Evaluation of the effect of balneotherapy in patients with osteoarthritis of the hands: a randomized controlled single-blind follow-up study.

OBJECTIVE

To evaluate the effectiveness of thermal mineral water compared with magnetotherapy without balneotherapy as control, in the treatment of hand osteoarthritis.

DESIGN

Randomized controlled single-blind follow-up study.

SETTING

Rheumatology specialist clinic of Gunaras Health Spa.

SUBJECTS

Patients between 50 and 70 years of age with hand osteoarthritis, randomly assigned into three groups.

INTERVENTIONS

The subjects in the first two groups bathed in thermal mineral water of two different temperatures (36°C and 38°C) for three weeks five times a week for 20 minutes a day and received magnetotherapy to their hands three times weekly. The third group received only magnetotherapy.

OUTCOME MEASURES

Visual analogue scale scores, handgrip strength, pinchgrip strength, the number of swollen and tender joints of the hand, the duration of morning joint stiffness, Health Assessment Questionnaire, and Short Form-36 questionnaire. The study parameters were administered at baseline, immediately after treatment and after 13 weeks.

RESULTS

The study included 63 patients. Statistically significant improvement was observed in several studied parameters after the treatment and during the follow-up study in the thermal water groups versus the control group. The 38°C thermal water treatment significantly improved the pinch strength of the right hand (0.6 (95% confidence interval (CI) 0.2 to 1.1) vs. 0.03 (95% CI -0.3 to 0.4), P < 0.05) and the Health Assessment Questionnaire parameters (-0.4 (95% CI -0.6 to -0.2) vs. -0.1 (95% CI -0.2 to 0.1), P < 0.01) even in the long term.

CONCLUSIONS

Balneotherapy combined with magnetotherapy improved the pain and function as well as the quality of life in patients with hand osteoarthritis.