The use of water for therapeutic applications is likely as ancient as humanity.
Spa treatment, including hydrotherapy and balneotherapy, was still prevalent until the early twentieth century.
But this decreased with the development of effective analgesics.
No analgesic, though, is able to combat pain regardless of potency.
Reports of life-threatening adverse drug reactions led to a renewed concern in a spa treatment. Nevertheless, there is indeed confusion regarding hydrotherapy and balneotherapy.
The former utilizes strictly, water, while the latter uses natural thermal mineral water. Spa therapy uses a range of distinct treatment methods, including hydrotherapy and balneotherapy, and by changing the setting and mood generates a unique therapeutic atmosphere of its own.
Because of methodological problems and absence of financing for studies, the impacts of ' water medicines ' in pain relief have rarely been rigorously evaluated through randomized, monitored studies.
The few that have been performed, however, show that in inflammatory and noninflammatory rheumatic diseases, chronic low back pain, and fibromyalgia, pain can be eased.
Pain relief in several studies has spanned 3 to 9 months. Spa therapy's placebo impact plays a significant role. The processes of the intervention of water
treatment-in particular the special effects asserted for natural mineral waters-remain mainly unspecified.
Human life has certainly been full of physical and psychologic pain ever since its beginnings. Pleasure, it is well known, reduces pain. ( Stevens,1989)
In postindustrial societies, chronic pain syndromes appear to be on the ascendant, owing to "unpleasant." psychologic and mechanical factors (Anderson 1993 ) ( Macfarlane 1999)
In ancient times, water therapy was an integral part of the therapeutic inventory of medicine. Physicians, including Aesculapius, Hippocrates, Galen, and Celsus,frequently used water as treatment.
Patients admitted to the healing temples of Aesculapius first washed in a large pool before being accepted to the 'wards.'
Floating on water and immersion were found useful in relaxing muscles. ( Kjelllgren 2001 ) (Garrett G 1997 )
A range of varying disorders has been considered suitable for therapy, some of which are treated in contemporary spas, particularly musculoskeletal discomfort.
Roman baths and spas were centers not only for cleansing, exercising, and medical treatment but also for relaxation and meeting friends and
In many European countries, as well as in Japan and Israel, this therapeutic approach has been effectively used as a remedy for multiple diseases in conventional medicine.
Thousands of years of history and the proliferation of spa facilities have undoubtedly led to
availability in many countries.
Spa treatment aims at:
The term ' spa ' originates from the name of a Belgian town where, in the fourteenth century, a thermal spring has been discovered.
Spa therapy is a viable treatment for many rheumatic diseases.
The processes by which immersion in mineral or thermal water or mud application alleviates rheumatic pain is not fully grasped.
Its complexity is the culmination in evaluating the importance of spa treatment.
Probably the cumulative advantage is the direct result of a mixture of variables with mechanical, heat and chemical outcomes among the most notable. All play significant functions in buoyancy, immersion, endurance, and temperature.
According to the gate theory, warm stimuli may affect muscle tone and intensity of pain, helping to alleviate muscle spasms and boost the tolerance for pain.
Pain relief may be due to stress and temperature of the water on the skin.
Mud-bath therapy rises concentrations of plasma b-endorphin and corticotropin, cortisol, growth hormone, and prolactin secretion.
Recently, thermal mud-pack therapy has been shown to induce a decrease in circulating concentrations of prostaglandin E2 (PGE2), leukotriene B4 (LTB4), interleukin-1b (IL-1b), and
tumor necrosis factor-a (TNF-a), significant inflammatory and pain mediators.
Spa treatment has been discovered to trigger growth factor-1 (IGF1) that stimulates cartilage metabolism and transforms growth factor-b (TGF-b).
There is also proof of beneficial intervention on the oxidant / antioxidant scheme both by mud - packs and thermal baths, with the reduced discharge of reactive oxygen (ROS) and nitrogen (RNS) organisms.
Perhaps the most critical aspect of spa therapy is the psychologic effect of removal from the stress of home and work.
This effect has long been recognized in patients after admission to hospital and in rheumatoid arthritis the benefit of hospitalization, in terms of pain relief far exceeds that of antirheumatic drugs, except large doses of corticosteroids ( Lee P, 1974 ).
Besides, there is an immunosuppressive benefit in thermal stress.
The patients receiving spa therapy experienced not only reduced pain and improved function but also experienced the higher physical and mental quality of life and less anxiety and
depression (Constant F, (1995), Franke A,(2000).
