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 ) .
Long-term efficacy of radon spa therapy in rheumatoid arthritis--a randomized, sham-controlled study and follow-up.
OBJECTIVE To quantify the efficacy of a series of baths containing natural radon and carbon dioxide ( 1.3 kBq/l , 1.6 g carbon dioxide/l on average ) versus artificial carbon dioxide baths alone in patients with rheumatoid arthritis . SUBJECTS Sixty patients participating in an in-patient rehabilitation programme including a series of 15 baths were r and omly assigned to two groups . DESIGN Pain intensity ( 100 mm visual analogue scale ) and functional restrictions [ Keitel functional test , Arthritis Impact Measurement Scales ( AIMS question naire ) ] were measured at baseline , after completion of treatment and 3 and 6 months thereafter . To investigate whether the overall value of the outcomes was the same in both groups , the overall mean was analysed by Student 's t-test for independent sample s. RESULTS The two groups showed a similar baseline situation . After completion of treatment , relevant clinical improvements were observed in both groups , with no notable group differences . However , the follow-up revealed sustained effects in the radon arm , and a return to baseline levels in the sham arm . After 6 months , marked between-group differences were found for both end-points ( pain intensity : -16.9 % , 95 % confidence interval -27.6 to -6.2 % ; AIMS score : 0.57 , 95 % confidence interval 0.16 to 0.98 ) . The between-group differences were statistically significant for both overall means ( pain intensity , P : = 0.04 ; AIMS , P : = 0.01 ) . CONCLUSION Marked short-term improvements in both groups at the end of treatment may have masked potential specific therapeutic effects of radon baths . However , after 6 months of follow-up the effects were lasting only in patients of the radon arm . This suggests that this component of the rehabilitative intervention can induce beneficial long-term effects
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 ) .