For people suffering from knee osteoarthritis, two weeks of spa therapy created an array of marked improvements that lasted up to nine months, according to recent research.

The study, “Short- and Long-Term Effects of Spa Therapy in Knee Osteoarthritis,” involved 80 outpatients, both male and female, with primary bilateral knee osteoarthritis. These subjects ranged in age from 54 to 81, and all had been experiencing symptoms of knee osteoarthritis for at least one year before the study began.

The participants were randomly assigned to either a spa therapy group or a control group. Subjects assigned to the control group continued to receive standard care for their knee osteoarthritis, including exercise, NSAIDs and analgesics.

People in the spa therapy group had mud packs applied on both knees for 20 minutes, at an initial temperature of 113 degrees Fahrenheit. They also soaked in bicarbonate-sulfate mineral bath water at a temperature of about 100 degrees Fahrenheit for 15 minutes. These spa applications occurred daily for a total of 12 days during a two-week period.

All subjects in the study were assessed a total of five times: once at baseline, before the start of the study; a second time at two weeks, immediately after the study ended; and then at follow-up points three, six and nine months from the start of the study.

Outcome measures assessed at each of these points included spontaneous pain; severity of knee osteoarthritis; total pain score, total stiffness score and total physical function score; and quality of life. Subjects recorded the total number of NSAIDs and analgesics they took each day in a diary provided by the researchers.

Results of the study revealed a statistically significant reduction in spontaneous pain among subjects in the spa therapy group when compared to baseline numbers. According to the researchers, a difference between the two groups was evident at the two-week mark and persisted to nine-month follow-up. In the control group, there was no significant difference in spontaneous pain from baseline to any of the follow-up points.

Similar results were found for severity of knee osteoarthritis, as well as pain, stiffness and physical function.

As for quality of life, there was a significant improvement in the spa group after two weeks, followed by a continuous progressive improvement throughout the follow-up period. In the control group, there also was a significant improvement, but it did not show up until the six-month mark.

Also in the control group, there was no significant change in the amount of NSAIDs consumed throughout the study and follow-up period. In the spa group, however, a decrease in NSAID consumption reached significance at two weeks and continued to be significantly lower until the six-month follow-up point.

“In conclusion, our results … confirm that the beneficial effects of spa therapy in patients with knee [osteoarthritis] last over time,” state the study’s authors, “with positive effects on the painful symptomatology and a significant improvement on functional capacities.”

Authors: Antonella Fioravanti, Francesca Iacoponi, Barbara Bellisai, Luca Cantarini and Mauro Galeazzi.

Sources: Rheumatology Unit, Department of Clinical Medicine and Immunological Sciences, University of Siena, Italy. Originally published in the American Journal of Physical Medicine & Rehabilitation (Vol. 88, No. 12, December 2009).

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