Advertisement

International Journal of Biometeorology

, Volume 60, Issue 1, pp 1–8 | Cite as

May spa therapy be a valid opportunity to treat hand osteoarthritis? A review of clinical trials and mechanisms of action

  • Nicola Angelo Fortunati
  • Antonella Fioravanti
  • Gina Seri
  • Simone Cinelli
  • Sara TentiEmail author
Review

Abstract

Osteoarthritis (OA) is the most common form of arthritis and its current treatment includes non-pharmacological and pharmacological modalities. Spa therapy represents a popular treatment for many rheumatic diseases. The aim of this review was to summarize the currently available information on clinical effects and mechanisms of action of spa therapy in OA of the hand. We conducted a search of the literature to extract articles describing randomized clinical trials (RCTs) in hand OA published in the period 1952–2015. We identified three assessable articles reporting RCTs on spa therapy in hand OA. Data from these clinical trials support a beneficial effect of spa therapy on pain, function and quality of life in hand OA. Spa therapy seems to have a role in the treatment of hand OA. However, additional RCTs are necessary to clarify the mechanisms of action and the effects of the application of thermal treatments.

Keywords

Spa therapy Balneotherapy Mud-pack therapy Hand osteoarthritis Randomized controlled trials 

Notes

Conflict of interest

The authors declare that they have no conflict of interest.

Authors' contribution

All authors were involved in drafting the article or revising it critically for important intellectual content, and all authors approved the final version to be published.

