Spa Therapy for Fibromyalgia

A combination of thalassotherapy, exercise and education decreases the symptoms of fibromyalgia syndrome and improves quality of life, according to a recent study.

“Spa treatment for primary fibromyalgia syndrome: a combination of thalassotherapy, exercise and patient education improves symptoms and quality of life” was conducted by staff of the Medisch Spectrum Twente Hospital Department of Rheumatology and the University Twente Department of Rheumatology and Communication Studies, in Enschede, The Netherlands; and the Mongi Slim Hospital Department of Rheumatology in Tunis, Tunisia.

Fifty-eight people with fibromyalgia were randomly assigned to the spa group, and 76 were randomly assigned to the control group.

The spa therapy consisted of two-and-a-half weeks at a Tunisian resort, during which sessions of thalassotherapy, exercise and education took place. Individualized thalassotherapy sessions included four of the following: Turkish bath, hot packs with algae, massage while lying under a shower, whirlpool, underwater jet stream massage, pool exercise or massage. Seven or eight of these sessions took place during a 15-day period and lasted around three hours each.

Seven one-hour sessions of group exercise were scheduled on thalassotherapy off-days and included warm-up, stretching and low-impact aerobic exercise, such as treadmill walking, cycling or swimming.

Seven education sessions, provided by a rheumatologist, covered general information on fibromyalgia; the importance of fitness and exercise; emotions and fibromyalgia; and several other aspects of living with this condition.

Subjects in the control group continued with standard care for fibromyalgia with no knowledge of the spa comparison group. Control subjects were told they were part of a study assessing the impact of fibromyalgia on health and social functioning.

Outcome measures—assessed for both groups at baseline, as well as three, six and 12 months later—were general health, disease-specific health status, fatigue, physical fitness and tender points.

Results of the study showed significant improvement in the spa group for physical health after three months, but not six or 12 months later. The spa group showed a 26-percent improvement in fatigue, and the difference remained statistically significant for six months.

“Results of this study confirm our hypothesis that a combination of thalassotherapy, exercise and patient education can significantly improve symptoms and health-related quality of life in fibromyalgia,” state the study’s authors. “After six months, however, most differences between spa and control group were no longer statistically significant, indicating that our combined program should be regarded as a palliative treatment with temporary effects.”

— Source: Medisch Spectrum Twente Hospital Department of Rheumatology and the University Twente Department of Rheumatology and Communication Studies, in Enschede, The Netherlands; and the Mongi Slim Hospital Department of Rheumatology in Tunis, Tunisia. Authors: T.R. Zijlstra; M.A.F.J. van de Laar; H.J. Bernelot Moens; E. Taal; L. Zakraoui; and J.J. Rasker. Originally published in Rheumatology, 2005, Vol. 44, pp. 539-546.

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