Balneotherapy significantly improves symptoms of osteoarthritis

A systematic review was conducted by Carmela Protano et al to evaluate the effects of balneotherapy with thermal mineral water for managing the symptoms and signs of osteoarthritis located at any anatomical site.

The proposed treatment was balneotherapy, consisting of 20 or 30 min/day of bathing, once or twice a day, for 2 to 3 weeks of total duration, coupled or not to other spa therapies, as magnetotherapy or physiotherapy only when homogeneously performed on both “sperimental” and “control” group.

Balneotherapy, due to its several beneficial effects, has been recommended by The OARSI guidelines (Osteoarthritis Research Society International) as a complementary non-pharmacological treatment for gonarthrosis, coxarthrosis and polyarticular osteoarthritis.

Besides, balneotherapy is cited for its positive effects on osteoarthritis also in the EULAR (European League Against Rheumatism) recommendations for the health professional’s approach to pain management in inflammatory arthritis and osteoarthritis, while ARC (American College of Rheumatology/Arthritis Foundation) made a conditionally recommendation for thermal intervention.

The systematic review was conducted according to the PRISMA Statement. The following databases were consulted: PubMed, Scopus, Web of Science, Cochrane Library, DOAJ and PEDro. The authors included clinical trials evaluating the effects of balneotherapy as a treatment for patients with osteoarthritis, published in English and Italian language, led on human subjects. The protocol was registered in PROSPERO.

Overall, 17 studies have been included in the review. All of these studies were performed on adults or elderly patients suffering from osteoarthritis localized to knees, hips, hands or lumbar spine. The treatment assessed was always the balneotherapy with thermal mineral water. The outcomes evaluated were pain, palpation/pressure sensibility, articular tenderness, functional ability, quality of life, mobility, deambulation, ability to climb stairs, medical objective and patients’ subjective evaluation, superoxide dismutase enzyme activity, serum levels of interleukin-2 receptors.

The results of all the included studies agree and demonstrated an improvement of all the symptoms and signs investigated. In particular, pain and quality of life were the main symptoms evaluated and both improved after the treatment with thermal water in all the studies included in the review. These effects can be attributed to physical and chemical-physical properties of thermal mineral water used. However, the quality of many studies resulted not so high due and, consequently, it is necessary to perform new clinical trial in this field using more correct methods for conducting the study and for processing statistical data.

Further reading:

Balneotherapy for osteoarthritis: a systematic review

Carmela Protano, Mario Fontana et al

Rheumatology International (2023) 43:1597–1610

https://doi.org/10.1007/s00296-023-05358-7