Agigea.
• sapropelic muds of continental lakes : Amara , Sovata -Lac Ursu, Bazna, Lacul Sărat-Brăila ,Turda, Câineni.
• fossil sapropelic fossil muds : Ocna Sibiului.

2. Peat sludge: Mangalia Nord (marine peat), Covasna, Borsec, Poiana Stampei.
3. Mineral sludges : Săcelu, Sângiorz-Bãi, Bãile Govora (iodized siliceous silt) Geoagiu Băi (feruginous silt).

How to run a mud bath correctly?

Mud baths are carried out  in tubs of heated water to which 10-12 kg of sludge is added, gradually increasing its concentration to 10-25%. 

The mixture can be heated up to 44ºC. For patients with cardiovascular diseases, the temperature should not exceed 37ºC, and for those with inflammatory rheumatic diseases below 36ºC. The bath lasts 20-40 minutes. The bath should be followed by a shower at 37-38ºC and rest for at least one hour. 

A cure consists of 12-15 daily baths.

Therapeutic indications of a mud bath

Inflammatory rheumatic diseases: 

• rheumatoid arthritis; 

• ankylosing spondylitis; 

• psoriatic arthritis in chronic forms; 

• chronic degenerative rheumatic diseases: spondylitis, simple disc disease, chronic lumbago, coxarthrosis, gonarthrosis, abarticular rheumatism - chronic tendinitis, posttraumatic sequelae.

Diseases of the central and peripheral nervous system: 

• paresthesias; 

• pareze; 

• muscle atrophy.

Chronic gynecological inflammatory conditions - primary/ secondary infertility

Mud baths improve the body's metabolism in general by stimulating the functioning of the endocrine glands and are recommended for endocrine disorders: 

• hypothyroidism; 

• hypoparathyroidism;

• pituitary dwarfism;

• obesity;

• rickets in children.

In dermatology, numerous studies and research into both the curative and prophylactic action of therapeutic mud have established that certain dermatoses can benefit from long-lasting relief. Peloid therapy may be indicated in:

• squamous dermatoses (especially in psoriasis, early stage ichthyosis, keratodermatitis);

• in seborrheic syndrome (seborrheic dermatitis, polymorphous acne, acne rosacea), in allergodermas (chronic eczema and urticaria);

• diffuse and limited neurodermatitis, pruritus;

• occupational eczema and constitutional eczema (atopic dermatitis), scleroderma.

In dermatologic conditions, therapeutic muds can be used in different forms of application:

a) Mud baths, at temperatures of 36-37°C, lasting 15-30 minutes, 2-3 times a day, indicated in psoriasis, chronic eczema, pruritus.

b) Applications of cold mud (mud ounctions), associated with heliotherapy and lake baths (e.g. Lake Techirghiol), indicated in psoriasis, chronic eczema, pruritus.

c) Hot mud wraps, at a temperature of 46-48°C, lasting 15-30 minutes, indicated in extensive neurodermatitis with lichenification, in old forms of psoriasis, resistant to usual spa treatments.

Benefits of a mud bath

The mud spa treatment produces favorable effects that persist for a long time by modifying the adaptive response to various stimuli. Peloids act on:

• Cardio-vascular system by stimulating cardio-vascular reactions with increased hemodynamics through central and peripheral mechanisms.
• Nervous system by sedative or excitatory effects on the central nervous system and on the vegetative nervous system by sedating pain receptors.
• The mud spa treatment increases the antimicrobial defense capacity by increasing the phagocytic power of leukocytes - evidenced by changes in the opsonocytophagic index (O.O.C.)
• Under the action of sludge there is a harmonic stimulation in all the glands in the sense of increasing enzymatic and synthetic activity while preserving the specificity of each one. Related to the endocrine functional harmonizing activity is also the stimulation of the hypothalamic-pituitary-adrenal hypothalamic axis activity, which is translated by the optimization of plasma levels of β- endorphin.

General contraindications of a mud bath

1. Acute febrile conditions.
2. Chronic rheumatic diseases in acute flare.
3. Infectious diseases during the contagious period.
4. Infectious venereal diseases (syphilis, gonorrhea).
5. Malignant tumors, regardless of shape, location or stage.
6. Pathologic pregnancy in any month and normal pregnancy over 3 months.
7. Epilepsy.
8. Chronic alcoholism with neuropsychiatric disorders, Drug addictions.
9. Decompensated diabetes mellitus, overt heart, liver or kidney failure.

Recommended spas: Techirghiol, EforieAmara, Sovata - Lake Ursu, Bazna, Lacul Sărat-Brăila, Ocna Sibiului , Poiana Stampei.

Dr.Gabriela Dogaru

Primary Doctor Recovery, physical medicine and balneology - Clinical Hospital for Recovery Cluj-Napoca

First Vice-President of the Romanian Association of Balneology

References - Constantin Munteanu. Balneotherapy. Editura Balneară, Bucharest, 2013;