Balneotherapy
How can balneotherapy nourish you?
Balneotherapy involves bathing in mineral-rich waters such as geothermal hot springs for therapeutic purposes. This is based on the understanding that the minerals found in the waters and the gases that are emitted can enhance well-being. Common minerals found in waters used for balneotherapy include magnesium, potassium, sodium and natural salts.
While immersion in hot thermal waters is the most common form of balneotherapy, other forms of balneotherapy[1] involve the use of cold thermal waters, the application of mud packs, immersion of specific body parts, the inhalation of mineral-rich gases or the drinking of mineral water. Mud therapy[2] or geotherapy, are similar modalities with long-standing histories that rely on the naturally occurring minerals in mud or soil to achieve similar aims. It is these minerals that set balneotherapy apart from hydrotherapy[3], a water therapy commonly used to assist rehabilitation.
Bathing in mineral-rich waters has been practised for centuries to help ailments ranging from skin conditions to rheumatic diseases. There are reports that the use of thermal waters traced back to the Roman Empire, while hot springs or ‘onsen’ have been and continue to be an essential part of Japanese culture. Balneotherapy was traditionally enjoyed in naturally-occurring mineral-rich bodies of water such as the Dead Sea in Israel and Jordan, the Kangal Hot Springs in Turkey, and the Blue Lagoon in Iceland[4], but it is now also offered in spas and treatment centres. Medical Spas focus on providing science-based treatments utilising local natural resources such as natural healing water, peloids, gases, and climatic conditions for treatment[6]
In addition to the modality’s health-promoting properties, taking time out to soak in thermal waters is known to provide feelings of relaxation. Growing awareness of the importance of wellness, in addition to Balneotherapy’s suitability for people of all ages, is seeing it grow in popularity[5], with it increasingly being offered alongside other therapies such as physiotherapy[6] and naturopathy.
Benefits of balneotherapy
While geothermal bathing has been used since ancient times, scientific evidence is only starting to assess how exactly it can provide benefits for our wellbeing. Part of the difficulty in assessing the effectiveness of Balneotherapy is the differing mineral contents and concentrations in various bodies of thermal waters, which can change due to environmental factors. Nevertheless, a developing body of evidence is evaluating the use of balneotherapy in a wide range of conditions[7] such as chronic arthritis, heart failure and chronic lung conditions.
One common use for balneotherapy is in the treatment of the chronic skin conditions psoriasis and atopic dermatitis. For these conditions, thermal waters rich with salt or sulphur are considered to be particularly useful and have been shown to reduce inflammation, regulate immune processes, and increase quality of life[8]. Another study that treated psoriatic patients with balneotherapy and other therapies to address comorbidities such as joint pain caused by psoriasis for three weeks, found that it was capable of easing the symptoms of psoriasis and related joint pain[9], which helped to facilitate ‘decreased anxiety and improvement in daily living’.
Balneotherapy is also reported to be effective in soothing muscle tension[10] and a range of musculoskeletal conditions. Hungarian researchers conducted a meta-analysis of studies involving Hungarian thermal waters and concluded that their review appeared to confirm that Balneotherapy reduced pain in degenerative joint and spinal disease, osteoarthritis of the hand and knee and chronic low back pain[11]. Interestingly, the benefits were reported in the nine studies reviewed, despite the various thermal waters in the studies having different compositions of minerals.
Another chronic condition that this modality is reported to assist is Chronic Obstructive Pulmonary Disease (COPD). A peer-reviewed article examined available studies and concluded that salt-bromide-iodine thermal water had anti-bacterial and anti-inflammatory effects, which could assist in preventing respiratory infections[12] – an important part of managing COPD. The authors noted that these findings were particularly useful for those with COPD who found gym-based exercises challenging due to difficulty breathing.
In addition to its benefits for physical conditions, there is also evidence that balneotherapy has a positive effect on reducing stress symptoms and pain, and in improving mood[13]. A study comparing the use of balneotherapy, music therapy and no therapy found that balneotherapy was more effective than the other interventions, and resulted in reduced levels of stress and fatigue as well as improved cognitive function.
Balneotherapy may assist in relieving symptoms related to:
What to expect from a balneotherapy session?
A balneotherapy session generally involves immersing yourself in a pool of thermal water, often heated to 30 or 40 degrees Celsius. You may have a specified time limit in which to spend in the thermal water, or you may be left to determine this. Depending on whether it is a private setting and the rules of the facility[14], they may request that you do not wear any clothing during your treatment.
After the session, people have reported feeling calm and rejuvenated. It is important to drink lots of water before and after your session to rehydrate, especially if the thermal waters are heated.
Thermal waters in various facilities are likely to have different mineral components, and some minerals may be more effective for certain conditions. If you are aiming to address a specific condition, do make enquiries with the facility beforehand to ensure it is suitable for you.
Balneotherapy is intended to be a complementary therapy and is not recommended for open wounds or conditions where the skin has a broken barrier such as acute dermatitis flares and skin infections, or people with cancer, cardiovascular disease, and immune deficiency symptoms[1].
As with any exercise or wellness program, please consult your medical professional before commencing Balneotherapy. You are encouraged to advise your therapist about any health conditions or concerns so that they can provide advice and tailor the session to your requirements.
References
1. Balneotherapy. ScienceDirect; [cited on 2024 Nov 27].
2. Mud Therapy. ScienceDirect; [cited on 2024 Nov 27].
3. What is Hydrotherapy and How Does It Work? Live Well Rehab; [cited on 2024 Nov 27].
4. Saavedra C. Balneotherapy. DermNet; 2020.
6. Balneotherapy (Mineral Spas). Health Point Physiotherapy; [cited on 2024 Nov 27].
7. Matsumoto S. Evaluation of the role of balneotherapy in rehabilitation Medicine. Journal of Nippon Medical School; 2018.
8. Cacciapuoti S, Luciano M, Megna M, Annunziata M, Napolitano M, Patruno C, et al. The Role of thermal water in Chronic skin Diseases Management: A Review of the literature. Journal of Clinical Medicine; 2020.
10. Matsumoto S. Evaluation of the role of balneotherapy in rehabilitation Medicine. Journal of Nippon Medical School; 2018.
11. Bender T, Bálint G, Prohászka Z, Géher P, Tefner IK. Evidence-based hydro- and balneotherapy in Hungary—a systematic review and meta-analysis. International Journal of Biometeorology; 2013.
12. Khaltaev N, Solimene U, Vitale F, Zanasi A. Balneotherapy and hydrotherapy in chronic respiratory disease. Journal of Thoracic Disease; 2020.
13. Rapolienė L, Razbadauskas A, Sąlyga J, Martinkėnas A. Stress and fatigue management using balneotherapy in a Short-Time randomized controlled trial. Evidence-based Complementary and Alternative Medicine; 2016.
14. What To Expect With Balneotherapy (Therapeutic Bathing). Cure Joy; 2017.
15. Balneology. European SPAS Association; [cited on 2024 Nov 27].