We found silver level evidence ( www.cochranemsk.org ) concerning the beneficial effects of mineral baths compared to no treatment .
Of all other balneological treatments no clear effects were found .
BACKGROUND Balneotherapy ( or spa therapy , mineral baths ) for patients with arthritis is one of the oldest forms of therapy .
One of the aims of balneotherapy is to soothe the pain and as a consequence to relieve patients ' suffering and make them feel well .
In this up date we included one extra study .
OBJECTIVES To assess the effectiveness of  balneotherapy  for patients with osteoarthritis ( OA ) .
[No difference in effectiveness measured between treatment in a thermal bath and in an exercise bath in patients with rheumatoid arthritis].
OBJECTIVE To determine whether hydrotherapy in a thermomineral institution is superior to the same hydrotherapy in an ordinary hospital exercise-bath . DESIGN Controlled therapeutic trial . SETTING The thermomineral institution at Arcen and the exercise bath at the Maasl and Hospital in Sittard , the Netherl and s. PATIENTS AND METHODS 46 patients with rheumatoid arthritis were treated in a by a skilled physiotherapist , according to a st and ardized exercise-scheme : 27 were treated in the thermomineral institution  and 19 ( control-group ) in the hospital exercise-bath .  Each patient received 12 treatments in 12 weeks . ENDPOINTS PARAMETERS : Morning stiffness , erythrocyte sedimentation rate , Ritchie index , amount of pain , answers to 11 questions concerning the activities of daily life , and psychosocial aspects of the disease . The various subjective and objective parameters were scored by the same physician . RESULTS Statistically significant improvement was observed in both groups concerning morning stiffness . Other subjective parameters improved , but did not reach significance . Objective parameters did not change significantly . Between-group differences were not found . CONCLUSION Hydrotherapy has a positive effect on some subjective but not on objective parameters in patients with rheumatoid arthritis , whether it is applied in a thermomineral institution or an ordinary hospital exercise bath
We found silver level evidence ( www.cochranemsk.org ) concerning the beneficial effects of mineral baths compared to no treatment .
Of all other balneological treatments no clear effects were found .
BACKGROUND Balneotherapy ( or spa therapy , mineral baths ) for patients with arthritis is one of the oldest forms of therapy .
One of the aims of balneotherapy is to soothe the pain and as a consequence to relieve patients ' suffering and make them feel well .
In this up date we included one extra study .
OBJECTIVES To assess the effectiveness of  balneotherapy  for patients with osteoarthritis ( OA ) .