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 ) .
Balneotherapy for rheumatoid arthritis at the Dead Sea.
Thirty-six patients with active rheumatoid arthritis were treated for 12 days at the Ein Gedi Spa . The patients were allocated r and omly to four study groups . Group 1 ( n = 9 ) was treated with daily baths in the Dead Sea , group 2 ( n = 9 ) was treated with daily sulphur baths , group 3 ( n = 10 ) was treated with a combination of daily Dead Sea bathing and sulphur baths , and group 4 ( n = 8) served as a control group . All patients were assessed by a rheumatologist who was blinded to the treatment modalities and group allocation . Clinical parameters assessed included : duration of morning stiffness , 15 m walk time , grip strength , activities of daily living , patient 's assessment of disease severity , number of active joints , and the Ritchie articular index . Statistically significant improvement lasting up to 3 months was observed only in the three treatment groups
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 ) .