We used the data published recently by a team headed by the late Professor Shaul Sukenik, in order to shed light on the huge amount of work realized by this exceptional physician, who devoted his life to his family, his profession and the Dead Sea.   Particularly, he wanted very early - and always succeeded - to apply the strictest rules of clinical studies in the fields of Balneotherapy and Spa treatment, thus lifting them up to their highest level of credibility. Thanks to his works, one can stipulate with authority that Dead Sea treatments are beneficial in several rheumatologic disease and have a good safety profile.   The Dead Sea, the deepest and most saline lake on earth, has been known from biblical times for its healing properties. The systematic review presented critically the level of evidence for the claims of therapeutic effects of Dead Sea treatments in several rheumatologic, skin and lung diseases and, as well, reviewed these treatments’ safety.   The authors found bona fide evidence that Dead Sea treatments are especially effective in psoriasis due to both special characteristics of solar ultraviolet radiation and Dead Sea water balneotherapy. Dead Sea mud and balneotherapy have been found to be beneficial in rheumatologic diseases, including rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, and knee osteoarthritis.   In the safety analysis, no evidence was found for an increase in skin neoplasia, although skin actinic damage seems to be amplified in patients treated in the Dead Sea. Dead Sea treatments do not lead to worsening of high blood pressure. Substantial ingestion of Dead Sea water (generally in unusual near-drowning cases) is toxic and can result in cardiac rhythm disturbances because of electrolyte concentration abnormalities. Finally, laboratory analysis of Dead Sea mud did not reveal mineral concentrations that could represent a health concern for their intended use.

  The wide spectrum of therapies offered in the Dead Sea region includes the use of the natural mud, which has an unique composition reflecting the magnesium and mineral richness of the Dead Sea waters. Mud pack therapy applied to the whole body, alone, or in combination with other modalities of balneotherapy has been shown to improve many rheumatologic symptoms. The “Ahava Laboratories Ltd.” company located in the Dead Sea area, recently developed mud compresses that can be used in patients’ homes.   The aim of the present study was to assess the efficacy of home application of such mud compresses onto the back of patients suffering from chronic low back pain (LBP).   All patients were above age of 18 and had LBP for more than a year. The pain was localized to the region below the 12th rib and above the gluteal line. Exclusion criteria included acute back pain, inflammatory LBP, malignant disease, disk herniation, patients under narcotics, sensitivity to mud, Spa treatment in the last 6 months, scoliosis, pregnancy, infections, heart failure and osteoporosis.   The patients were randomized into two groups: group 1 treated with mineral-rich mud compresses, and group 2 treated with mineral depleted compresses, serving as a control group. The study was double blinded, neither patients nor physicians were aware of which type of compresses a patient received. Heated mud compresses were applied 5 times a week (from Sunday to Thursday), for three consecutive weeks totaling 15 treatments; the duration of each treatment was 20 minutes.   The study showed an improvement in patients suffering from chronic LBP self-treated at home with natural-mineral-rich mud packs. This improvement was demonstrated by the self-assessment of pain severity, based on a visual analog scale and by the score obtained through a functional questionnaire. The improvement in pain severity and functional score in the treatment group maintained one month after completing the therapy. In the control group, no improvement in the visual analog scale score was seen in any assessment, except for the Ronald & Morris score.