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Spa Therapies Improve Chronic Back Pain
People with chronic back pain showed significant improvement in general pain, back pain, mood and health satisfaction after three weeks of varying therapies at a spa resort in Bad Tatzmannsdorf, Austria.

"Contribution of Individual Spa Therapies in the Treatment of Chronic Pain" was conducted by Gerhard Strauss-Blasche, Ph.D., Cem Ekmekcioglu, M.D., Gerda Vacariu, M.D., Herbert Melchart, M.D., Veronika Fialka-Moser, M.D., and Wolfgang Marktl, M.D.

The study involved 151 subjects with an average age of 58, all of whom had experienced strong back pain for at least one year. Participants spent three weeks at the resort in eastern Austria, where they received two to four spa treatments per day. The treatments included mud applications, carbon dioxide baths, massage, exercise, spinal traction, hydrotherapy and electrotherapy.

The spa physician prescribed each subject’s treatment based on individual health status and which therapies the subject was inclined toward. On average, subjects experienced about four of the available therapies, some more frequently than others, for a total of approximately 37 therapy sessions per participant throughout the three-week stay.

General pain, back pain, negative mood and health satisfaction were measured on the first and last days of the study; a follow-up measurement was taken six weeks later. At the end of the study and at follow-up, a significant improvement was noted for all four outcomes.

Although little connection could be made between specific spa treatments and the positive outcome, the spa therapy as a whole proved successful.

"Except for the electrotherapies and, to a lesser extent, spinal traction, the treatments used in the context of spa therapy all have some known physiological and/or psychological effect," state the study’s authors. "Nevertheless, it was found that the bulk of improvement could not be explained by the number and type of individual spa therapies the patients received during their stay."

The authors present several theories as to why it was the general spa experience, and not the specific therapies involved, that improved subjects’ health and mood. One is the placebo effect of professional attention and subject involvement, regardless of the treatment. Also cited was the "structure" of the spa experience, "where phases of rest and phases of physiological stimulation are alternated in a stress-free environment."

"The most prominent finding is that each therapeutic application accounts for only a small percentage of overall treatment outcome," state the study’s authors. "Therefore, omitting an individual therapy should not effect outcome to any large extent."

 – Source: University of Vienna Departments of Physiology, Physical Medicine and Rehabilitation; Ludwig Boltzmann Institute for Physiological Rhythms Research; and Kurzentrum Bad Tatzmannsdorf. Authors: Gerhard Strauss-Blasche, Ph.D., Cem Ekmekcioglu, M.D., Gerda Vacariu, M.D., Herbert Melchart, M.D., Veronika Fialka-Moser, M.D., and Wolfgang Marktl, M.D. Originally published in The Clinical Journal of Pain, 2002, Vol. 18, No. 5, pp. 302-309.

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