In conclusion , even though limitations must be considered , evidence shows that BT and spa therapy can significantly improve QoL of patients with knee OA .
Moreover , reduction of drug consumption and improvement of algofunctional indexes may be other beneficial effects .
Knee osteoarthritis ( OA ) is a degenerative disease which is expected to become one of the leading causes of disability by the next years .
This work aims to assess if balneotherapy and spa therapy can significantly improve Quality of Life ( QoL ) of patients with knee OA .
Bath thermal waters in the treatment of knee osteoarthritis: a randomized controlled clinical trial.
BACKGROUND Osteoarthritis is a degenerative disease associated with pain , reduced range of motion , and impaired function . Balneotherapy or bathing in thermal or mineral waters is used as a non-invasive treatment for various rheumatic diseases . AIM To evaluate the effectiveness of hot sulfurous and non-sulfurous waters in the treatment of  knee osteoarthritis  . DESIGN A r and omized , assessor-blind , controlled trial . SETTING A spa resort . POPULATION One hundred and forty patients of both genders , mean age of 64.8±8.9 years , with knee osteoarthritis and chronic knee pain . METHODS Patients were r and omized into three groups : the sulfurous water ( SW ) group ( N.=47 ) , non-sulfurous water ( NSW ) group ( N.=50 ) , or control group ( N.=43 ) who received no treatment . Patients were not blinded to treatment allocation . Treatment groups received 30 individual thermal baths ( three 20-minute baths a week for 10 weeks ) at 37 - 39 ° C . The outcome measures were pain ( visual analog scale , VAS ) , physical function ( Western Ontario and McMaster Universities Osteoarthritis Index , WOMAC ; Lequesne Algofunctional Index , LAFI ; Stanford Health Assessment Question naire , HAQ ) , and use of pain medication . Patients were assessed before treatment ( T1 ) , at treatment endpoint ( T2 ) , and two months post-intervention ( T3 ) . Intra- and intergroup comparisons were performed at a significance level of 0.05 ( P<0.05 ) . RESULTS A significant decrease in VAS pain scores ( pain during movement , at rest , and at night ) and use of pain medication , and improvement in WOMAC , LAFI and HAQ scores were observed from baseline to T2 and T3 within treatment groups ( P<0.001 ) , and between controls and both treatment groups at T2 and T3 ( P<0.001 ) . No significant differences in these variables were observed between treatment groups at T2 , but patients in the SW group reported less pain and better functional status than those in the NSW group at T3 , showing a lasting effect of sulfurous water baths . CONCLUSIONS Both therapeutic methods were effective in the treatment of knee osteoarthritis ; however , sulfurous baths yielded longer-lasting effects than non-sulfurous water baths . CLINICAL REHABILITATION IMPACT Baths in thermal waters , especially those in sulfurous waters , are effective in reducing pain and improving physical function in patients with knee osteoarthritis
In conclusion , even though limitations must be considered , evidence shows that BT and spa therapy can significantly improve QoL of patients with knee OA .
Moreover , reduction of drug consumption and improvement of algofunctional indexes may be other beneficial effects .
Knee osteoarthritis ( OA ) is a degenerative disease which is expected to become one of the leading causes of disability by the next years .
This work aims to assess if balneotherapy and spa therapy can significantly improve Quality of Life ( QoL ) of patients with knee OA .