Effects of balneotherapy on quality of life in osteoarthritis

Researchers at the University of Siena, in Italy, evaluated whether balneotherapy (treatment of disease by baths) with mineral sulphate-bicarbonate-calcium water might achieve symptomatic improvement, and improve quality of life of patients with symptomatic knee osteoarthritis.

First, the details.

  • 60 people with primary bilateral knee osteoarthris, according to American College of Rheumatology (ACR) criteria, were randomly assigned to a treatment group for 12 weeks.
    • Daily sulphate-bicarbonate-calcium mineral water bath
    • A control group continued their regular outpatient care routine.
  • Patients were evaluated by Visual Analogue Scale (VAS) for spontaneous pain, Lequesne and WOMAC Index for gonarthrosis, SF-36, Arthritis Impact Measurement Scale (AIMS) and symptomatic drugs consumption.
    • The WOMAC index is a validated patient questionnaire used to evaluate coxarthrosis and gonarthrosis by evaluating symptoms and motor impairment in daily life.
    • Gonarthrosis is a disorder of the knee joint, generally implying early joint surface damage of any kind.
    • Coxarthrosis refers to a noninflammatory degenerative disease of the hip joint, which usually appears in late middle or old age.
  • The researchers were not aware of the treatment given — single-blind.

And, the results.

  • There was significant improvement in all parameters at the end of the cycle of balneotherapy, which persisted throughout follow-up.
  • This symptomatic effect was confirmed by the significant reduction of symptomatic drugs consumption.
  • In the control group no significant differences were noted.
  • The differences between the two groups were significant for all parameters from day 15 to 12 weeks.
  • Tolerability of balneotherapy seemed to be good, with light and transitory side effects.

The bottom line?

The authors concluded, “Results confirm that the beneficial effects of balneotherapy in patients with knee osteoarthritis last over time, with positive effects on the painful symptomatology, a significant improvement on functional capacities and quality of life.

The authors believe, “Balneotherapy can represent a useful backup to pharmacological treatment of knee osteoarthritis or a valid alternative for patients who do not tolerate pharmacological treatments.”

In general, reviewers of balneotherapy have concluded, “existing research is not sufficiently strong to draw firm conclusions.” A summary of several reviews is here.

5/18/11 20:56 JR

Hi, I’m JR

John Russo, Jr., PharmD, is president of The MedCom Resource, Inc. Previously, he was senior vice president of medical communications at, a complementary and alternative medicine website.