Rheumatology International

, Volume 26, Issue 2, pp 168–172 | Cite as

SPA therapy in fibromyalgia: a randomised controlled clinic study

  • Arif DönmezEmail author
  • M. Zeki Karagülle
  • Nuran Tercan
  • Mustafa Dinler
  • Halim İşsever
  • Mine Karagülle
  • Mustafa Turan
Original Article


Objective: The aim of the present study is to evaluate the effectiveness of spa therapy in the management of fibromyalgia. Methods: Thirty women with fibromyalgia were randomly assigned to either a spa therapy group or a control group. The spa therapy group (n = 16) had spa treatment for 2 weeks in addition to their medical treatment. The control group (n = 14) continued to have their medical treatment and/or daily exercises. An investigator who was blinded for the intervention assessed all the patients for 9 months. Improvements in Fibromyalgia Impact Questionnaire (FIQ), pain and number of tender points were primary outcomes. Secondary outcome measures were improvement in sleep disturbance, fatigue, gastrointestinal symptoms, anxiety, Beck Depression Inventory and patient’s global evaluation. Results: the spa group was found to be superior to the control group at the end of intervention in terms of FIQ, pain, tender point count, fatigue and patients’ global assessment. This superiority remained for 6 months in FIQ, 1 month in pain and tender point count. Conclusion: It was concluded that the addition of spa therapy to medical therapy has both short- and long-term beneficial effects in female patients with fibromyalgia.