The mechanism of action of these effects may be adaptive modifications in regulatory systems,
especially of autonomous functions, and behavioral changes (Gutenbrunner C, 1998, Hildebrandt
G, 1996 ).
Balneotherapy is a form of hydrotherapy. It includes the use of water or bathing to cure diseases, such as a warm afternoon bath, or baths with modified mineral content. Balneotherapy offers a reckoning of natural thermal mineral waters.
Shai et al. ( Shanji J, 1985 ) in Israel noted, however, increased serum concentrations of bromine, rubidium, calcium, and zinc
in psoriatic patients after bathing in the Dead Sea. Warm baths can have a positive impact on sleep by progressively growing core body temperature, with the subsequent decrease in core body temperature, encouraging sleep.
Despite its frequent use, the function of balneotherapy for insomnia has been examined by a few research studies. Some have suggested that warm bath balneotherapy has a positive impact on health.
For therapy to be effective, it should be performed in the evening, with at least 20 to 30 minutes between the end of the bath and bedtime to allow for initiation of core body temperature cooling.
A meta-analysis of balneotherapy demonstrated that it is an effective treatment for fibromyalgia, and consistently improves sleep quality for this population.
One study comparing balneotherapy to pool-based exercise noted an improvement in both groups.
Balneotherapy alone may thus be a viable option for patients unable to perform pool exercises.
Balneotherapy is an ancient practice that uses water to relieve and regenerate the organism. Archeologists in the palace of Knossos found vestiges of ancient bathrooms dating back to 1700 B.C., suggesting that the Greeks valued the effects of a good, prolonged dip.
The father of modern medicine, Hippocrates also recorded the water's healing energy. He promoted the use of saline baths and frequently bathed his patients in seawater to heal some ailments, including muscle pain and arthritis. Ancient Egyptians similarly embraced water-based therapies with eagerness.
Cleopatra (69-30 B.C.) visited the Dead Sea to immerse in its mineral-rich waters and may have introduced close to its seashores pharmaceutical and cosmetic facilities.
But it was the Romans who took bathing to a different level of complexity.
Initially, Roman baths were tight, private, and discreet.
Later on, there have appeared bigger baths in the surroundings, followed by large baths throughout the population.
The Caracalla Baths characterized the apex of the Roman bathing experience.
The Caracalla Baths spanned 27 acres and were capable of accommodating 1,600 individuals at the moment. They were built between 206 A.D. and 217 A.D.
Balneotherapy and mud therapy have been used empirically since time immemorial to treat a wide range of conditions [A brief history].
Thermal baths are considered an integral part of traditional medicine in many cultures and countries (France, Italy, Spain, Portugal, Germany, Austria, Switzerland, Turkey, Poland, Czech Republic, Hungary, Romania, Russia, Israel, Japan, and others), and nowadays they are a relevant part of the public health systems of many countries within and outside Europe [A proposal for].
Balneotherapy is a complementary procedure that is clinically efficient in the treatment of low-
grade pathologies associated with inflammation and stress.
In medical hydrology and physical medicine, spa treatment involves various methods relying on
the therapeutic properties of water, including balneotherapy and hydrotherapy.
Balneotherapy is an incorporation of procedures which, based on scientific evidence, employs
medically and legally identified mineral-medicinal waters, muds, and natural gases from natural
springs for therapeutic reasons within thermal spa center facilities, depending on scientific
It is noted that the mechanisms of these activities involve neuroendocrine and immunological responses — including both humoral and cell-mediated immunity.
The effectiveness undertakes anti-inflammatory, analgesic, antioxidant, chondroprotective, and anabolic activities together with neuroendocrine-immune regulation in various conditions.
Temperature plays a critical element in the efficacy of balneotherapy..
Mineral-medicinal water and mud are frequently used warm as they are excellent heat transfer vehicles — capable of holding heat and releasing it slowly.
Thus, thermotherapeutic procedures can be regarded as such.
The peculiarity of balneotherapy is that its beneficial effects on the organism are brought about not only by the physical properties of mineral-medicinal water and mud but also by their chemical and biological composition.
Conversely, in other spa treatments such as hydrotherapy—in which plain tap water is used—
only the physical properties of water (temperature, hydrostatic pressure, hydrodynamics,
buoyancy, viscosity, electric conductivity, etc.) take part in the beneficial effects of the
intervention ( Gomes C. )
According to Archimedes ' law, some exercises in water are made convenient, while others such as walking are harder. Due to stress and temperature impacts on nerve cells and muscle relaxation, pain can be eased.
