The effect of balneological treatment (hydrotherapy and peloidotherapy) on patients with chronic low back pain and serum cytokine levels

Purpose: To investigate the effects of hydrotherapy and peloidotherapy on clinical status and serum cytokine levels in patients with chronic low back pain. Material and Method: Seventy-four patients with chronic low back pain and accepted to participate in the study were dived into two groups by randomization. Four patient from each groups dropped out from the study for various reasons. All patients were assessed before and end of the therapy, at the 1 and 3th month with pain, pa- tient's and doctor's global assessment, pain during rest and exercise, finger-floor distance, Schober and Modified Schober tests, Oswetry Disability Index, Short Form-36. Venous blood sample were taken from all patients before/1.day and after therapy/12.day to measure serum IL-6 and IL-10. The patients in the treatment group received 10 sessions hydrotherapy at 36-38°C for 20 mi- nutes a day, and afterwards mud-pack treatment on lumbar region at 43°C. A home-based standardized exercise program was given to all patients. Results: In the treatment group, statistically significant improvement was observed in pain, patient's and doctor's global assessment, pain during rest and exercise, ODI, SF-36 parameters and continued for 3 months. In the control group statistically significant improvement was observed in pain, patient's and doctor's global assessment, pain during exercise, ODI scores and continued for 3 months. Decrease in low back pain, pain during rest and exercise, Modified Schober test, patient's and doctor's global assessment score and increase in SF-36 pain and general health scores showed significantly superiority in favor of the treatment group in all evaluations. There was a significant increase in IL-10 values from baseline at the end of treatment in the treatment group. Conclusion: Hydrotherapy and peloidotherapy provide clinical improvement in chronic low back pain and increase an anti-inflammatory cytokine IL-10. Key words: balneotherapy, hydrotherapy, peloidotherapy, chronic low back pain, cytokine, interleukin