Effectiveness of Balneotherapy in Chronic Low Back Pain – a Randomized Single-Blind Controlled Follow-up Study

Abstract

Objective: Balneotherapy, a domain of medical science, focuses on utilizing the beneficial effects of medicinal waters. Low back pain is among the most prevalent musculoskeletal disorders affecting a large proportion of the population during their lifetime. Although small in number, all controlled studies published on this subject have demonstrated the benefits of balneotherapy. This present study was undertaken to compare the effects of hydrotherapy with mineral water vs. tap water on low back pain. Patients and Methods: A single-blind clinical study was carried out to appraise the therapeutic efficacy of reduced sulphurous water on 60 patients with low back pain. 30 subjects took baths in reduced sulphurous mineral water, whereas the other 30 patients used modified tap water of matching odor. Parameters determined at baseline, after balneo-/hydrotherapy, and at the end of the 3-month follow-up period included the results of the Visual Analogue Scale (VAS) score, the modified Oswestry index, mobility of the spine, antalgic posture, tenderness of the paravertebral muscles on palpation, the dose requirements for analgesics, and the efficacy assessed by the investigators and by the patients. Results: Bathing in mineral water resulted in a statistically significant improvement. This was reflected by the VAS (p < 0.01) and manifested by the mitigation of muscle spasm (p < 0.01), the alleviation of local tenderness (p < 0.01), the enhanced flexion-extension and rotation of the spine (p < 0.01) as well as by the improvement of the Schober’s index (p < 0.01). All these beneficial changes persisted as long as 3 months after the completion of balneotherapy. By contrast, hydrotherapy with tap water resulted only in the temporary improvement of just a single parameter: the VAS score improved significantly (p < 0.01). Conclusions: Balneotherapy in itself can alleviate low back pain. As demonstrated by this study, the analgesic efficacy and improvement of mobility accomplished by the use of mineral water is significantly superior to that afforded by hydrotherapy with tap water. Our results clearly establish the beneficial effects of mineral water. Moreover, it is a valuable adjunct to other forms of physical treatment as well as to pharmacotherapy.

Non-Pharmacological Therapies in Pain Management

“…Hot application stimulates the immune system, provides hormones that are suppressing the stress to be released, stimulates the circulation and digestion systems, increases the blood flow and provides muscle relaxation thus reducing the sensitivity developed against the pain (Karagöz, 2006). It is stated in the literature that hydrotherapy is effective while treating back and chronic lumbago (Balogh et al 2005;Hartel & Volger 2004).…”

Nonpharmacological correction of low back pain by single or integrated means of medical rehabilitation and the evaluation of their effectiveness

“…Mineralinės vonios žymiai mažino skausmą, raumenų spazmus, gerino nugaros raumenų lenkimą, tiesimą bei Medicina (Kaunas) 2009; 45 (9) rotaciją. Baigus gydymą, teigiamas mineralinių vonių poveikis išliko tris mėnesius, tuo tarpu gėlojo vandens vonių poveikis sumažino tik skausmą (56). Išvados 1.…”

Effects of balneotherapy on musculoskeletal disorders with chronic pain

“…the author rated the results as "encouraging" as regards the decrease of pain, and emphasized the need for further research [61]. since 2005, two tap water-controlled rcts have evaluated the effect of balneotherapy on chronic low back pain, and described the significantly better effects of balneotherapy on pain, mobility, and quality of life compared to hydrotherapy in chronic low back pain [62][63].…”

“…mineral water and peloids may also have a specific chemical effect. the significantly better effects of balneotherapy on pain, mobility, and quality of life compared to hydrotherapy in knee [54][55][56][57][58], and hand osteoarthritis [59] and in chronic low back pain [62][63] might indicate an additional specific chemical effect of thermal mineral water resulting from its composition.…”

“…a randomiZEd-controllEd, singlE blind, follow-up pilot study Objectives as mentioned in the literary overview, since the meta-analysis of pittler et al rated the results as only "encouraging" [61], two tap water-controlled rcts have showed the beneficial effect of balneotherapy on clinical parameters in patients with chronic low back pain [62][63]. the beneficial effect of hidro-and balneotherapy on quality of life in patients with chronic low back pain has been also reported [63,128].…”