Clinical Rheumatology

, Volume 26, Issue 6, pp 890–894 | Cite as

The effect of the thermal mineral water of Nagybaracska on patients with knee joint osteoarthritis—a double blind study

  • Géza P. BálintEmail author
  • W. Watson Buchanan
  • András Ádám
  • István Ratkó
  • László Poór
  • Péter V. Bálint
  • Éva Somos
  • Ildikó Tefner
  • Tamás Bender
Original Article


To study the effect of thermal mineral water of Nagybaracska (Hungary) on patients with primary knee osteoarthritis in a randomized, double-blind clinical trial, 64 patients with nonsurgical knee joint osteoarthritis were randomly selected either into the thermal mineral water or into the tap water group in a non-spa resort village. The patients of both groups received 30-min sessions of bathing, 5 days a week for four consecutive weeks. The patients were evaluated by a blind observer immediately before and at the end of the trial using Western Ontario and McMaster Osteoarthritis (WOMAC) indices and follow-up assessment 3 months later. Twenty-seven patients of the 32 patients who received thermal mineral water and 25 of the 32 of those treated with tap water completed the trial. The WOMAC activity, pain, and total scores improved significantly in the thermal mineral-water-treated group. The improvement remained also at the end of the 3-month follow-up. The WOMAC activity, pain, and total scores improved significantly also in the tap water group at the end of the treatment course, but no improvement was detected at the end of the 3-month follow-up period. The treatment with the thermal mineral water of Nagybaracska significantly improved activity, pain, and total WOMAC scores of patients with nonsurgical OA of the knee. Even after 3 months, significant improvement was observed compared to the scores before the treatment or to tap water treatment.


Balneotherapy Knee Osteoarthritis Physiotherapy Spa Treatment 



The authors would like to thank Pal Pacher for his technical help.


