Spa Therapy for Osteoarthritis
Two weeks of balneotherapy and mud-pack applications per year, two years in a row, significantly improved symptoms of osteoarthritis, and reduced the amount of hospital stays, missed workdays and necessary medication associated with this disease, according to recent research.

"Clinical efficacy and cost-effectiveness evidence of SPA therapy in osteoarthritis" was conducted by staff at the Institute of Rheumatology at the University of Siena, in Siena, Italy; the Section of Epidemiology and Biostatistics at the University of L'Aquila, in L'Aquila, Italy; and the Section of Clinical Hydrology at the University of Milan, in Milan, Italy.

The study focused on the role of spa therapy in easing osteoarthritis, as part of the Italian Ministry of Health's Decree of December 1994 to define the role of spa therapy in various sectors of medicine. This particular study was titled the "Naiade Italian Project," named after the goddess of water in classical mythology.

The Naiade project observed people with osteoarthritis over the course of two years. Initially, there were 11,437 subjects in the study, but the total number of subjects assessed overall was 6,111.

Each participant experienced one annual cycle of balneotherapy and mud-pack applications per year for two years. Each cycle lasted two weeks and consisted of 12 sessions of mud-pack applications and mineral baths. The study took place in 98 Italian spas, and subjects were randomly assigned to receive baths of either sulphurous water, sodium chloride-bromide-iodide water, sulphate water or biocarbonate water.

Four assessments were performed by the same physician: one at baseline, before the first spa cycle; one two weeks later, immediately after the first spa cycle; one a year later, before the start of the second cycle; and one immediately after the second cycle.

Outcome variables measured were pain, functional ability, use of symptomatic drugs, number of hospitalizations and missed workdays due to osteoarthritis, and the use of physical or alternative therapy during the one-year period before the second spa cycle.

Results showed significant improvements for all the outcome variables, regardless of what type of water was used. The improvements persisted throughout the two-year study span.

"Analysis of the parameters studied showed not only a clear reduction in articular symptoms at the end of the first cycle of spa therapy, but also, above all, a progressive improvement after the second cycle [of spa therapy]," state the study's authors.

The percentage of subjects who used osteoarthritis medication and physical or alternative therapy decreased significantly after both cycles of spa therapy, along with the number of hospitalizations and missed workdays, as well.

"The data clearly and correctly shows the economically advantageous aspects of spa therapies in the treatment of [osteoarthrits]," state the authors.

 - Source: Institute of Rheumatology at the University of Siena, in Siena, Italy; Section of Epidemiology and Biostatistics at the University of l'Aquila, in l'Aquila, Italy; and Section of Clinical Hydrology at the University of Milan, in Milan, Italy. Authors: A. Fioravanti, M.Valenti, E. Altobelli, F. Di Orio, G. Nappi, A Crisanti, L. Cantarini and R. Marcolongo. Originally published in Panminerva Medica 2003, Vol. 45, No. 3, pp. 211-217.

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