Godište 35 supplement 2 - Institut za reumatologiju

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SUMMARY
The Institutefor Prevention, Treatment and Rehabilitation of Rheumatic and Cardiovascular Diseases
"Niška Banja"
THE PLACE OF BALNEOTHERAPY IN THE TREATMENT OF RHEUMATIC DISEASES
ALEKSANDAR DIMIĆ
Spa therapy comprises the use of natural factors such hydrotherapy, mud therapy, gas, as well as
the change of the surrounding and climate, active and passive rest and the combination with physical and
medicaments therapy. Spa therapy has a significant place in the treatment of almost all kinds of rheumatic
diseases. The effects of balneotherapy are based on the chemical and mineral structure of the components
and their absorption. The effects like vasodilatation, the increase of stroke volume, stimulation of
metabolism as well as the immune system are well documented. Significant variation of endorphin,
cortisol and ACTH the increase of the insulin growth factor 1, decrease of the alpha tumor necrosis factor,
decrease of serum levels of azoth oxide and mieloperoxidase are found, and this the explanation for
favorable effect of spa therapy in various forms of arthritis. The approach to these patients should be
cautious, with the reduction of all elements of so called balneotherapeutic dosage. In the treatment of OA
the most favorable influence have carbondioxid, sulphuric and radon waters in the combination with mud
therapy.
Spa therapy can be also used in the prevention and treatment of OP. Physical activity and
exercises have a great impact in the prevention and treatment of established OP. Swimming is especially
favorable. During spa treatment an education concerning diet rich in calcium should be performed. After
vertebral compression fracture due to OP the use of moist heat can be very useful in order to alleviate the
pain and to prepare the patient for exercises that increase the strength of dorsal and abdominal muscles.
All these activities are more acceptable during spa treatment in the specialized centers.
Spa therapy should be used isolated or in so called balneophysical and
balneophysicomedicamentous complex, respecting the principle of the individual dosage.
Key woords: balneotherapy, rheumatic diseases