Spa therapy is one of the most commonly used non-pharmacological approaches for many rheumatic diseases.
In Fibromyalgia it may be useful for the chronic widespread musculoskeletal pain. Because of the unknown aetiology and the not clearly understood pathogenesis, there is no standard therapy regimen for Fibromyalgia.

Also, the mechanisms of action of spa therapy are not completely known, but most likely the benefits could be derived from mechanical, physical and chemical factors. Muscle tone and pain intensity can be positively influenced by mud packs and thermal baths.

The efficacy of balneotherapy in Fibromyalgia has been well demonstrated, while controlled studies using mud packs are lacking.

A randomized clinical trial was performed to evaluate the effects and the tolerability of mud-bath treatment in Fibromyalgia patients, who are poor responders to pharmacological therapy.

Eighty people with primary Fibromyalgia were randomly allocated to two groups: forty were submitted to a cycle of 12 mud packs and thermal baths, and forty were considered as controls. At baseline, after thermal treatment and after 16 weeks, patients were evaluated by the following:

• FIQ
• Tender points count
• VAS for "minor" symptoms
• AIMS1
• HAQ

Control patients were assessed at the same time periods.

A significant improvement of all evaluation parameters after mud-bath therapy and after 16 weeks was observed. Mud packs were well tolerated and no drop-outs were recorded.

The results suggest the efficacy and the tolerability of mud-bath treatment in primary Fibromyalgia.

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