Evaluation of the effect of balneotherapy in patients with osteoarthritis of the hands: a randomized controlled single-blind follow-up study

Abstract

Objective: To evaluate the effectiveness of thermal mineral water compared with magnetotherapy without balneotherapy as control, in the treatment of hand osteoarthritis.

Design: Randomized controlled single-blind follow-up study.

Setting: Rheumatology specialist clinic of Gunaras Health Spa.

Subjects: Patients between 50 and 70 years of age with hand osteoarthritis, randomly assigned into three groups.

Interventions: The subjects in the first two groups bathed in thermal mineral water of two different temperatures (36°C and 38°C) for three weeks five times a week for 20 minutes a day and received magnetotherapy to their hands three times weekly. The third group received only magnetotherapy.

Outcome measures: Visual analogue scale scores, handgrip strength, pinchgrip strength, the number of swollen and tender joints of the hand, the duration of morning joint stiffness, Health Assessment Questionnaire, and Short Form-36 questionnaire. The study parameters were administered at baseline, immediately after treatment and after 13 weeks.

Results: The study included 63 patients. Statistically significant improvement was observed in several studied parameters after the treatment and during the follow-up study in the thermal water groups versus the control group. The 38°C thermal water treatment significantly improved the pinch strength of the right hand (0.6 (95% confidence interval (CI) 0.2 to 1.1) vs. 0.03 (95% CI −0.3 to 0.4), P < 0.05) and the Health Assessment Questionnaire parameters (−0.4 (95% CI −0.6 to −0.2) vs. −0.1 (95% CI −0.2 to 0.1), P < 0.01) even in the long term.

Conclusions: Balneotherapy combined with magnetotherapy improved the pain and function as well as the quality of life in patients with hand osteoarthritis.