According to hydrotherapy advocates, coldwater triggers superficial blood vessels to constrict, shifting blood flow away from the body's surface into organs.
Hot water dilates surface blood vessels, activates sweat glands, and removes residues from body tissues. Hot and cold water alternations are supposed to reduce inflammation and enhance circulation and lymphatic drainage.
Popular varieties are as follows:
Physiological modifications in the body appear initially to be caused by the influence of water buoyancy and heat transfer into the body.
A layer of water envelops the body in an ordinary bath, rapidly cooling to body temperature. This effect of ' wet suit ' efficiently prevents heat transfer to the body.
With its flowing currents, hydrotherapy breaks this layer and enables the instant and efficient transfer of heat, soothing tensed muscles and improving blood flow to the tissues.
The warmth has a sedative action on the nerve endings, reducing pain and distress.
The buoyancy effect removes the gravity influence and enables the free motion of joints and muscles.
The jet pressure, therefore, provides a more profound impact, while the water pressure helps eliminate edema (liquid inflammation) in the tissues.
This stress also affects the slight and profound touch receptors in the nerve cells, assisting the pain-carrying fibers in preventing from transmitting their ' painful ' signals to the brain.
According to GATE pain theory, the pleasant feeling effectively enables the flow of painful impulses to ' block out. '
Also, the tension continues to produce endorphins, the same pain-killing substances produced through intense exercise, massage, or acupuncture.
Cold to lukewarm water is generally useful for swelling; it gets worse with too much heat. Coldwater stimulates tissue circulation and reduces inflammation; this draws more cells to an injury site and encourages healing.
The mechanical effects of hydrotherapy are, therefore:
The impacts are due to one's conscious awareness of hydrotherapy-induced impulses. Massage in any form is a stimulus that can refresh a stiff or fatigued limb or joint if given for a short time.
However, more extended exposure will aggravate one's response, decreasing sensory distractions, and resulting in relaxation.
It can be used before sports activities as a pre-workout activity that enhances the whole body and lessen the risk of injury.
Hydrotherapy is beneficial in encouraging rehabilitation and avoiding subsequent stiffness after intensive training.
Hydrotherapy will encourage the revert of lymph flow and purification from the body of waste products, thereby accelerating regeneration.
Hydrotherapy provides an outstanding way for a relaxed, safe, and pain-free body to recover and preserve.
A body in a state of comfort and equilibrium can assist us in dealing with a
contemporary existence that is often over-stressed. Buoyancy, immersion, resistance, and temperature all play essential roles.
According to the gate theory, pain relief may be due to the pressure and temperature of the water on the skin. ( Melzck R, Wall PD ( 1965 )
Water immersion induced an increase in methionine-encephalin plasma levels and, conversely, suppressed plasma - B endorphin, corticotropin, and prolactin levels. ( Coruzzi P, 1988 ).
Muscle relaxation ( Kjelllgren A 2001, Garrett G ( 1997 ) ) and reduced joint swelling ( Grahame R, O' Hare JP, Hall J, ) may also play a role.
Significant improvements in mood and tension may contribute to the results ( Hall J,1996). Reilly and Bird found that group therapy in a community swimming pool was more effective than individual treatment in the pool of a hospital. This was probably due to concentrating on health improvement and well being, instead of disease, and to encouraging social interaction ( Reilly KA,2001).
Shanji J, Barak S, Levi D et al. ( 1985 ) Skin penetration
of minerals in psoriatics and guinea-pigs bathing in hypertonic salt solutions.
Pharmacol Res Commun 17:501 - 512
Andrejew SV, Selenskaja VS ( 1991 ) Das Verhalten des in den Korper aus dem Sulfidbad
eindringenden Schwefels. In: Pratzel HG, Buhring M, Evers A (eds) Schwefel in der Medizin. DEmeter, Grafelfing pp. 35-41
Pratzel HG, Aigner UM, Weinert D, Limbach B ( 1992 ). Zur analgetischen Wirksamkeit eines Schwefelmoorbades bei weichteilreumatischen Beschwerden.
Eine randomisierte Doppelblindstudie. Phys Rehab Kur Med 2:92 - 97
Gutenbrunner C, Kopetzki K, Neues-Lahusen M, Gehrke A ( 1999 )
Wirkungen naturlicher thermoindifferenter Schwefelbader auf Hautdurchblutung und
Schmerzempfindlichkeit bei Gesunden und Patienten mit chronisher Polyarthitis. Akt Reumatol 24: 117 - 123
Karagulle MZ, Tutuncu Zn, Aslan O, Basak E, Mutlu A ( 1996 ) Effects of thermal sulfur bath cure on adjuvant arthritic rats. Phys Rehab Kur Med 6:53 - 57
Jockel H ( 1997 ) Praktische Erfahrungen mit der Radontherapie. In : Pratzel HG, Deetjen P ( eds ) Radon in der Kurortmedizin.
