Mud Massage—Yes, Even Without a Wet Table

By Anne Williams
[Spa Elan]

When mud and massage are combined, the result is a sumptuous bodywork session that reduces clients’ muscular tension and allows deep relaxation. While mud treatments have historically been a spa experience, today’s massage therapists can offer fangotherapy—fango is the Italian word for mud—even without a shower or wet table.

Fango Choices: Clay, mud, peat

Clay, mud, and peat have different therapeutic properties, and all of these products can be used in the fango therapy treatment procedure outlined below. Let’s look at the different characteristics of each fango substance.


Clay is mainly mineral and is the most stimulating of the fango substances. Many different types of clay are commercially available from different soils and environments around the world. Clays from marine sediments, or from areas around hot springs or geysers, usually have higher mineral content, but all commercially available clay has the same basic properties. First, clay holds heat well and can be warmed and used to decrease muscle tension and relax the body. Second, clay is highly absorbent and is used to draw impurities and moisture from the surface of the skin. This drawing action stimulates circulation and lymphatic flow and purifies the skin. Clay is also useful as a carrier product for other therapeutic substances. Items like essential oils, herbal infusions, seaweed, and natural food items (fruit juices, honey, mashed fruits, milk, and yogurt) can be mixed into clay to make interesting treatment products.


While mud is mainly mineral in origin, like clay, it contains 2–4 percent organic substances, which play an important role in its therapeutic use. Therapeutic mud is matured or ripened in natural mineral water. The maturing process for each mud may be slightly different, but generally involves the oxidation and reduction of the mud over a period of up to 12 months. The process of maturing the mud is characterized by changes in the chemical composition of the mud and in appearance.

A good example is the maturing process used at the Piestany Spa in Slovakia. The brown Piestany mud, used as a treatment for arthritis, is matured to increase its sulfur content by curing the mud in outdoor storage units and exposing it to bacteria, which reduce the mud’s sulfates to sulfides. This changes the mud’s color from brown to black.1

Sulfur, which occurs naturally in the vicinity of volcanoes and hot springs, is perhaps the most important component in therapeutic mud. Sulfur baths have been a viable means of reducing oxidative stress on the body, decreasing inflammation in muscles and joints,2 and easing inflammatory conditions such as osteoarthritis and rheumatoid arthritis. Individuals report that they experience increased strength, decreased morning stiffness, better walking ability, and decreased pain after sulfur mud treatment.3 Therapeutic mud is also used successfully for bursitis, sprains, strains, tendonitis, and other musculoskeletal injuries and disorders.4


Sphagnum is the main genus of mosses that form a bog. As the sphagnum moss decays, the bog becomes filled with a deeper and deeper layer of dead sphagnum, which is known as peat. The lack of oxygen in the bog, as well as the acidic conditions created by sphagnum, slows the growth of microbes. This is why human bodies unearthed from peat bogs thousands of years after burial are perfectly preserved. As the rate of decomposition is very slow, the minerals usually recycled by living things remain in the peat.5 Peat is therapeutically the most active of the three fango substances and beneficial for a wide range of musculoskeletal conditions. European studies have concluded that peat is analgesic, anti-inflammatory, antiviral, a circulatory stimulant, endocrine-balancing, and is immune-boosting.6–9 An example of popular peat is Moor mud.

Mud Massage Procedure

To prepare for a mud massage, first set the massage table with a bottom sheet, then a plastic sheet (available from spa suppliers) over the top. Cut a second piece of plastic and set it aside, along with a second sheet and large bath towel. The client will lie on top of the plastic sheet and be draped at different times by the second plastic sheet, massage sheet, and blanket.

Place a bowl of warm water, four dry hand towels, moisture lotion, paper towels, two pair of vinyl gloves, and two dry skin brushes on a worktable. Put the fango in a mixing bowl, and float it in a hot water bath. Warm the mud to between 104°F and 110°F. Next, place 16 hot moist hand towels in a 9-12 quart soda cooler that’s placed within easy reach of the massage table. It works well to use a heat lamp suspended above the treatment table or a freestanding heat lamp beside the table to keep the client from getting cold. If no heat lamp is available, the treatment room will need to be very warm.

Step 1

Begin the treatment with the client in the prone position. Drape the client’s gluteals. Dry brush the legs, working from the ankle to the hip, then dry brush the back (See image 1).

