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 ) .
Effect of Sulfur Baths on Antioxidative Defense Systems, Peroxide Concentrations and Lipid Levels in Patients with Degenerative Osteoarthritis
Background : Due to possible antiinflammatory effects , sulfur baths are widely used for the treatment of rheumatic diseases . Previously it was demonstrated that drinking cures with sulfur can improve the antioxidative defense system and lower the peroxide levels of patients with chronic degenerative osteoarthritis . Objective : This study therefore sought to investigate the effect of 3-week therapy with sulfur baths on antioxidative defense systems , peroxide concentrations , and lipid levels in patients with degenerative osteoarthritis . Patients and Methods : After r and omization one group of patients ( n = 19 ) received sulfur baths during their stay at a health resort ( sulfur group ) , whereas the other age-matched patient group served as controls ( n = 19 , control group ) , only receiving spa therapy .  Total cholesterol levels , HDL , LDL , triglycerides and the antioxidative status , glutathione peroxidase , and superoxide dismutase ( SOD ) activities , and peroxide concentration , as an oxidative stress parameter , were evaluated at the begin and end of therapy . Results : A 17.2 % decline in peroxide concentrations ( p = 0.10 , n.s . ) and significant lower SOD activities ( p < 0.001 ) were detected in the sulfur group at the end of the therapy . Until the end of therapy total cholesterol levels changed differentially ( p = 0.007 ) in the sulfur group ( from 229.11 ± 34.47 mg/dl to 217.46 ± 40.45 mg/dl ) and in the control group ( from 197.63 ± 34.66 mg/dl to 207.95 ± 33.02 mg/dl ) . A similar significant group difference was found for LDL ( p = 0.017 ) , with a 5.9 % reduction in the sulfur group and a 6.1 % increase in the control group . Triglyceride concentrations were nonsignificantly reduced in both groups after 3 weeks at the health resort ( sulfur group 11.2 % , control group 20.2 % ) . HDL values only minimally changed in both groups . Conclusions : The results presented here suggest that a sulfur bath therapy could cause a reduction in oxidative stress , alterations of SOD activities , and a tendency towards improvement of lipid levels
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 ) .