Home exercises are as effective as outpatient hydrotherapy for osteoarthritis of the hip. Balneotherapy at the Dead Sea area for knee osteoarthritis. Spa therapy for gonarthrosis: a prospective study. Prolonged effects of 3 week therapy in a spa resort on lumbar spine, knee and hip osteoarthritis: follow-up after 6 months. A randomized controlled trial. The therapeutic effects of Cserkeszölö thermal water in osteoarthritis of the knee: a double blind, controlled, follow-up study. The effect of balneotherapy on osteoarthritis. Is an intermittent regimen effective?
Hydrotherapy for OA of the hip has rarely been evaluated in controlled studies. Forty-seven patients with OA of the hip were followed for 18 weeks. Patients were randomly allocated either to a regimen of home exercises or to twice weekly hydrotherapy for 6 weeks in addition to home exercises. There was an improvement seen in both subjective and objective measures in both groups with treatment. There was no significant difference between the two groups. Response to treatment appeared independent of age, sex and radiological severity. We conclude that for most patients, a carefully graded and supervised regimen of home exercises is beneficial and there is little benefit in adding hydrotherapy to this regimen. Balneotherapy at the Dead Sea area has been applied in various inflammatory rheumatic diseases such as rheumatoid arthritis and psoriatic arthritis. The efficacy of balneotherapy at the Dead Sea area for the treatment of degenerative rheumatic diseases has not yet been formally evaluated.
                To evaluate the efficacy of balneotherapy at the Dead Sea area in patients suffering from osteoarthritis of the knees.
                Forty patients were randomly allocated into four groups of 10 patients. Group I was treated by bathing in a sulphur pool, group 2 by bathing in the Dead Sea, group 3 by a combination of sulphur pool and bathing in the Dead Sea, and group 4 served as the control group receiving no balneotherapy. The duration of balneotherapy was 2 weeks.
                Significant improvement as measured by the Lequesne index of severity of osteoarthritis was observed in all three treatment groups, but not in the control group. This improvement lasted up to 3 months of follow-up in patients in all three treatment groups.
                Balneotherapy at the Dead Sea area has a beneficial effect on patients with osteoarthritis of the knees, an effect that lastas at least 3 months. The objective of this study was to evaluate the effect of spa therapy on clinical parameters of patients with gonarthrosis. Patients with gonarthrosis (n = 33) underwent a 2-week spa therapy using three treatment regimes and a 20-week follow-up as follows: group I (n = 11) had mineral water baths and hot native mineral mud packs, group II (n = 12) had mineral water baths and rinsed mineral-free mud packs and group III (n = 10) had tap water baths and mineral-free mud packs. The patients and the assessing rheumatologist were blinded to the difference in the treatment protocols. A significant improvement in the index of severity of the knee (ISK), as well as night pain scores, was achieved in group I. Improvement in physical findings and a reduction in pain ratings on a visual analogue scale (VAS) did not reach statistical significance. Analgesic consumption was significantly decreased in both groups I and III for up to 12 weeks. Global improvement assessed by patients and physician was observed in all three groups up to 16 weeks but persisted to the end of the follow-up period in group I only. Patients with gonarthrosis seemed to benefit from spa therapy under all three regimes. However, for two parameters (night pain and ISK) the combination of mineral water baths and mud packs (group I) appeared to be superior. Spa therapy is frequently used in daily rheumatological practice, but its benefit remains to be evaluated. A prospective randomized controlled study was conducted in 1993 in patients with osteoarthritis of the hip, knee or lumbar spine. Treatment was either spa therapy at Vichy (France) of 3 weeks duration (spa group) or usual therapy (control group). Assessment criteria were pain (visual analogue scale), functional impairment (Lequesne's index for hip or knee disease, Main and Waddell's for lumbar spinal diseases), quality of life index [revised Arthritis Impact Measurement Scale (AIMS2)], and analgesic and/or non-steroidal anti-inflammatory drug (NSAID) consumption. Patients were included by randomization into one of the two arms (spa or control) and assessment criteria were collected before spa therapy or the control period, and 3 and 24 weeks thereafter. A total of 188 patients (lumbar spine 95, knee 64, hip 29) were included in the study (spa group 91, control group 97). Changes in the assessment criteria after a 6 month follow-up period showed improvement in terms of pain, functional impairment and quality of life, with a reduced intake of symptomatic drugs (NSAID and analgesic drugs) in the spa group. This study suggests that spa therapy of 3 weeks duration has a prolonged, beneficial, symptomatic effect in osteoarthritis. The effects of thermal water from Cserkeszölö in Hungary were appraised in a randomised, double blind study conducted on 58 patients with osteoarthritis of the knee. Balneotherapy was delivered as a 15-day course of 30-min daily sessions performed with thermal water (active treatment) or tap water of similar colour and odour (placebo treatment). The musculoskeletal status of participants was evaluated at baseline, at the end of the balneotherapy course, and 3 months later. Study endpoints (initial pain, range of motion, tenderness on palpation, stair climbing, physicians' opinion and subjective rating by patients, and ambulation) were assessed using visual analogue scales and symptom scores. Both groups improved; however, the magnitude of improvement was significantly greater in patients treated with thermal water from Cserkeszölö. Background: Balneotherapy is used as a treatment modality for various musculoskeletal disorders. The aim of this study was to evaluate the effectiveness of intermittent balneotherapy in patients with knee osteoarthritis (OA). Methods: Seventy-two patients with knee OA were included in the study. Patients were divided into two groups: group A (48 patients) was given intermittent once weekly treatment for 6 weeks; group B (24 patients) served as a control group. Evaluation was done prior to study entry, at weeks 4 and 6, and 4 weeks following completion of treatment (week 10). Assessment included global pain score (VAS), WOMAC index, Lequesne's functional index, patients' and physician's disease severity score, and NSAID/analgesic consumption. Results: Following balneotherapy, a statistically significant improvement, determined by the reduction in the mean changes of most outcome parameters (VAS, WOMAC, and Lequesne's index), was noted in group A at weeks 4 and 6 and was sustained 4 weeks after cessation of treatment (week 10). Significant improvement in both physician's and patients' disease severity scores, as well as a reduction in analgesic and NSAID consumption, were also noted in group A. No improvement was found in the control group in any of the tested parameters. Conclusions: Intermittent balneotherapy appears to be effective in the treatment of knee OA.
We found silver level evidence (www.cochranemsk.org) concerning the beneficial effects of mineral baths compared to no treatment. Of all other balneological treatments no clear effects were found. However, the scientific evidence is weak because of the poor methodological quality and the absence of an adequate statistical analysis and data presentation. Therefore, the noted "positive findings" should be viewed with caution.