The therapeutic effect of balneotherapy: evaluation of the evidence from randomised controlled trials

Authors: Falagas ME (1,2) , Zarkadoulia E (1) , Rafailidis PI (1)
Affiliations:
(1) Alfa Institute of Biomedical Sciences (AIBS) (2) Department of Medicine, Tufts University School of Medicine
Source: Int J Clin Pract. 2009 Jul;63(7):1068-84
DOI: 10.1111/j.1742-1241.2009.02062.x Publication date: 2009 Jul E-Publication date: June 22, 2009 Availability: abstract Copyright: 2009 Blackwell Publishing Ltd
Language: English Countries: Not specified Location: Not specified Correspondence address: Matthew E. Falagas, Alfa Institute of Biomedical Sciences (AIBS), 9 Neapoleos Street, 151 23 Marousi, Greece Tel.: + 30 210 683 9604 Fax: + 30 210 683 9605 Email: m.falagas@aibs.gr

Keywords

Article abstract

STUDY DESIGN:

Systematic review.

SUMMARY OF BACKGROUND DATA:

There is widespread popular belief that balneotherapy is effective in the treatment of various ailments.

METHODS:

We searched PubMed (1950-2006), Scopus and Cochrane library for randomised controlled trials (RCTs), examining the clinical effect of balneotherapy (both as a solitary approach and in the context of spa) on various diseases.

RESULTS:

A total of 203 potentially relevant articles were identified. In all, 29 RCTs were further evaluated; 22 of them (75.8%) investigated the use of balneotherapy in rheumatological diseases and eight osteoarthritis, six fibromyalgia, four ankylosing spondylitis, four rheumatoid arthritis and three RCTs (10.3%) in other musculoskeletal system diseases (chronic low back pain). In addition, three relevant studies focused on psoriasis and one on Parkinson's disease. A total of 1720 patients with rheumatological and other musculoskeletal diseases were evaluated in these studies. Balneotherapy did result in more pain improvement (statistically different) in patients with rheumatological diseases and chronic low back pain in comparison to the control group in 17 (68%) of the 25 RCTs examined. In the remaining eight studies, pain was improved in the balneotherapy treatment arm, but this improvement was statistically not different than that of the comparator treatment arm(s). This beneficial effect lasted for different periods of time: 10 days in one study, 2 weeks in one study, 3 weeks in one study, 12 weeks in 2 studies, 3 months in 11 studies, 16-20 weeks in one study, 24 weeks in three studies, 6 months in three studies, 40 weeks in one study and 1 year in one study.

CONCLUSION:

The available data suggest that balneotherapy may be truly associated with improvement in several rheumatological diseases. However, existing research is not sufficiently strong to draw firm conclusions.

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