References

  1. Addimanda O, Mancarella L, Dolzani P et al (2012) Clinical associations in patients with osteoarthritis. Scand J Rheumatol 41:310–313CrossRefGoogle Scholar
  2. Altman RD (2010) Pharmacological therapies for osteoarthritis of the hand: a review of the evidence. Drugs Aging 27:729–745CrossRefGoogle Scholar
  3. Altman RD, Dreiser RL, Fisher CL et al (2009) Diclofenac sodium gel in patients with primary hand osteoarthritis: a randomized, double-blind, placebo-controlled trial. J Rheumatol 36:1991–1999CrossRefGoogle Scholar
  4. Ardiç F, Ozgen M, Aybek H, Rota S, Cubukçu D, Gökgöz A (2007) Effects of balneotherapy on serum IL-1, PGE2 and LTB4 levels in fibromyalgia patients. Rheumatol Int 27:441–446CrossRefGoogle Scholar
  5. Bellamy N, Campbell J, Haraoui B, Buchbinder et al (2002) Dimensionality and clinical importance of pain and disability in hand osteoarthritis: development of the Australian/Canadian (AUSCAN) osteoarthritis hand index. Osteoarthritis Cartilag 10:855–862CrossRefGoogle Scholar
  6. Bellometti S, Galzigna L (1998) Serum levels of a prostaglandin and a leukotriene after thermal mud pack therapy. J Investig Med 46:140–145Google Scholar
  7. Bellometti S, Galzigna L, Richelmi P, Gregotti C, Bertè F (2002) Both serum receptors of tumor necrosis factor are influenced by mud pack treatment in osteoarthrotic patients. Int J Tissue React 24:57–64Google Scholar
  8. Bender T, Karagülle Z, Bálint GP et al (2005) Hydrotherapy, balneotherapy, and spa treatment in pain management. Rheumatol Int 25:220–224CrossRefGoogle Scholar
  9. Bender T, Bariska J, Vàghy R et al (2007) Effect of balneotherapy on the Antoxidant System – A controlled pilot study. Arch Med Res 38:86–89CrossRefGoogle Scholar
  10. Braga PC, Sambataro G, Dal Sasso M et al (2008) Antioxidant effect of sulphurous thermal water on human neutrophil bursts: chemiluminescence evaluation. Respiration 75:193–201CrossRefGoogle Scholar
  11. Bresalier RS, Sandler RS, Quan H et al (2005) Adenomatous Polyp Prevention on Vioxx (APPROVe) Trial investigators Cardiovascular events associated with rofecoxib in a colorectal adenoma chemoprevention trial. N Engl J Med 352:1092–1102CrossRefGoogle Scholar
  12. Britschka ZMN, Teodoro WR, Velosa APP, de Mello SB (2007) The effect of Brazilian black mud treatment in chronic experimental arthritis. Rheumatol Int 28:39–45CrossRefGoogle Scholar
  13. Burguera EF, Vela-Anero A, Magalhães J et al (2014) Effect of hydrogen sulfide sources on inflammation and catabolic markers on interleukin 1β-stimulated human articular chondrocytes. Osteoarthritis Cartilag 22:1026–1035CrossRefGoogle Scholar
  14. Cecchettin M, Bellometti S, Lalli A et al (1995) Serum interleukin 1 changes in artrhosic patients after mud-packs treatment. Phys Rheab Kur Med 5:92–93CrossRefGoogle Scholar
  15. Cozzi F, Carrara M, Sfriso P et al (2004) Anti-inflammatory effect of mud-bath applications on adjuvant arthritis in rats. Clin Exp Rheumatol 22:763–766Google Scholar
  16. Dahaghin S, Bierma-Zeinstra SM, Ginai AZ et al (2005) Prevalence and pattern of radiographic hand osteoarthritis and associations with pain and disability (The Rotterdam study). Ann Rheum Dis 64:682–687CrossRefGoogle Scholar
  17. Dreiser RL, Maheu E, Guillou GB (2000) Sensitivity to change of the functional index for hand osteoarthritis. Osteoarthritis Cartilag 8(Suppl A):S25–S28CrossRefGoogle Scholar
  18. EuroQol Group (1990) EuroQol: a new facility for the measurement of health related quality of life. Health Policy 16:199–208CrossRefGoogle Scholar
  19. Fioravanti A, Valenti M, Altobelli E et al (2003) Clinical efficacy and cost-effectiveness evidence of spa therapy in osteoarthritis. The results of "Naiade" Italian Project. Panminerva Med 45:211–217Google Scholar
  20. Fioravanti A, Cantarini L, Bacarelli MR et al (2011a) Effects of spa therapy on serum leptin and adiponectin levels in patients with knee osteoarthritis. Rheumatol Int 31:879–882CrossRefGoogle Scholar
  21. Fioravanti A, Cantarini L, Guidelli GM, Galeazzi M (2011b) Mechanisms of action of spa therapies in rheumatic diseases: what scientific evidence is there? Rheumatol Int 31:1–8CrossRefGoogle Scholar
