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Balneotherapy – Origin, Benefits, Efficacy, and Methodology
Hot water has been used for many years in widespread cultures and places to treat musculoskeletal aches and pains. Many geographical sites that have unique physical and chemical properties are used by people suffering from many different types of disorders. These disorders have been traditionally called “rheumatism”

Water is considered to be the essence of life. Humans are completely dependent on the continued availability of water, just like other life forms. Thus, human civilization has developed varied sources of fresh water.

  • Since ancient times, water has been given a place of significance in human culture, religion, and leisure.
  • Water is considered to be the spiritual and moral aspect of cleansing the body and soul.
  • It is said to have the ability to purify, cure and correct.

The use of water for medical purposes dates back to ancient times and is prevalent in many cultures around the world.1

What Is Balneotherapy? Where Does It Originate?
Balneotherapy is a traditional modality in medicine. It is defined as the use of natural mineral waters, natural sources of different gases (CO2, H2S, and Rn), and natural peloids and mud for medicinal purposes such as prevention, rehabilitation and treatment of diseases.2

There are several ways in which balneotherapy can be administered:

  • Head-out immersion in mineral water
  • Application of mud packs or peloid-packs to body regions
  • Exposure to gases during bathing
  • Inhalation of gases
  • Drinking mineral water2

The therapy can be given at spas with a special resort environment and atmosphere, or elsewhere.2

How Is Balneotherpay Beneficial?
Balneotherapy has been used in Europe and in other parts of the world traditionally since ancient times for the treatment of:

  • Musculoskeletal disorders
  • Gynaecological disorders
  • Dermatological ailments, such as psoriasis
  • Peripheral vascular disease2

Other applications of balneotherapy are:

  • Inhalation therapy for laryngeal diseases
  • Oncology rehabilitation programs – the drug sparing effect can be used in psychiatry.
  • Cardiovascular rehabilitation – this occurs due to the positive haemorheological effects of natural carbonated mineral water.2

Bathing in Dead Sea water and exposure to ultraviolet radiation has a healing effect on psoriasis.

  • It reduces pain and improves joint function, as well as quality of life, in rheumatoid arthritis, ankylosing spondylitis, psoriatic arthritis, and osteoarthritis.
  • It does not increase blood pressure.

Thermal mineral water has been used empirically to treat various ailments for centuries.2

Studies/Research On The Efficacy Of Balneotherapy

  • In the last 30 years, the efficacy of balneotherapy in treating certain disorders has been proven by several controlled trials.
  • The mode of action of balneotherapy is still unclear.2

Thermal mineral water brings relief from pain due to different musculoskeletal disorders.

  • The composition of mineral water, qualitatively and quantitatively does not matter.
  • It is suggested that minerals act on cutaneous nerve endings and bring about long-lasting gate control.2

How is Balneotherapy Performed?

  • Spa therapy refers to the combination of balneotherapy and other treatments administered in a spa setting.
  • Medical spas are located in areas where the elements of the earth are present.

The direct action of balneotherapy takes into account physical action of water on the body, such as hydrostatic pressure, viscosity, buoyancy, and frictional resistance. The thermal, chemical, and pharmacologic effects of percutaneous absorption of the substance being used are also considered.

  • Substances found in hot spring waters are carbon dioxide, chloride, hydrogen sulfide, iron, sulfate, acid and radon.
  • Mineral waters contain cations such as potassium, calcium, sodium, and magnesium as well as anions such as SO4-, Cl-, and HCO3-. The concentration of these ions is quite high (1 g/L).
  • In spring water, the levels of nitrogen compounds such as nitrogen dioxide, nitrogen oxide and nitrates are very low. The water also has very little bacteria.
  • Mineral-containing muds, plant preparations, and peat muds are also used.

The indirect actions of balneotherapy occur due to repeated application of therapeutic stimulation, such as climatic exposure to the elements, social and psychological effects of change in external environment and training effects of exercises.3

How Can People Get Started With Balneotherapy?
Balneotherapy differs from hydrotherapy in that there are no acquatic exercises involved. It can be administered in two ways:

  • In the traditional approach, patient is required to stay in the spa for the entire duration of treatment (10-21 days).
  • In the intermittent regimen approach, patient goes home after each daily treatment session.4

Any Precautions, Interactions, Or Contraindications
There are no known safety concerns associated with balneotherapy. No significant adverse effects have been reported in scientific studies.

1. Ablin JN, Häuser W, Buskila D. Spa treatment (balneotherapy) for fibromyalgia-a qualitative-narrative review and a historical perspective. Evid Based Complement Alternat Med. 2013;2013:638050. doi: 10.1155/2013/638050. Epub 2013 Jul 31. PubMed PMID: 23983795; PubMed Central PMCID: PMC3747489.

2. Bender T, Bálint G, Prohászka Z, Géher P, Tefner IK. Evidence-based hydro- and balneotherapy in Hungary–a systematic review and meta-analysis. Int J Biometeorol. 2014 Apr;58(3):311-23. doi: 10.1007/s00484-013-0667-6. Epub 2013 May 16. PubMed PMID: 23677421; PubMed Central PMCID: PMC3955132.

3. Pizzorno J.E., Murray M.T. Textbook of Natural Medicine. Elsevier Health Sciences; 2012. 1916p.

4. Sherman G, Zeller L, Avriel A, Friger M, Harari M, Sukenik S. Intermittent balneotherapy at the Dead Sea area for patients with knee osteoarthritis. Isr Med Assoc J. 2009 Feb;11(2):88-93. PubMed PMID: 19432036.


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