Therapeutic Benefit of Balneotherapy and Hydrotherapy in the Management of Fibromyalgia Syndrome

A Qualitative Systematic Review and Meta-analysis of Randomized Controlled Trials

Johannes Naumann; Catharina Sadaghiani


Arthritis Res Ther. 2014;16(R141) 

In This Article


In summary, based on the limited number of studies analyzed, small sample sizes and risk of bias attributed to the studies, it appears difficult to determine the overall benefit of BT and HT. There is a risk of overestimating the evidence on the efficacy of HT and even more so BT. However, although evidence is limited, recommendations in recent evidence-based interdisciplinary guidelines emphasize a patient-tailored approach with aerobic exercises, CBT and MCT according to the key symptoms of FMS.[4] In this context, BT and HT offer a wide variety of treatment opportunities, which can be perfectly adapted to the patients' abilities and preferences. Unlike pharmacological treatments with questionable clinical relevance and frequent side effects,[12] the results of this review underline the potential value of BT and HT as supplementary therapy in the management of major symptoms of FMS.

In order to provide a better database for meta-analyses (internal validity), the use of a core set of outcome measures (outcome measures in rheumatology (OMERACT)[85]) including response rates is desirable. Future authors should use the consolidated standards of reporting trials (CONSORT) checklist[86] to report study results. Major interest should focus on long-term results and maintenance of beneficial effects. Given the popularity of BT and HT among patients with FMS, further studies with robust methodology are warranted to demonstrate and confirm the therapeutic benefits.