Balneotherapy Reduces Pain in Patients with Fibromyalgia, Trial Shows

Balneotherapy Reduces Pain in Patients with Fibromyalgia, Trial Shows

A type of spa therapy called balneotherapy was found to be safe and effective in reducing pain in patients with primary fibromyalgia, a clinical trial shows.

Findings were reported in the study, “Is balneotherapy effective for fibromyalgia? Results from a 6-month double-blind randomized clinical trial,” published in the journal Clinical Rheumatology.

Fibromyalgia is associated with chronic widespread pain, fatigue, and tenderness in specific sites of the body called tender points. Management of the disease usually requires a combination of approaches with pharmacological and nonpharmacological treatments, such as hot and cold applications, patient education, physical rehabilitation, and balneotherapy.

Balneotherapy consists of immersing the patient in mineralized and/or thermal waters from natural springs.

Previous clinical trials using balneotherapy to treat physical conditions showed improvements in pain and tender point counts, which lasted from three to six months. Researchers also concluded that balneotherapy is well-tolerated and causes less side effects in patients than pharmacological treatments. However, some aspects of these studies were limited or may have led to bias.

Conducted in Italy, this prospective, randomized, double-blind study (NCT02548065) investigated the effectiveness and tolerability of balneotherapy with a highly mineralized sulfate water in primary fibromyalgia patients.

The study enrolled 100 patients with fibromyalgia who were randomized to receive 12 applications of either daily balneotherapy with highly mineralized sulfate water, called the BT group, or with tap water, the control group, over two weeks. Clinical outcomes were measured at initial screening, at the beginning of the treatment, immediately after the treatment, and then again at three and six months.

The trial’s primary objective measure was the change in global pain using two international scales: Visual Analogue Scale (VAS) and Fibromyalgia Impact Questionnaire total score (FIQ-Total). Secondary outcomes related to symptom severity and the presence of other conditions were also measured.

Researchers found a significant improvement in global pain in the BT group, measured by the VAS and FIQ-Total scales, at the end of the treatment, lasting for six months. No significant changes were found in the control group.

Similar results were found for secondary outcomes except anxiety, where no significant differences were observed in either group. Adverse events, including pain or stiffness, headache, and lack of energy or strength, were reported in 10 patients in the BT group and 22 patients in the control group. In the BT group, these side effects were generally mild and temporary, and no patient discontinued treatment. In the control group, two patients had to stop the therapy due to an exacerbation of symptoms.

Heat, chemical and antioxidant activity of the minerals, and reduced levels of inflammatory molecules in the bloodstream were among the factors pinpointed as the main reasons for these improvements.

These results support the short- and long-term benefits of balneotherapy use in fibromyalgia.

“Considering the usual side effects often associated with pharmacological therapy, this conclusion underlines the practical utility and the growing importance of BT among other complementary and non-pharmacological modalities in the management of fibromyalgia,” the researchers concluded.