Spa therapy together with supervised self-mobilisation improves pain, function and quality of life in patients with chronic shoulder pain: a single-blind randomised controlled trial

Abstract

To determine whether spa therapy has a beneficial effect on pain and disability in patients with chronic shoulder pain, this single-blind randomised controlled clinical trial included patients with chronic shoulder pain due to miscellaneous conditions attending one of four spa centres as outpatients. Patients were randomised into two groups: spa therapy (18 days of standardised treatment combining thermal therapy together with supervised mobilisation in a thermal pool) and controls (spa therapy delayed for 6 months: ‘immediate versus delayed treatment’ paradigm). All patients continued usual treatments during the 6-month follow-up period. The main endpoint was the mean change in the French-Quick DASH (F-QD) score at 6 months. The effect size of spa therapy was calculated, and the proportion of patients reaching minimal clinically important improvement (MCII) was compared. Secondary endpoints were the mean change in SF-36, treatment use and tolerance. One hundred eighty-six patients were included (94 patients as controls, 92 in the spa group) and analysed by intention to treat. At 6 months, the mean change in the F-QD score was statistically significantly greater among spa therapy patients than controls (− 32.6 versus − 8.15%; p < 0.001) with an effect size of 1.32 (95%CI: 0.97–1.68). A significantly greater proportion of spa therapy patients reached MCII (59.3 versus 17.9%). Spa therapy was well tolerated with a significant impact on SF-36 components but not on drug intake. Spa therapy provided a statistically significant benefit on pain, function and quality of life in patients with chronic shoulder pain after 6 months compared with usual care.

Effects of Complex Spa Therapy in Patients with Osteoarthritis of the Spine Receiving Treatments in Health Resorts in South-Eastern Poland

“…During the initial period of spa therapy problems related to pain may temporarily become aggrevated 17 . As a rule, however, the therapy is well tolerated, as a result of which it can be applied multiple times 17,18,21 . Other researchers reported such undesirable events as: more severe pain, increased blood pressure, weakness, allergic reaction and higher temperature.…”

Pre-habilitation in Enhanced Recovery After Surgery Programs: A New Potential for Balneology and Physical Medicine to Benefit Patients

“…In the recent decades, more and more studies (including high-quality meta-analysis and systematic reviews) have reported the beneficial effects of balneotherapy, including mud therapy, on different clinical outcomes in patients with osteoarthritis (OA) [11][12][13], rheumatoid arthritis [13], fibromyalgia [14], and other rheumatic conditions [15]. The main clinical parameters improved by balneotherapy and mud therapy in OA and other rheumatic conditions are analgesic drug consumption, function, stiffness, pain, and quality of life [1,14,15,].…”

“…Psoriasis treatment increasingly often utilises balneophysiotherapy (5-9). Balneophototherapy is administered in many countries and uses various natural resources (11)(12)(13)(14)(15)(16)(17)(18). The majority of studies evaluate 311-nm UVB radiation with bathing in the Dead Sea, Dead Sea salt solutions, or brine baths with parameters similar to those of the Dead Sea water.…”

“…Treatment of psoriasis includes sulphide/hydrogen sulphide baths, 311-nm UVB radiation, and cryotherapy (7)(8)(9)(10)(11)(12)(13)(14)(15)(16).…”

Noninvasive management of soft tissue disorders of the shoulder: A clinical practice guideline from the Ontario Protocol for Traffic Injury Management (OPTIMa) collaboration

“…The second updated searches of seven systematic reviews (extending from April 15, 2013 to April 26, 2019) for this guideline yielded 842 articles (after duplicates removed), of which 32 were relevant and 19 RCTs (reported in 21 articles) had a low risk of bias (Apeldoorn et al, 2017;Bjornsson Hallgren et al, 2017;Calvo-Lobo et al, 2018;Chary-Valckenaere et al, 2018;Devereaux et al, 2016;Goksu et al, 2016;Haik et al, 2017;Heron et al, 2017;Holmgren et al, 2012;Kibar et al, 2017;Kolk et al, 2013;Kromer et al, 2014;Kvalvaag et al, 2017Kvalvaag et al, , 2018Li et al, 2017;Littlewood et al, 2016;Mintken et al, 2016;Nazligul et al, 2018;Perez-Merino et al, 2016;Perez-Palomares et al, 2017;van der Dolder et al, 2015) and 11 studies had a high risk of bias (Beaudreuil et al, 2015;Del Castillo-Gonzalez et al, 2016;Ketola et al, 2017;Lugo et al, 2016;Moezy et al, 2014;Osteras & Torstensen, 2010;Pan et al, 2016;Rueda et al, 2016;Seven et al, 2017;Subasi et al, 2016;Zhang et al, 2016;Appendices VIB and VIII) Littlewood et al, 2016); (e) passive physical modalities (9 articles; Apeldoorn et al, 2017;Devereaux et al, 2016;Goksu et al, 2016;…”