Spa treatment Balneotherapy Fibromyalgia Fatigue Pain 


  1. 1.
    Goldenberg DL (1998) Fibromyalgia and related syndromes. In: Klippel JH, Dieppe PA (eds) Rheumatology, 2nd edn. Mosby, LondonGoogle Scholar
  2. 2.
    Oran Ö, Dönmez A, Erdogan N, Turan M (2002) Psychiatric co-morbidity affects of symptoms of fibromyalgia. Phys Med Rehabil Kuror 12:284–287CrossRefGoogle Scholar
  3. 3.
    Wolfe F, Smyte HA, Yunus MB, Bennett RM, Bombardier C, Goldenberg DL, Tugwell P, Campbell SM, Abeles M, Clark P et al (1990) The American Collage of Rheumatology 1990 criteria for classification of fibromyalgia: report of the multicentre criteria committee. Arthritis Rheum 33:160–172PubMedGoogle Scholar
  4. 4.
    Wolfe F, Ross K, Anderson J, Russell IJ, Hebert L (1995) The prevalence and characteristics of fibromyalgia in the general population. Arthritis Rheum 38:19–28PubMedGoogle Scholar
  5. 5.
    Burchardt CS, Bjelle A (1994) Education programmes for fibromyalgia patients: description and evaluation. Baillieres Clin Rheumatol 8:935–956PubMedGoogle Scholar
  6. 6.
    Brückle W, Bornmann M, Weber H (1997) Patientenschulung bei Fibromyalgie. Akt Rheumatol 22:92–97Google Scholar
  7. 7.
    Bennet RM (1996) Multidisciplinary group programs to treat fibromyalgia patients. Rheum Dis Clin North Am 22:351–367PubMedGoogle Scholar
  8. 8.
    Sprott H (2003) What can rehabilitation interventions achieve in patients with primary fibromyalgia? Curr Opin Rheumatol 15:145–150CrossRefPubMedGoogle Scholar
  9. 9.
    Karagülle MZ, M Karagülle (2004) Balneotherapie und Kurorttherapie rheumatischer Erkrankungen in der Türkei: Ein systematischer Review. Forsch Komplementärmed Klass Naturheilkd 11:33–41CrossRefPubMedGoogle Scholar
  10. 10.
    Dönmez A, Karagülle Z, Turan M (1995) Balneotherapie mit Akratoterme bei Gonartrose. Zeitschrift Naturamed 7:20–23Google Scholar
  11. 11.
    Odabaşı E, Karagulle MZ, Karagulle M, Turan M, Karagülle O (2002) Comparison of two traditional spa therapy regimens in patients with knee osteoarthritis. Phys Med Rehabil Kuror 12:337–341CrossRefGoogle Scholar
  12. 12.
    Kovacs I, Bender T (2002) The therapeutic effects of Cserkeszölö thermal water in osteoarthritis of knee: a double blind, controlled, follow up study. Rheumatol Int 21:218–221CrossRefPubMedGoogle Scholar
  13. 13.
    Bender T, Karagülle Z, Bálint GZ, Gutenbrunner Chr, Bálint PV, Sukenik S (2004) Hydrotherapy, balneotherapy, and spa treatment in pain management. Rheumatol Int 25:220-224CrossRefPubMedGoogle Scholar
  14. 14.
    Van Tubergen A, Landewe R, van der Heijde D, Hidding A, Wolter N, Asscher M, Falkenbach A, Genth E, The HG, van der Linden S (2001) Combined spa–exercise therapy is effective in patients with ankylosing spondylitis: a randomized controlled trial. Arthritis Rheum 45:430–438CrossRefPubMedGoogle Scholar
  15. 15.
    Sukenik S, Buskila D, Neuman L, Kleiner-Baumgarten A, Zimlichman S, Horowitz J (1990) Sulphur bath and mud pack treatment for rheumatoid arthritis in the Dead Sea area. Ann Rheum Dis 49:99–102Google Scholar
  16. 16.
    Yurtkuran M, Çeliktaş M (1996) A randomized, controlled trial of balneotherapy in the treatment of patients with primary fibromyalgia syndrome. Phys Rehabil Kur Med 6:109–112Google Scholar
  17. 17.
    Neuman L, Sukenik S, Bolotin A, Shakra MA, Amir M, Flusser D, Buskila D (2001)The effect of balneotherapy at the Dead Sea on the quality of life of patients with fibromyalgia. Rheumatol Int 20:15–19CrossRefGoogle Scholar
  18. 18.
    Buskila D, Shakra MA, Neumann L, Odes L, Shneider E, Flusser D, Sukenik S (2001) Balneotherapy for fibromyalgia at the Dead Sea. Rheumatol Int 20:105–108CrossRefPubMedGoogle Scholar
  19. 19.
    Evcik D, Kızılay B, Gökcen E (2002) The effects of balneotherapy on fibromyalgia patients. Rheumatol Int 22:56–59CrossRefPubMedGoogle Scholar
  20. 20.
    Şen U, Karagülle MZ, Karagülle M, Dönmez A, Şen C (2002) Comparison of the efficacy of two different traditional spa regimens in patients with fibromyalgia syndrome. PTT Hastanesi Tıp Dergisi 24:78–81Google Scholar
  21. 21.
    Burckhardt CS, Clark SR, Bennet RM (1991) The Fibromyalgia Impact Questionnaire: development and validation. J Rheumatol 18:728–733PubMedGoogle Scholar
  22. 22.
    Sarmer S, Ergin S, Yavuzer G (2000) The validity and reliability of the Turkish version of the Fibromyalgia Impact Questionnaire. Rheumatol Int 20:9–12CrossRefPubMedGoogle Scholar
  23. 23.
    Beck AT, Ward CH, Mendelson M, Mock J, Erbaugh J (1961) An inventory for measuring depression. Arch Gen Psychiatry 4:561–571PubMedGoogle Scholar
  24. 24.
    Altan L, Bingöl Ü, Aykaç M, Koç Z, Yurtkuran M (2003) Investigation of the effects of pool-based exercise on fibromyalgia syndrome. Rheumatol Int 24:272-277PubMedGoogle Scholar
  25. 25.
    Kubota K, Kurabayashi H, Tamura K, Kawada E, Tamura J, Shirakura T (1992) A transient rise in plasma beta-endorphin after a traditional 47 degrees C hot-spring bath in Kusatsu-spa, Japan. Life Sci 51:1877–1880CrossRefPubMedGoogle Scholar
  26. 26.
    Yurtkuran M, Ulus H, Irdesel J (1993) The effect of balneotherapy on plasma endorphine level in patient with osteoarthritis. Phys Rehabil Kur Med 3:130–132Google Scholar
  27. 27.
    van Tubergen A, Hidding A (2002) Spa and exercise treatment in ankylosing spondylitis: fact or fancy? Best Pract Res Clin Rheumatol 16:653–666PubMedGoogle Scholar

Copyright information

© Springer-Verlag 2005

Authors and Affiliations

  • Arif Dönmez
    • 1
    Email author
  • M. Zeki Karagülle
    • 1
  • Nuran Tercan
    • 1
  • Mustafa Dinler
    • 1
  • Halim İşsever
    • 2
  • Mine Karagülle
    • 1
  • Mustafa Turan
    • 1
  1. 1.Department of Medical Ecology and Hydroclimatology, İstanbul Medical Facultyİstanbul UniversityIstanbulTurkey
  2. 2.Department of Public Health, İstanbul Medical Facultyİstanbul UniversityIstanbulTurkey

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