Twelve weeks of thermal therapy, which consisted of time in a sauna and underwater exercise in a heated pool, resulted in a significant decrease of pain and symptoms, along with a significant increase in quality of life, among women with fibromyalgia. According to researchers, these improvements remained relatively stable six months after the thermal therapy ended.

The study, “Effects of thermal therapy combining sauna therapy and underwater exercise in patients with fibromyalgia,” involved 44 female fibromyalgia patients, ranging in age from 24 to 62, with a mean age of about 43 years.

All participants fulfilled the American College of Rheumatology (ACR) criteria for a diagnosis of fibromyalgia syndrome. The ACR criteria states that at least 11 of 18 tender point sites should be painful upon digital palpation at a pressure of 4 kilograms.

Subjects in this study were assigned to receive 12 weeks of thermal therapy. The thermal therapy protocol consisted of time in a sauna, resting under blankets in a warm room and underwater exercise in a heated pool. The women also took part in a conventional rehabilitation program.

The sauna therapy took place three days a week, 15 minutes per day. Subjects rested in the supine position in a far-infrared-ray dry sauna heated to 140 degrees Fahrenheit. In an effort to sustain the soothing effects of the heat, participants were then instructed to rest for 30 more minutes, covered with a blanket, in a room heated to about 80 degrees Fahrenheit.

The underwater exercise took place two days a week, 30 minutes per day, in a pool that was heated to about 87 degrees Fahrenheit. These sessions involved aerobic exercises set to music and led by a trained instructor. According to the study’s authors, this underwater exercise program “aimed to improve the patients’ endurance capacity, postural control, flexibility, mobility, water walking, and symptoms such as daytime fatigue, exhaustion and tiredness.”

In addition to the thermal therapy, subjects also participated in a conventional rehabilitation program five times per week, with a focus on range of motion, muscle strengthening, basic activity training, gait and activities of daily living.

Outcome measures for this study were severity of pain, evaluated according to a visual analog scale; number of tender points painful upon digital palpation at a pressure of 4 kilograms; symptoms of fibromyalgia, assessed using a fibromyalgia impact questionnaire; and quality of life, measured from a 36-question survey. These outcomes were evaluated at baseline, then immediately after the 12 weeks of thermal therapy, then once more six months after the thermal therapy ended.

Results of the research revealed significant reductions in pain and symptoms immediately after the 12 weeks of thermal therapy. Compared to baseline levels, subjects experienced reductions in pain and symptoms ranging from 31 to 77 percent. At the six-month follow-up point, these reductions remained relatively stable, about 28 to 68 percent lower than baseline.

Quality of life among the participants showed significant improvements after the 12-week intervention period, and these improvements were maintained six months later as well.


Authors: Shuji Matsumoto, Megumi Shimodozono, Seiji Etoh, Ryuji Miyata and Kazumi Kawahira.

Sources: Department of Rehabilitation and Physical Medicine, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan. Originally published in 2011 in Complementary Therapies in Clinical Practice, 17, 162-166.