  1. 1.
    Jackson R (1990) Waters and spas in the classical world. Med Hist Suppl (10):1–13PubMedGoogle Scholar
  2. 2.
    Buchanan WW, Kean WF (2003) Dr. William Bruce (1835–1920), the Scottish highland spa at Strathpeffer; and a possible description of polymyalgia rheumatica. J R Coll Physicians Edinb 33(Suppl 12):29–35PubMedGoogle Scholar
  3. 3.
    Rakic M, Forestier J, July 27, 1890–March 15, 1978 (1978) Arthritis Rheum 21:989–990PubMedCrossRefGoogle Scholar
  4. 4.
    Bálint GP How to research the effect of hydro- and balneotherapy and spa treatment? In T. Bender and H.G. Pratzel (eds) Health Resort Medicine in 2nd Millennium. Steffen, GmBH, Friedland MV-Germany ISMH Verlag 2004 p137Google Scholar
  5. 5.
    Szucs L, Ratkó I, Lesko T, Szoor I, Genti G, Bálint G (1989) Double-blind trial on the effectiveness of the Puspokladany thermal water on arthrosis of the knee-joints. J R Soc Health 109:7–9PubMedGoogle Scholar
  6. 6.
    Kovacs I, Bender T (2002) The therapeutic effects of Cserkeszölö thermal water in osteoarthritis of the knee: a double blind, controlled, follow-up study. Rheumatol Int 21:218–221PubMedCrossRefGoogle Scholar
  7. 7.
    Bálint G, Bender T, Szabó E (1993) Spa treatment in arthritis. J Rheumatol 20:1623–1625PubMedGoogle Scholar
  8. 8.
    Guillemin F, Constant F, Collin JF, Boulange M (1994) Short and long-term effect of spa therapy in chronic low back pain. Br J Rheumatol 33:148–151PubMedCrossRefGoogle Scholar
  9. 9.
    Konrad K, Tatrai T, Hunka A, Vereckei E, Korondi I (1992) Controlled trial of balneotherapy in treatment of low back pain. Ann Rheum Dis 51:820–822PubMedGoogle Scholar
  10. 10.
    Normative Decision of Health Ministry (1999/74) The Official Journal of HungaryGoogle Scholar
  11. 11.
    Altman, R, Asch E, Bloch D (1986) Development of criteria for the classification and reporting of osteoarthritis. Classification of osteoarthritis of the knee. Diagnostic and Therapeutic Criteria Committee of the American Rheumatism Association. Arthritis Rheum 29:1039–1049PubMedCrossRefGoogle Scholar
  12. 12.
    Bellamy N, Goldsmith CH, Buchanan WW, Campbell J, Duku E (2002) Prior score availability: observations using the WOMAC osteoarthritis index. Br J Rheumatol 1991;30:150–151CrossRefGoogle Scholar
  13. 13.
    Geytenbeek J (2002) Evidence for effective hydrotherapy. Physiotherapy 88:514–529CrossRefGoogle Scholar
  14. 14.
    Bender T, Karagulle Z, Bálint GP, Gutenbrunner C, Bálint PV, Sukenik S (2005) Hydrotherapy, balneotherapy, and spa treatment in pain management. Rheumatol Int 25:220–224PubMedCrossRefGoogle Scholar
  15. 15.
    Elkayam O, Wigler I, Tishler M et al (1991) Effect of spa therapy in Tiberias on patients with rheumatoid arthritis and osteoarthritis. J Rheumatol 18:1799–1803PubMedGoogle Scholar
  16. 16.
    Yilmaz B, Goktepe AS, Alaca R, Mohur H, Kayar AH (2004) Comparison of a generic and a disease specific quality of life scale to assess a comprehensive spa therapy program for knee osteoarthritis. Joint Bone Spine 71:563–566PubMedCrossRefGoogle Scholar
  17. 17.
    Guillemin F, Virion JM, Escudier P, De Talance N, Weryha G (2001) Effect on osteoarthritis of spa therapy at Bourbonne-les-Bains. Joint Bone Spine 68:499–503PubMedCrossRefGoogle Scholar
  18. 18.
    Wigler I, Elkayam O, Paran D, Yaron M (1995) Spa therapy for gonarthrosis: a prospective study. Rheumatol Int 15:65–68PubMedCrossRefGoogle Scholar
  19. 19.
    Verhagen AP, de Vet HC, de Bie RA, Kessels AG, Boers M, Knipschild PG (2000) Balneotherapy for rheumatoid arthritis and osteoarthritis. Cochrane Database Syst Rev 2:CD000518PubMedGoogle Scholar
  20. 20.
    Franke A, Reiner L, Pratzel HG, Franke T, Resch KL (2000) Long-term efficacy of radon spa therapy in rheumatoid arthritis—a randomized, sham-controlled study and follow-up. Rheumatology 39:894–902PubMedCrossRefGoogle Scholar
  21. 21.
    Sukenik S, Buskila D, Neumann L, Kleiner-Baumgarten A, Zimlichman S, Horowitz J (1990) Sulphur bath and mud pack treatment for rheumatoid arthritis at the Dead Sea area. Ann Rheum Dis 49:99–102PubMedCrossRefGoogle Scholar
  22. 22.
    van Tubergen A, Landewe R, van der Heijde D et al (2001) Combined spa–exercise therapy is effective in patients with ankylosing spondylitis: a randomized controlled trial. Arthritis Rheum 45:430–438PubMedCrossRefGoogle Scholar
  23. 23.
    Evcik D, Kýzýlay B, Gökçen E (2002) The effects of balneotherapy on fibromyalgia patients. Rheumatol Int 22:56–59PubMedCrossRefGoogle Scholar
  24. 24.
    Neumann L, Sukenik S, Bolotin A et al (2004) The effect of balneotherapy at the Dead Sea on the quality of life of patients with fibromyalgia syndrome. Clin Rheumatol 20:15–19CrossRefGoogle Scholar
  25. 25.
    Sukenik S, Giryes H, Halevy S, Neumann L, Flusser D, Buskila D (1994) Treatment of psoriatic arthritis at the Dead Sea. J Rheumatol 21:1305–1309PubMedGoogle Scholar
  26. 26.
    Van Tubergen A, Boonen A, Landewe R et al (2002) Cost effectiveness of combined spa–exercise therapy in ankylosing spondylitis: a randomized controlled trial. Arthritis Rheum 47:459–467PubMedCrossRefGoogle Scholar
  27. 27.
    van Tubergen A, van der Linden S (2002) A brief history of spa therapy. Ann Rheum Dis 61:273–275PubMedCrossRefGoogle Scholar
  28. 28.
    Bender T, Bálint PV, Bálint GP (2002) A brief history of spa therapy. Ann Rheum Dis 61:949PubMedCrossRefGoogle Scholar

Copyright information

© Clinical Rheumatology 2006

Authors and Affiliations

  • Géza P. Bálint
    • 1
    Email author
  • W. Watson Buchanan
    • 2
  • András Ádám
    • 3
  • István Ratkó
    • 1
  • László Poór
    • 4
  • Péter V. Bálint
    • 1
  • Éva Somos
    • 4
  • Ildikó Tefner
    • 1
  • Tamás Bender
    • 5
  1. 1.National Institute of Rheumatology and PhysiotherapyBudapestHungary
  2. 2.Faculty of Health Sciences, McMaster UniversityHamiltonCanada
  3. 3.General Practice Service of DávodDávodHungary
  4. 4.Municipal Hospital of BajaBajaHungary
  5. 5.Hospital of the Hospitaller Brothers of St. John of GodBudapestHungary

Personalised recommendations