Step 2

Hold the mixing bowl in one hand and use the other to apply a layer of warm fango to the posterior body, working from one ankle up the posterior leg to the back and around to the second leg (See image 2). Place the mixing bowl back in the hot water bath and massage the fango into the body using a variety of strokes (See image 3). Add warm water to your gloved hands if the mud starts to get sticky as you massage. It works well to cover the upper body with the plastic drape and a bath towel while you massage the legs. When you massage the back, move the plastic drape to cover the legs to keep the client warm. This also prevents the fango from drying out, especially if a heat lamp is used.

Step 3

At the conclusion of the massage, place six hot moist towels over the fango. Use compression strokes to loosen the fango, then remove the fango from the client. Place the dirty towels in a tub under the massage table. Some fango types, like Moor mud, are fairly difficult to get off the client’s body with one set of towels, so additional towels will be needed. Others, like kaolin clay, come off more easily, especially if a bit of massage oil is added to the clay mixture once the water and clay have been combined. One option is to use a body wash with warm water to lift leftover fango off the body. The body wash is removed with three hot, moist towels.


Step 4

Remove the first set of gloves, blot the client with a dry hand towel, and apply moisture lotion to the posterior body. Before turning the client, use a moist hand towel to wipe mud off the bottom plastic sheet so the client doesn’t turn onto a soiled surface. If possible, keep all the mud on the client and off of the treatment table. Turn the client into the supine position and place the client in a breast drape and anterior pelvic drape. Notice that plastic sticks to mud and to the client. It is normal to need to un-stick the plastic and have the client un-stick herself before turning to the supine position. Put on the second set of gloves.

Step 5

Repeat the dry brush and fango massage steps on anterior body areas and cover the client in plastic and a blanket (See image 4). Massage the face while the fango absorbs into the anterior body.

Step 6

Remove the fango with hot moist towels using the same methods applied to the posterior body. Apply moisture lotion to the skin.

Step 7

Finish the treatment with a neck and shoulder massage and spritz an aroma

mist in a high arch over the client to fill the room with a refreshing scent

and to signal the end of the service. Try having your client select a scent

before the session as a way to partner on the process. This finishing mist

then signals the end of your combined experience (See image 5). 

 Anne Williams is a licensed massage therapist, esthetician, aromatherapist, certified reflexologist, registered counselor, educator, and author. The work outlined in this article and the images are adapted from portions of the author’s textbook, Spa Bodywork: A Guide for Massage Therapists (Lippincott Williams & Wilkins, 2007). Williams is also the education program director for Associated Bodywork & Massage Professionals. She can be reached at or


1. R.R. Bergel, “The Biology and Physics of Peloids,” Dermascope (November 2000).

2. C. Ekmekcioglu, et al. “Effect of Sulfur Baths on Antioxidative Defense Systems, Peroxide Concentrations, and Lipid Levels in Patients with Degenerative Osteoarthritis,” Research in Complementary and Classical Natural Medicine 9 (2002): 216-220.

3. O. Elkayam, et al. “Immediate and Delayed Effects of Treatment at the Dead Sea in Patients with Psoriatic Arthritis,” Rheumatology International 19, no. 3 (2000): 77–82.

4. A.M. Beer, A. Grozeva, P. Sagorchev, J. Lukanov, “Comparative Study of the Thermal Properties of Mud and Peat Solutions Applied in Clinical Practice,” Biomedical technology 48, no. 11 (November 2003): 301–5.

5. R.W. Kimmerer, Gathering Moss, A Natural and Cultural History of Mosses (Oregon: Oregon State University Press, 2003), 113.

6. C. Comacchi, J. Hercogova, “A Single Mud Treatment Induces Normalization of Stratum Corneum Hydration, Transepidermal Water Loss, Skin Surface pH and Sebum Content in Patients with Seborrhoeic Dermatitis,” Journal of European Academic Dermatology 18, no. 3 (May 2004): 372–4.

7. A. Carabelli, et al. “Effect of Thermal Mud Baths on Normal, Dry, and Seborrheic Skin.” Clinical Ter. 149, no. 4 (Jul–Aug 1998):271–5. 

8. A. Pizzoferrato, et al. “Beta-endorphin and Stress Hormones in Patients Affected by Osteoarthritis,” Minerva Med 91, no. 10 (October 2000): 239–45.

9. A.M. Beer, et al. “The Effect of Peat Components on Endocrine and Immunological Parameters and on Trace Elements,” Department of Natural Cure, Blankenstein Hospital, Hattingen, Germany. Clinical Laboratory 47, no. 3–4 (2001): 61–7.