  22. Fioravanti A, Giannitti C, Bellisai B et al (2011c) Efficacy of balneotherapy on pain, function and quality of life in patients with osteoarthritis of the knee. Int J Biometeorol 56:583–590CrossRefGoogle Scholar
  23. Fioravanti A, Lamboglia A, Pascarelli NA et al (2013) Thermal water of Vetriolo, Trentino, inhibits the negative effect of interleukin 1β on nitric oxide production and apoptosis in human osteoarthritic chondrocytes. J Biol Regul Homeost Agents 27:891–902Google Scholar
  24. Fioravanti A, Bacaro G, Giannitti C, et al (2014) One-year follow-up of mud-bath therapy in patients with bilateral knee osteoarthritis: a randomized, single-blind controlled trial. Int J Biometeorol Dec17 [Epub ahead of print]Google Scholar
  25. Fioravanti A, Tenti S, Giannitti C et al (2014b) Short- and long-term effects of mud-bath treatment on hand osteoarthritis: a randomized clinical trial. Int J Biometeorol 58:79–86CrossRefGoogle Scholar
  26. Fioravanti A, Giannitti C, Cheleschi S, et al (2015) Circulating levels of adiponectin, resistin, and visfatin after mud-bath therapy in patients with bilateral knee osteoarthritis. Int J Biometeorol Mar 7 [Epub ahead of print]Google Scholar
  27. Forestier R, Desfour H, Tessier JM et al (2010) Spa therapy in the treatment of knee osteoarthritis: a large randomised multicentre trial. Ann Rheum Dis 69:660–665CrossRefGoogle Scholar
  28. Fox B, Schantz JT, Haigh R et al (2012) Inducible hydrogen sulfide synthesis in chondrocytes and mesenchymal progenitor cells: is H2S a novel cytoprotective mediator in the inflamed joint? J Cell Mol Med 16:896–910CrossRefGoogle Scholar
  29. Francin PJ, Abot A, Guillaume C et al (2014) Association between adiponectin and cartilage degradation in human osteoarthritis. Osteoarthritis Cartilag 22:519–526CrossRefGoogle Scholar
  30. Fries JF, Spitz PW, Kraines RG, Holman HR (1980) Measurement of patient outcome in arthritis. Arthritis Rheum 23:137–145CrossRefGoogle Scholar
  31. Gabay C, Medinger-Sadowski C, Gascon D et al (2011) A Symptomatic effects of chondroitin 4 and chondroitin 6 sulfate on hand osteoarthritis: a randomized, double-blind, placebo-controlled clinical trial at a single center. Arthritis Rheum 63:3383–3391CrossRefGoogle Scholar
  32. Gandini F, Giannitti C, Fattore G et al (2012) Validation of an Italian version of the functional index for hand osteoarthritis (FIHOA). Mod Rheumatol 22:758–765CrossRefGoogle Scholar
  33. Guidelli GM, Tenti S, De Nobili E, Fioravanti A (2012) Fibromyalgia syndrome and spa therapy: myth or reality? Clin Med Insights Arthritis Musculoskelet Disord 5:19–26CrossRefGoogle Scholar
  34. Gutenbrunner C, Bender T, Cantista P et al (2010) A proposal for a worldwide definition of health resort medicine, balneology, medical hydrology and climatology. Int J Biometeorol 54:495–507CrossRefGoogle Scholar
  35. Horváth K, Kulisch Á, Németh A, Bender T (2012) Evaluation of the effect of balneotherapy in patients with osteoarthritis of the hands: a randomized controlled single-blind follow-up study. Clin Rehabil 26:431–441CrossRefGoogle Scholar
  36. Kearney PM, Baigent C, Godwin J et al (2006) Do selective cyclo-oxygenase-2 inhibitors and traditional non-steroidal anti-inflammatory drugs increase the risk of atherothrombosis? Meta-analysis of randomised trials. BMJ 332:1302–1308CrossRefGoogle Scholar
  37. Kloesch B, Liszt M, Steiner G, Brӧll J (2012) Inhibitors of p38 and ERK1/2 MAPkinase and hydrogen sulphide block constitutive and IL-1β-induced IL-6 amd IL-8 expression in the human chondrocyte cell line C-28/I2. Rheumatol Int 32:729–736CrossRefGoogle Scholar
  38. Koskinen A, Juslin S, Nieminen R et al (2011) Adiponectin associates with markers of cartilage degradation in osteoarthritis and induces production of proinflammatory and catabolic factors through mitogen activated protein kinase pathways. Arthritis Res Ther 13:R184CrossRefGoogle Scholar
  39. Koskinen A, Vuolteenaho K, Moilanen T, Moilanen E (2014) Resistin as a factor in osteoarthritis: synovial fluid resistin concentrations correlate positively with interleukin 6 and matrix metalloproteinases MMP-1 and MMP-3. Scand J Rheumatol 43:249–253CrossRefGoogle Scholar