Kappel M, Gyhrs A, Galbo H, Pedersen BK ( 1997 ) The response on glucoregulatory hormones of in vivo whole-body hyperthermia. Int. J Hyperthermia 13: 413 - 421
Bellometti S, Galzigna L ( 1998 ) Serum levels of prostaglandin and leukotriene after thermal mud pack therapy. j Investig Med 46: 140 - 145
Lee P, Kennedy AC, Anderson J, Buchanan WW ( 1974 ) Benefits of hospitalization in
rheumatoid arthritis. Q J Med 42" 205 - 214
Strauss-Blasche G, Ekmekcioglu C, Leibetseder V, Melchart H, Marktl W ( 2002 )
Seasonal variation in effect of spa therapy on chronic pain.
Lee P, Webb J, Anderson J, Buchanan WW ( 1973 ) Method of assessing the therapeutic
potential of anti-inflammatory drugs in rheumatoid arthritis. Br Med J 2: 685 - 688
Helliwell PS ( 1989 ) An appraisal of medicinal spa therapy for rheumatological disorders. J R Soc Health 109 : 3 - 7
Constant F, Collin JF, Guillemin F, Boulange ( 1995 ) Effectiveness of spa therapy in chronic low back pain: a randomized clinical trial. J Rheumatol 22:1315 - 1320
Evcik D, Kizilay B, Gokcen E ( 2002 ) The effects of balneotherapy on fibromyalgia patients. Rheumatol Int 22:54-59
Gutenbrunner C, Hildebrandt G ( 1998 ) Textbook of balneology and medical climatology ( German ). Springer, Berlin Heidelberg Bew York Tokyo.
Hildebrandt G, Gutenbrunner C ( 1996 ) Uber adaptive Normalisierung.
Forsch Komplementarmed 3: 236 - 243.
Franke A, Reiner L, Pratzel HG, Franke T, Resch Kl ( 2000 ) Long-term efficacy of radon spa therapy in rheumatoid arthritis - a randomized, sham-controlled study and follow-up. rheumatology ( Oxford ) 39: 894 - 902
DE Vierville Jp (1997) Aquatic rehabilitation: a historical perspective. In " Becker Be, Cole AJ (eds) Comprehensive aquatic therapy. First. edn.
Butterworth-Heinermann, Boston, pp 1-16
Melzck R, Wall PD ( 1965 ) Pain mechanism: a new theory. Science 150:971 -979
Coruzzi P, Ravanetti C, Musiari L, Biggi A, Vescovi PP, Novarini A ( 1988 ) Circulating opioid peptides during water immersion in normal man. Clin Sci ( Lond ) 74: 133 - 136
Kjelllgren A, Sundequist U, Norlander T, Archer T ( 2001 ) Effects of flotation - REST on
muscle tention pain. Pain Res Manag 6: 181 - 189
Garrett G ( 1997 ) Hydrotherapeutic applications in arthritis rehabilitation. In: Becker BR, Cole AJ ( eds) Comprehensive aquatic therapy. First edn. Butterworth - Heinermann, Boston, pp 103-122.
Grahame R, Hunt JN, Kitchen S, Gabell A ( 1978 ) The diuretic and natriuretic effect of water immersion - a possible rationale for balneotherapy. Ann Rheum Dis 37:567
O' Hare JP, Heywood A, Dodds P, Corral RJM, Dieppe P ( 1984 ) Water immersion in
rheumatoid arthritis. Br J Rheumatol 23: 117 - 118
Hall J, Skevington SM, Maddison PJ, Chapman K ( 1996 ) A randomized and controlled
trial of hydrotherapy in rheumatoid arthritis. Arthritis Care Res 9: 206 - 215
Reilly KA, Bird HA ( 2001 ) Prophylactic hydrotherapy. Rheumatology ( Oxford ) 40: 4- 6
Mechanisms of action of spa therapies in rheumatic diseases:
what scientific evidence is there?
Antonella Fioravanti • Luca Cantarini •
Copyright © 2022 CenterforAncientAlchemyandTheHealingArts - All Rights Reserved.
Powered by GoDaddy Website Builder