Medical Hydrology and Balneology: Environmental Aspects

Which option; Balneotherapy or Spa Therapy
for treating osteoarthritis?
Karagülle MZ (1) , Karagülle M (1)
(1) Istanbul University. Istanbul Faculty of Medicine. Department of Medical Ecology and
Hydroclimatology, Istanbul, Turkey
mzkaragulle@tnn.net
Balneotherapy and spa therapy are the oldest forms of therapy that have been
used for centuries in the management of musculoskeletal disorders. “Balneo” comes
from the Latin word for bath; “balneum”. It refers simply to bathing in thermal or
mineral waters. Balneotherapy of modern times may be defined as “the therapeutic
use of mineral and thermal waters, usually through water immersion of part or all of
the body, but also through drinking certain amount of water and inhaling the vaporized
or dispersed water. The word “spa” comes from the name of a Belgian town
where a thermal spring was discovered in the fourteenth century. Throughout the
medical literature, it is common to come across the terminology spa therapy or
“complex spa therapy” which essentially means that the patient is receiving balneotherapy
(principal component) combined with mud therapy, hydrotherapy, exercise,
massage and possibly other natural therapy modalities. To what extent do other
modalities rather than balneotherpy contribute to the overall favorable effect of spa
therapy remains an enigma, considering the widespread use of spa therapy in
Europe? Additionally, it has to be stated that there is no scientific proof that balneotherapy
is only effective within the setting of a health resort.
Recently there are growing efforts to establish a scientific basis for balneotherapy
and spa therapy especially in Europe. The problem in assessing the value of spa
therapy is its complexity. Many factors may contribute positively to the therapeutic
effects of spa therapy, such as change of environment, the “spa-scenery”, the absence
of (house) work duties, physical and mental relaxation, the non-competitive
atmosphere with similarly suffering companions, combined therapies, etc. Furthermore,
to date it has not been clearly defined as to how many procedures and/or what
procedures when combined with balneotherapy constitute spa therapy and as a
result, these two terminologies have been used arbitrarily. Despite semantic, there is
an important question that it not yet answered satisfactorily- is spa therapy more
efficacious than balneotherapy? On the other hand balneotherapy alone is also
difficult to study, since it is usually part of total spa therapy. However, it has been
possible to compare the effects of balneotherapy with those of warm tap water in
double-blind trials in osteoarthritis of the knees. In other controlled trials, ambula-
Balnea
2012, núm. 6, 133-134
133
ISBN: 978-84-669-1887-0
978-84-669-3482-4