Spa Treatments May Improve Pain, Quality of Life in Chronic Venous Insufficiency

By Reuters Staff

October 01, 2019

NEW YORK (Reuters Health) - Balneotherapy may help improve some symptoms of chronic venous insufficiency (CVI), according to a new Cochrane Review.

Based on moderate- to low-certainty evidence, two to three weeks of balneotherapy modestly improved pain, quality of life and changes in skin pigmentation, Dr. Melissa Andreia de Moraes Silva of Universidade Federal de Sao Paolo in Brazil and colleagues found. But the treatment did not affect disease severity, leg ulcers or edema, when compared with no treatment.

Historically, balneotherapy involves bathing in mineral waters, gases and peloids at resort spas, although the term can refer to any therapy involving water, the authors note in their report, online August 29 in the Cochrane Database of Systematic Reviews.

"Bathing in natural mineral or thermal waters appears to have positive effects related to specific properties of immersion in water, which are due to hydrostatic pressure, osmotic pressure and temperature," they add. "The effects of balneotherapy are based on both the chemical and physical properties of the agents."

Balneotherapy can improve symptoms in patients with osteoarthritis, rheumatoid arthritis and other severe diseases, and is also widely used in some countries, such as France, to treat CVI, the authors add.

While recent guidelines on treating CVI do not address non-conventional therapies such as balneotherapy, Dr. de Moraes Silva and her colleagues add, "there is increasing evidence of the role of these modalities in preventing disease progression and in optimising the results of surgical and pharmacological treatments."

They reviewed seven randomized controlled trials including 891 patients. Six studies compared balneotherapy with no treatment, and the seventh compared it to the phlebotonic Melilotus officinalis.

When compared to no treatment, balneotherapy did not appear to improve disease severity signs and symptoms, but "probably" improved health-related quality of life and pain. The study comparing balneotherapy to Melilotus officinalis did not find clear differences in pain or edema.

"Most studies report positive results, but provide insufficient evidence to support data, with small numbers of participants and limited data," Dr. de Moraes Silva and her team write. "The scientific evidence is insufficient due to the high risk of bias in most studies and the lack of adequate statistical analysis."

They conclude: "We believe that it is essential and possible to carry out randomised trials assessing the effectiveness of balneotherapy with low risk of bias in order to provide solid evidence for the treatment of CVI."


Cochrane Database Syst Rev 2019.