The impact of mud therapy on chronic low back pain

Abstract

Chronic low back pain (CLBP) remains one of the most prevalent and disabling musculoskeletal conditions affecting millions globally. Conventional pharmacological interventions often provide temporary relief and are associated with potential side effects, including gastrointestinal complications, dependency, and tolerance. Ayurveda, an ancient Indian system of medicine, emphasizes holistic approaches that address the root cause of diseases through natural means. Among these, Mud Therapy (Mrid Lepa Chikitsa) is a significant intervention for managing musculoskeletal disorders like CLBP. This article presents a critical review of mud therapy, its mechanisms, procedure, clinical efficacy, and supporting data to establish its role as an effective, complementary approach for managing chronic low back pain. Introduction Chronic low back pain (CLBP), typically defined as pain persisting for more than 12 weeks, is one of the most prevalent musculoskeletal conditions worldwide. It affects approximately 23% of the global adult population at any given time, with a lifetime prevalence estimated to be between 60% and 70%. CLBP not only impairs physical functioning but also contributes significantly to the reduction of work productivity, increased absenteeism, and an overall deterioration in quality of life. The social and economic burden of chronic low back pain is substantial, as it frequently leads to long-term disability, loss of earnings, and higher healthcare costs. The underlying causes of CLBP are multifactorial, often involving a combination of structural, biomechanical, and psychosocial factors. Common etiologies include degenerative disc disease, lumbar spondylosis, intervertebral disc herniation, postural abnormalities, muscular imbalances, and sedentary lifestyle habits. These causative factors frequently result in chronic inflammation, muscular spasms, nerve impingement, and restricted mobility, perpetuating a cycle of pain and disability. According to Ayurvedic principles, CLBP is closely associated with the vitiation of Vata dosha, the biological energy responsible for movement and nervous system regulation. Aggravation of Vata can lead to tissue degeneration (dhatu kshaya), dryness, stiffness, and pain, particularly in the asthi dhatu (bone tissue) and majja dhatu (marrow and nervous tissue). The modern medical approach to CLBP management typically includes pharmacological interventions such as non-steroidal anti-inflammatory drugs (NSAIDs), muscle relaxants, analgesics, corticosteroid injections, and, in some cases, surgical interventions like discectomy, spinal fusion, or laminectomy. Physiotherapy modalities, including exercises for core strengthening, postural correction, and transcutaneous electrical nerve stimulation (TENS), are also widely employed. While these treatments offer symptomatic relief, they often fail to address the underlying pathophysiological imbalances or provide sustainable outcomes. Furthermore, long-term use of NSAIDs and other analgesics is associated with adverse effects, including gastrointestinal disturbances, renal impairment, and cardiovascular risks. Surgical interventions carry their own risks and do not guarantee permanent relief. In this context, there is a growing interest in complementary and alternative medicine (CAM) modalities that focus on holistic and integrative approaches to CLBP management. Ayurveda, the ancient Indian system of medicine, offers time-tested therapeutic strategies aimed at restoring doshic balance, nourishing degenerated tissues, and improving overall vitality.