Medical Mud-Pack Therapy Reduces Inflammatory Cytokine Gene Expression and Pain in Knee Osteoarthritis

Osteoarthritis (OA) is a debilitating degenerative joint disorder characterized by chronic pain and functional impairment, with immune-inflammatory processes playing a crucial role in its pathogenesis. Current standard-of-care often involves pain management and physical therapy, but these approaches may not fully address the underlying inflammatory drivers. There is a growing interest in complementary therapies that can modulate inflammatory pathways and improve clinical outcomes, particularly by targeting key cytokines like TNF-α, IL-6, and IL-1β.

Researchers conducted a randomized controlled trial involving 32 patients with knee osteoarthritis, assigning them to either a medical mud-pack therapy (MMT) group (n=16) or a control group (n=16). The MMT group received medical mud-pack therapy in addition to standard care, while the control group performed exercise only. Molecular assessments utilized quantitative PCR to measure gene expression of key inflammatory cytokines and miRNA. Clinical outcomes were evaluated using the Visual Analog Scale (VAS) for pain and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) for function, with pre- and post-treatment measurements.

The MMT group demonstrated significant reductions in the gene expression of several key inflammatory markers. TNF-α expression decreased from 1.90 ± 0.41 to 1.43 ± 0.33 (p < 0.05), IL-6 expression fell from 1.34 ± 0.31 to 0.93 ± 0.27 (p < 0.05), and IL-1β expression was reduced from 2.20 ± 0.40 to 1.81 ± 0.34 (p < 0.05). In contrast, the control group showed no significant molecular changes. Between-group comparisons revealed greater reductions in the MMT group for all cytokines, with Δ differences ranging from -0.38 to -0.51 (95% CI not crossing zero, p < 0.05) and large effect sizes (d = 0.88-1.12). miR-140 expression remained unchanged in both groups (p > 0.05).