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Background: There is a growing interest in treatments involving natural means and procedures, alternative to those of conventional medicine. Some special sands are being used worldwide in therapeutic applications, especially in musculoskeletal problems. Objectives: To compare the effect of Siwan traditional therapy versus conventional therapy for functional disability and pain in rheumatoid arthritis. Design: A prospective, randomized, single-blind, pre-post-test, controlled trial. Setting: Four physical therapy departments in four multidiscipline, outpatient medical centers, located in Marsa Matrouh. The study was conducted between June 2015 and August 2016. Participants: Thirty patient’s rheumatoid arthritis (aged between 20 and 50 y) according to the American Rheumatism Association criteria 2010, participated in the study. Interventions: The patients were randomly assigned into 2 equal groups. Group (A) received Siwan traditional therapy in the form of sand bathing, followed by massage with olive oil for 7 d and group (B) received conventional physical therapy for two months’ day after day in the form of heat application, electrical stimulation (TENS), and exercise. Main outcome measure: The primary outcome was pain severity measured by visual analogue scale while the secondary outcome was functional disability measured by Health Assessment Questionnaire (HAQ). Results: Thirty patient with rheumatoid arthritis (group (A) n=15; group (B) n=15) were randomized and analysed. Comparing both groups post-program revealed that there were significant differences (P