Chronic musculoskeletal pain is a prevalent health concern among older workers affecting their quality of life and overall well-being.
Objective
This study aimed to assess the combined effects of a short-term intervention involving sea mud application with local heat and complex exercises in a sea pine forest (SPF) setting, compared to a physical modalities group receiving regular physical modality (PM) intervention with stretching exercises.
Methods
The study focused on assessing the impact on pain reduction, improvement in health-related quality of life (HRQoL) measured using the EQ-5D, and reduction in stress scores among older adults dealing with chronic musculoskeletal pain. A total of 24 participants were randomly assigned to either the thalassotherapy or the physical modalities group.
Results
The results indicated a significant reduction in pain over time in both groups, suggesting that both interventions contributed to pain reduction. Although both interventions led to improvements in HRQoL and stress reduction, a significant difference in HRQoL improvement was observed between the thalassotherapy and physical modalities groups.
Conclusions
These findings highlight the potential benefits of thalassotherapy-based interventions in the management of chronic musculoskeletal pain in older workers.
MaresovaPJavanmardiEBarakovicS, et al.Consequences of chronic diseases and other limitations associated with old age – a scoping review. BMC Public Health2019; 19: 1431.
2.
LimaACPMaximiano-BarretoMAMartinsTCR, et al.Factors associated with poor health literacy in older adults: a systematic review. Geriatr Nurs2024; 55: 242–254.
3.
KimJLeeIHongH, et al.Multimorbidity and health-related quality of life in Korean older adults: a mediation analysis on handgrip strength. J Mens Health2022; 18: 202.
4.
KomolsuradejNSrikrajangSRatanapisitC, et al.Effects of pain management on work ability in aging workers with chronic musculoskeletal pain: a cross-sectional study. Sci Rep2025; 15: 11315.
5.
GrosmanYKalichmanL. The intersection of sarcopenia and musculoskeletal pain: addressing interconnected challenges in aging care. Int J Environ Res Public Health2025; 22: 547.
6.
KremerMBeckerLJBarrotM, et al.How to study anxiety and depression in rodent models of chronic pain?Eur J Neurosci2021; 53: 236–270.
7.
SchwanJSclafaniJTawfikVL. Chronic pain management in the elderly. Anesthesiol Clin2019; 37: 547–560.
8.
LeungDKYFongAPCWongFHC, et al.Nonpharmacological interventions for chronic pain in older adults: a systematic review and meta-analysis. Gerontologist2024; 64: gnae010.
9.
VinstrupJSundstrupEAndersenLL. Psychosocial stress and musculoskeletal pain among senior workers from nine occupational groups: cross-sectional findings from the SeniorWorkingLife study. BMJ Open2021; 11: e043520.
10.
StoeszBChimneyKDengC, et al.Incidence, risk factors, and outcomes of non-fatal work-related injuries among older workers: a review of research from 2010 to 2019. Saf Sci2020; 126: 104668.
11.
HanssonRORobsonSMLimasMJ. Stress and coping among older workers. Work2001; 17: 247–256.
12.
OakmanJLambertKAWealeVP, et al.The effect of preference and actual days spent working from home on stress and musculoskeletal pain in older workers. Int Arch Occup Environ Health2023; 96: 1113–1121.
13.
YurcuGYuncuENAkıncıZ. Motivation, co-creation, mental well-being and cross-cultural differences: the case of thalassotherapy in Turkey. J Tour Cult Change2024; 22: 164–189.
14.
GomesCSFernandesJVFernandesFV, et al.Salt mineral water and thalassotherapy. In: Minerals latu sensu and human health. Springer, 2021, pp.631–656.
15.
CostanzoMDe GiglioMAGilhen-BakerM, et al.The chemical basis of seawater therapies: a review. Environ Chem Lett2024; 22: 2133–2149.
16.
KorogluSYıldızM. Effectiveness of hydrotherapy and balneotherapy for anxiety and depression symptoms: a meta-analysis. Curr Psychol2024; 43: 24193–24204.
17.
RodriguesHBrochadoATroilocM, et al.Wellness comes in salty water: thalassotherapy spas and service level of satisfaction. Int J Spa Wellness2022; 5: 71–90.
18.
ChaeG-YLeeC-Y. Estimating public preferences for thalassotherapy centers using a choice experiment. Tour Manage Perspect2024; 50: 101214.
19.
EzhovVV. Climate-therapy at seaside resorts in modern medical and wellness practice. Probl Balneol Physiother Exercise Ther2021; 98: 60–66.
20.
HongSLimHSKimCG, et al.Evaluation method of ocean healing content on stress relieve effects by using smart watch and questionnaire. J Coast Res2024; 116: 493–497.
21.
FraioliAMennuniGFontanaM, et al.Efficacy of spa therapy, mud-pack therapy, balneotherapy, and mud-bath therapy in the management of knee osteoarthritis. A systematic review. BioMed Res Int2018; 2018: 1–9.
22.
