This study aimed to investigate the effects of balneological outpatient treatment (
hydrotherapy and peloidotherapy) on clinical status and serum
cytokine levels in patients with chronic
low back pain (CLBP). Seventy-four patients with CLBP who accepted to participate to the study were randomly divided into two groups. The study group was given ten sessions (in 2 weeks) of
hydrotherapy, peloidotherapy, and home exercise, while the control group was given only home exercise. All patients were assessed before and at the end of
therapy, at the 1st and 3rd months. The primary outcomes were
pain intensity on the visual analog scale (VAS) (VAS-
pain, VAS-rest, VAS-exercise) and Oswestry Disability Index (ODI). The secondary outcome measures included patient's and physician's global assessment (VAS-
PGA), (VAS-DGA), finger-to-floor distance (FFD), modified Schober test, Short Form-36 (SF-36), and the use of
analgesic drug. Venous blood samples were drawn from all patients before/1st day and after
therapy/12th day to measure serum
interleukin (IL)-6 and
IL-10 levels. Significant improvement was observed in the study group in VAS-
pain, VAS-rest, VAS-exercise, VAS-
PGA, VAS-DGA, ODI, and SF-36 parameters
after treatment and improvement maintained for 3 months. In the control group, significant improvement was observed in VAS-
pain, VAS-exercise, VAS-
PGA, VAS-DGA, and ODI scores on the 12th day and continued for 3 months. Decrease in
pain,
pain during rest and exercise, modified Schober test, VAS-
PGA, VAS-DGA, ODI scores, and the increase in SF-36
pain and general health scores showed superiority in favor of the study group in all evaluations. There was a significant increase in
IL-10 values from baseline at the end of treatment in the study group. The use of non-steroidal anti-inflammatory
drug (
NSAID) was significantly lower in the study group compared with the use of
NSAID in the control group in the 3rd month. Balneological outpatient treatment improved clinical status in CLBP patients. Although no significant correlation was clearly determined between
IL-10 levels and
pain score, this effect might be related to the observed increase in the anti-inflammatory
cytokine IL-10 levels that was observed only in the study group.