Written by Chrystal Moulton, Staff Writer. Thermal mineral bath therapy significantly improved quality of life (p<0.05) and functionality (p=0.01) in patients with osteoarthritis.
Osteoarthritis is the most common form of arthritis occurring in adults over the age of 50 1,2. It is a chronic disease characterized by progressive cartilage degeneration and affects the joints in the hands, knees, and hips 3. Current treatment for osteoarthritis is limited to non-steroidal anti-inflammatory drugs or selective cyclooxygenase 2 inhibitors 4. Hydrotherapy, specifically thermal mineral bath therapy, has been used historically to alleviate the pain associated with rheumatic diseases 5. In the current meta-analysis, researchers analyzed results from clinical trials on the efficacy of thermal mineral bath therapy for treatment of osteoarthritis 6.
Five electronic databases were searched for studies utilizing hydrotherapy in which mineral water was used to treat osteoarthritis. Studies were included if they were randomized controlled trials either parallel or case crossover design. The visual analog scale, WOMAC, or Lequesne index (LI) had to be used to assess pain and functionality at baseline and end of trial. Interventions for control group was not limited, however could not include mineral bath therapy. Studies were excluded if they were in a language other than English or if it had insufficient data. Researchers also assessed the risk of bias for each study.
A total of 534 studies related to thermal mineral hydrotherapy and osteoarthritis were found; of which, 16 randomized control studies met the inclusion criteria and were included in this meta-analysis. Data from 1273 participants were analyzed in this study (649 patients were allocated to the intervention groups and 624 to control groups). Risk bias assessment for each of the 16 studies included was low. Each trial also had low risk detection/performance bias, selection bias, and incomplete outcome data. With regard to pain relief, thermal mineral water therapy significantly improved visual analog scores (P<0.00001) and WOMAC scores (P<0.00001). Compared with the control group, patients treated with mineral water therapy also had significantly reduced Lequesne index (P = 0.011) [significantly improved functionality]. Three studies also demonstrated a significant improvement in quality of life for patients treated with thermal mineral water therapy even at 3-month follow up (p<0.05) 7-9. Thermal mineral water therapy was reported as generally safe; only four trials reported adverse effects. Side effects were light in intensity and generally included itchiness. However, none of the participants withdrew from the study as a result of adverse events.
Overall thermal mineral water bath therapy was shown to be an effective treatment for osteoarthritis. Mineral bath therapy significantly reduced pain and improved functionality of the affected joints. Quality of life was also significantly improved after treatment with thermal mineral water therapy. The researchers suspect that trace mineral penetration through the skin, composition of the solute content, water temperature, and other factors may contribute to these benefits 10. Further studies will be needed to determine a specific mechanism that provides these benefits.
Source: Ma, Tianwen, Xiaopeng Song, Yuanqiang Ma, Hailong Hu, Hui Bai, Yue Li, and Li Gao. “The effect of thermal mineral waters on pain relief, physical function and quality of life in patients with osteoarthritis: A systematic review and meta-analysis.” Medicine 100, no. 4 (2021).
© 2021 the Author(s). Published by Wolters Kluwer Health, Inc. This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial License 4.0 (CCBY-NC), where it is permissible to download, share, remix, transform, and buildup the work provided it is properly cited.
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Posted June 21, 2021.
Chrystal Moulton BA, PMP, is a 2008 graduate of the University of Illinois at Chicago. She graduated with a bachelor’s in psychology with a focus on premedical studies and is a licensed project manager. She currently resides in Indianapolis, IN.
References:
- Wu Y, Zhu S, Lv Z, et al. Effects of therapeutic ultrasound for knee osteoarthritis: a systematic review and meta-analysis. Clinical rehabilitation. 2019;33(12):1863-1875.
- Pereira D, Peleteiro B, Araújo J, Branco J, Santos RA, Ramos E. The effect of osteoarthritis definition on prevalence and incidence estimates: a systematic review. Osteoarthritis Cartilage. 2011;19(11):1270-1285.
- Bijlsma JW, Berenbaum F, Lafeber FP. Osteoarthritis: an update with relevance for clinical practice. Lancet. 2011;377(9783):2115-2126.
- Ofman JJ, MacLean CH, Straus WL, et al. A metaanalysis of severe upper gastrointestinal complications of nonsteroidal antiinflammatory drugs. The Journal of rheumatology. 2002;29(4):804-812.
- Cozzi F, Ciprian L, Carrara M, et al. Balneotherapy in chronic inflammatory rheumatic diseases-a narrative review. Int J Biometeorol. 2018;62(12):2065-2071.
- Ma T, Song X, Ma Y, et al. The effect of thermal mineral waters on pain relief, physical function and quality of life in patients with osteoarthritis: A systematic review and meta-analysis. Medicine (Baltimore). 2021;100(4):e24488.
- Hanzel A, Berényi K, Horváth K, Szendi K, Németh B, Varga C. Evidence for the therapeutic effect of the organic content in Szigetvár thermal water on osteoarthritis: a double-blind, randomized, controlled clinical trial. Int J Biometeorol. 2019;63(4):449-458.
- Fioravanti A, Tenti S, Giannitti C, Fortunati NA, Galeazzi M. Short- and long-term effects of mud-bath treatment on hand osteoarthritis: a randomized clinical trial. Int J Biometeorol. 2014;58(1):79-86.
- Hanzel A, Horvát K, Molics B, et al. Clinical improvement of patients with osteoarthritis using thermal mineral water at Szigetvár Spa-results of a randomised double-blind controlled study. Int J Biometeorol. 2018;62(2):253-259.
- Kosińska B, Grabowski ML. Sulfurous Balneotherapy in Poland: A Vignette on History and Contemporary Use. Adv Exp Med Biol. 2019;1211:51-59.