D’AngeloDCocliteDNapoletanoA, et al.The efficacy of balneotherapy, mud therapy and spa therapy in patients with osteoarthritis: an overview of reviews. Int J Biometeorol2021; 65: 1255–1271.
23.
HahmS-CShinH-JLeeM-G, et al.Mud therapy combined with core exercise for chronic nonspecific low back pain: a pilot, single-blind, randomized controlled trial. Evidence-Based Complementary Altern Med2020; 2020: 7547452.
24.
Cuesta-VargasAIWhiteMGonzález-SánchezM, et al.The optimal frequency of aquatic physiotherapy for individuals with chronic musculoskeletal pain: a randomised controlled trial. Disabil Rehabil2015; 37: 311–318.
25.
de AndradeSCde CarvalhoRFSoaresAS, et al.Thalassotherapy for fibromyalgia: a randomized controlled trial comparing aquatic exercises in sea water and water pool. Rheumatol Int2008; 29: 147–152.
26.
MorerCMichan-DonaAAlvarez-BadilloA, et al.Evaluation of the feasibility of a two-week course of aquatic therapy and thalassotherapy in a mild post-stroke population. Int J Environ Res Public Health2020; 17: 8163.
27.
NamE-SUhmD-C. Effects of phytoncides inhalation on serum cortisol level and life stress of college students. Korean J Adult Nurs2008; 20: 697–706.
28.
SundermannMChielliDSpellS. Nature as medicine: the 7th (unofficial) pillar of lifestyle medicine. Am J Lifestyle Med2023; 17: 717–729.
29.
RovielloVGilhen-BakerMVicidominiC, et al.Forest-bathing and physical activity as weapons against COVID-19: a review. Environ Chem Lett2022; 20: 131–140.
30.
O’BrienLForsterJ. Sustaining and changing sport and physical activity behaviours in the forest: an evaluated pilot intervention on five public forest sites in England. Urban For Urban Greening2020; 55: 126844.
31.
CameronMH. Physical agents in rehabilitation-E book: an evidence-based approach to practice. Elsevier Health Sciences, 2021.
LeeSHHanJHLeeSJ, et al.Comparison of seaweed pack and mudpack as treatment for knee osteoarthritis: a prospective randomized controlled study. Phys Ther Rehabil Sci2019; 8: 22–31.
34.
GrandySFoxKM. Change in health status (EQ-5D) over 5 years among individuals with and without type 2 diabetes mellitus in the SHIELD longitudinal study. Health Qual Life Outcomes2012; 10: 1–7.
35.
JoMWYunSCLeeSI. Estimating quality weights for EQ-5D health states with the time trade-off method in South Korea. Value Health2008; 11: 1186–1189.
36.
LeeYKNamHSChuangLH, et al.South Korean Time trade-off values for EQ-5D health states: modeling with observed values for 101 health states. Value Health2009; 12: 1187–1193.
37.
MalikM. Heart rate variability: standards of measurement, physiological interpretation, and clinical use: task force of the European Society of Cardiology and the North American Society for Pacing and Electrophysiology. Ann Noninvasive Electrocardiol1996; 1: 151–181.
38.
ChoiBJKimYHYunSY. The effects of floral arrangement on the stress index of the elderly with chronic diseases and its correlation with cognition. J People Plants Environ2019; 22: 269–277.
39.
El-TallawySNNalamasuRPergolizziJV, et al.Pain management during the COVID-19 pandemic. Pain Ther2020; 9: 453–466.
40.
Van WilderLRammantEClaysE, et al.A comprehensive catalogue of EQ-5D scores in chronic disease: results of a systematic review. Qual Life Res2019; 28: 3153–3161.
41.
HoffmanGJMalaniPNSolwayE, et al.Changes in activity levels, physical functioning, and fall risk during the COVID-19 pandemic. J Am Geriatr Soc2022; 70: 49–59.
42.
de Oliveira AlmeidaKNogueira AlvesIGde QueirozRS, et al.A systematic review on physical function, activities of daily living and health-related quality of life in COVID-19 survivors. Chronic Illn2023; 19: 279–303.
43.
FerreiraLNPereiraLNda Fé BrásM, et al.Quality of life under the COVID-19 quarantine. Qual Life Res2021; 30: 1389–1405.
44.
Van LeeuwenKMVan LoonMSVan NesFA, et al.What does quality of life mean to older adults? A thematic synthesis. PLoS One2019; 14: e0213263.
45.
OhSLeeMYeomJW, et al.Effect of aquomanual therapy on pain and physical function of patients with chronic musculoskeletal disorders: a pilot study using quantitative and qualitative methods. Eur J Integr Med2018; 17: 9–15.
46.
ByeonWJLeeSJKhilTG, et al.Association between a marine healing program and metabolic syndrome components and mental health indicators. Medicina (B Aires)2023; 59: 1263.
47.
ChennaouiMGomez-MerinoDVan BeersP, et al.Benefits of thalassotherapy with sleep management on mood states and well-being, and cognitive and physical capacities in healthy workers. J Sleep Disord Ther2018; 7: 2167–0277.
