International Journal of Biometeorology

, Volume 62, Issue 2, pp 253–259 | Cite as

Clinical improvement of patients with osteoarthritis using thermal mineral water at Szigetvár Spa—results of a randomised double-blind controlled study

  • Adrienn HanzelEmail author
  • Krisztina Horvát
  • Bálint Molics
  • Károly Berényi
  • Balázs Németh
  • Katalin Szendi
  • Csaba Varga
Original Paper


Since 1966, Szigetvár in Hungary is well recognised as a thermal spa. Many patients suffering from rheumatic diseases are treated with its thermal mineral water. Our objective was to investigate the effects of a 3-week-long outpatient balneotherapy-based rehabilitation program on patients suffering from osteoarthritis of the hips and the knees. During the treatment period, patients received a 30-min underwater jet massage in a bath tub, five times a week. One patient group received jet massage in a bath tub containing mineral water; the other group received the same treatment in tap water. Primary outcomes were measured by range of movement of the involved joints and Western Ontario and McMaster University Osteoarthritis Index (WOMAC). Visual analogue scale (VAS) was applied to measure current severity of pain. Furthermore, quality of life was assessed using the Short Form 36 questionnaire (SF-36). Range of movement (ROM) score, Western Ontario and McMaster University Osteoarthritis Index and visual analogue scale were determined before the first treatment, after the last treatment and 3 months after the last treatment. SF-36 questionnaire was filled in before the first and after the last treatment. Fifty patients (17 male, 33 female mean age 66.7 ± 4.79 years) were enrolled. After randomisation, patients were divided into two groups: tap water n = 24 and mineral water n = 26. Treatment with the thermal mineral water of Szigetvár significantly improved ROM, WOMAC scores, and SF-36-scored quality of life of the patients. Our double-blind study provided evidence for the beneficial health effects of another Hungarian thermal mineral water masking the colour, odour and pH of the tap water and mineral water.


Balneotherapy Arthritis Thermal water WOMAC 



The authors want to express their special thanks to Ms. I. Barhó-Barbarics, Mr. G. Budai and M. Bein. The present scientific contribution is dedicated to the 650th anniversary of the foundation of the University of Pécs, Hungary.


This work was financially supported by the Medical School, University of Pécs (PTE ÁOK-KA-2016/34039). Balázs Nemeth’s scientific work was supported by ÚNKP-17-3 New National Excellence Program of the Ministry of Human Capacities ( The funder had no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Compliance with ethical standards

The study protocol was approved by the Regional Ethics Committee of University of Pécs, Pécs, Hungary (Permission No. 5351), in accordance with the 2008 Helsinki declaration.

Conflict of interest

The authors declare that they have no conflict of interest.


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Copyright information

© ISB 2017

Authors and Affiliations

  • Adrienn Hanzel
    • 1
    • 2
    Email author
  • Krisztina Horvát
    • 3
  • Bálint Molics
    • 4
  • Károly Berényi
    • 2
  • Balázs Németh
    • 2
  • Katalin Szendi
    • 2
  • Csaba Varga
    • 2
  1. 1.Doctoral School, Faculty of Health SciencesUniversity of PécsPécsHungary
  2. 2.Department of Environmental Health, Institute of Public Health MedicineUniversity of PécsPécsHungary
  3. 3.Hospital of SzigetvárSzigetvárHungary
  4. 4.Faculty of Health SciencesUniversity of PécsPécsHungary

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