  40. Kovács C, Pecze M, Tihanyi A et al (2012) The effect of sulphurous water in patients with osteoarthritis of hand. Double-blind, randomized, controlled follow-up study. Clin Rheumatol 31:1437–1442CrossRefGoogle Scholar
  41. Kubota K, Kurabayashi H, Tamura K et al (1992) A transient rise in plasma beta-endorphin after a traditional 47 degrees C hot-spring bath in Kusatsu-spa, Japan. Life Sci 51:1877–1880CrossRefGoogle Scholar
  42. Kuczera M, Kokot F (1996) Effect of spa therapy on the endocrine system. I. Stress reaction hormones. Pol Arch Med Wewn 95:11–20Google Scholar
  43. Kulisch Á, Benkö Á, Bergmann A et al (2014) Evaluation of the effect of Lake Hévíz thermal mineral water in patients with osteoarthritis of the knee: a randomized, controlled, single-blind, follow-up study. Eur J Phys Rehabil Med 50:373–381Google Scholar
  44. Li L, Fox B, Keeble J, Salto-Tellez M et al (2013) The complex effects of the slow-releasing hydrogen sulfide donor GYY4137 in a model of acute joint inflammation and in human cartilage cells. J Cell Mol Med 17:365–376CrossRefGoogle Scholar
  45. Mahendira D, Towheed TE (2009) Systematic review of non-surgical therapies for osteoarthritis of the hand: an update. Osteoarthritis Cartilag 17:1263–1268CrossRefGoogle Scholar
  46. Massengale M, Lu B, Pan JJ et al (2012) Adipokine hormones and hand osteoarthritis: radiographic severity and pain. PLoS One 7, e47860CrossRefGoogle Scholar
  47. Melzack R, Wall PD (1965) Pain mechanisms: a new theory. Science 150:971–979CrossRefGoogle Scholar
  48. Oliveria SA, Felson DT, Reed JI et al (1995) AM Incidence of symptomatic hand, hip, and knee osteoarthritis among patients in a health maintenance organization. Arthritis Rheum 38:1134–1141CrossRefGoogle Scholar
  49. Presle N, Pottie P, Dumond H et al (2006) Differential distribution of adipokines between plasma and synovial fluid in patients with osteoarthritis. Contribution of joint tissues to their articular production. Osteoarthritis Cartilag 14:690–695CrossRefGoogle Scholar
  50. Senolt L, Housa D, Vernerova Z et al (2007) Resistin in rheumatoid arthritis synovial tissue, synovial fluid and serum. Ann Rheum Dis 66:458–463CrossRefGoogle Scholar
  51. Steppan CM, Bailey ST, Bhat S et al (2001) The hormone resistin links obesity to diabetes. Nature 409:307–312CrossRefGoogle Scholar
  52. Sukenik S, Flusser D, Abu-Shakra M (1999) The role of spa therapy in various rheumatic diseases. Rheum Dis Clin North Am 25:883–897CrossRefGoogle Scholar
  53. Tenti S, Cheleschi S, Galeazzi M et al (2014) Spa therapy: can be a valid option for treating knee osteoarthritis? Int J Biometeorol Oct 23 [Epub ahead of print]Google Scholar
  54. Verhagen AP, de Vet HC, de Bie RA et al (2000) Balneotherapy for rheumatoid arthritis and osteoarthritis. Cochrane Database Syst Rev 2, CD000518Google Scholar
  55. Ware JE Jr, Sherbourne CD (1992) The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med Care 30:473–483CrossRefGoogle Scholar
  56. Yusuf E, Nelissen RG, Ioan-Facsinay A et al (2010) Association between weight or body mass index and hand osteoarthritis: a systematic review. Ann Rheum Dis 69:761–765CrossRefGoogle Scholar
  57. Zhang Y, Jordan JM (2010) Epidemiology of osteoarthritis. Clin Geriatr Med 26:355–369CrossRefGoogle Scholar
  58. Zhang Y, Niu J, Kelly-Hayes M et al (2002) Prevalence of symptomatic hand osteoarthritis and its impact on functional status among the elderly: The Framingham Study. Am J Epidemiol 56:1021–1027CrossRefGoogle Scholar
  59. Zhang W, Doherty M, Leeb BF et al (2007) EULAR evidence based recommendations for the management of hand osteoarthritis: report of a Task Force of the EULAR Standing Committee for International Clinical Studies Including Therapeutics (ESCISIT). Ann Rheum Dis 66:377–388CrossRefGoogle Scholar

Copyright information

© ISB 2015

Authors and Affiliations

  • Nicola Angelo Fortunati
    • 1
  • Antonella Fioravanti
    • 2
  • Gina Seri
    • 1
  • Simone Cinelli
    • 2
  • Sara Tenti
    • 2
    Email author
  1. 1.Spa Centre of Fonteverde Natural Spa ResortSienaItaly
  2. 2.Rheumatology Unit, Department of Medicine, Surgery and NeuroscienceUniversity of SienaSienaItaly

Personalised recommendations