Effectiveness of balneotherapy and spa therapy for the treatment of chronic low back pain: a review on latest evidence

Abstract

In most European countries, balneotherapy and spa therapy are widely prescribed by physicians and preferred by European citizens for the treatment of musculoskeletal problems including chronic low back pain (LBP). We aimed to review and evaluate the recent evidence on the effectiveness of balneotherapy and spa therapy for patients with LBP. We comprehensively searched data bases for randomized controlled trials (RCTs) published in English between July 2005 and December 2013. We identified all trials testing balneotherapy or spa therapy for LBP that reported that the sequence of allocation was randomized. We finally included total of eight RCTs: two on balneotherapy and six on spa therapy. All reviewed trials reported that balneotherapy was superior in long term to tap water therapy in relieving pain and improving function and that spa therapy combining balneotherapy with mud pack therapy and/or exercise therapy, physiotherapy, and/or education was effective in the management of low back pain and superior or equally effective to the control treatments in short and long terms. We used Jadad scale to grade the methodological quality. Only three out of total eight had a score of above 3 indicating the good quality. The data from the RCTs indicates that overall evidence on effectiveness of balneotherapy and spa therapy in LBP is encouraging and reflects the consistency of previous evidence. However, the overall quality of trials is generally low. Better quality RCTs (well designed, conducted, and reported) are needed testing short- and long-term effects for relieving chronic back pain and proving broader beneficial effects.

Ultrasound with mineral water or aqua gel to reduce pain and improve the WOMAC of knee osteoarthritis

“…Evidence suggests that mineral water is safe and effective for treating patients with OA of the knee, and may be considered as one treatment option among many approaches in treating this disease [11]. Many studies have investigated how different types of non-pharmacological treatments affect pain and WOMAC index scores [1,13,24].…”

“…Nevertheless, both methods were found to be effective. The exact mechanism of action of mineral water is unknown, but the minerals absorbed from the water may have a therapeutic role [11]. …”

“…Balneotherapy is defined as the use of baths (in tubs or pools) containing thermal and/or mineral water from natural springs or drilled wells [11]. The main mode of balneotherapy includes immersion in thermal water with a natural temperature of at least 20ºC and/or mineral water with total mineral content of at least 1g/l.…”

The application of climatic therapy in the health resorts of the Black Sea coast of the Caucasus: the current state-of-the-art and the prospects for the further development

“…Большое внимание уделяется развитию клима-тотерапии и за рубежом: в Израиле [8][9][10][11], Австрии [12], Китае [13], Австралии [14], Германии [15,16], Вьетнаме [17] и других странах [18][19][20]. Зарубежные исследователи изучают возможности климатотера-пии в профилактике, лечении и реабилитации сер-дечно-сосудистых, кожных заболеваний, а также сахарного диабета, аллергических реакций, невро-зов и др.…”

Assessing medicinal qualities of groundwater from the Busko-Zdrój area (Poland) using the probabilistic method

“…In Poland, curative and geothermal water are very wide used in spas for medical treatment in baths and swimming pools, drinking treatment (crenotherapy), inhalation, irrigation, and rinsing (Chowaniec and Zuber 2008;Cię _ zkowski et al 2010;Dowgiałło 2012;Górecki et al 2014;Hałaj 2014;Tomaszewska and Szczepański 2014;. In various publications the effects of different types of thermo-mineral and geothermal waters used in spas in treatment purposes were studied (Cruz and Franca 2006;Lambrakis et al 2012;Balderer et al 2014;Karagülle and Karagülle 2015;Tenti et al 2015). Some of them presents also the results of investigation to use in balneotherapy the combine the therapeutic effects of clays and mineral waters, known as pelotherapy (Gámiz et al 2009;Rebelo et al 2011Rebelo et al , 2014.…”