Clinical Rheumatology

, Volume 36, Issue 8, pp 1839–1847 | Cite as

The effect of balneotherapy on pain relief, stiffness, and physical function in patients with osteoarthritis of the knee: a meta-analysis

  • Hiromi MatsumotoEmail author
  • Hiroshi Hagino
  • Kunihiko Hayashi
  • Yuki Ideno
  • Takashi Wada
  • Toru Ogata
  • Masami Akai
  • Atsushi Seichi
  • Tsutomu Iwaya
Original Article


This meta-analysis was performed to determine the effect of balneotherapy on relieving pain and stiffness and improving physical function, compared to controls, among patients with knee osteoarthritis. We searched electronic databases for eligible studies published from 2004 to December 31, 2016, with language restrictions of English or Japanese. We screened publications in Medline, Embase, Cochrane library, and the Japan Medical Abstracts Society Database using two approaches, MeSH terms and free words. Studies that examined the effect of balneotherapy for treating knee osteoarthritis of a ≥2-week duration were included. Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores were used as the outcome measure. A total of 102 publications were assessed according to the exclusion criteria of the study; eight clinical trial studies, which comprised a total of 359 cases and 375 controls, were included in this meta-analysis. The meta-analysis analyzed improvement in WOMAC score at the final follow-up visit, which varied from 2 to 12 months post-intervention. Our meta-analysis indicates that balneotherapy was clinically effective in relieving pain and stiffness, and improving function, as assessed by WOMAC score, compared to controls. However, there was high heterogeneity (88 to 93%). It is possible that balneotherapy may reduce pain and stiffness, and improve function, in individuals with knee osteoarthritis, although the quality of current publications contributes to the heterogeneity observed in this meta-analysis.


Balneotherapy Meta-analysis Osteoarthritis of the knee 



This study was supported by a Health and Labour Sciences Research Grant (Comprehensive Research on Life-Style Related Diseases including Cardiovascular Diseases and Diabetes Mellitus, H25-ippan-029).

Compliance with ethical standards




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Copyright information

© International League of Associations for Rheumatology (ILAR) 2017

Authors and Affiliations

  • Hiromi Matsumoto
    • 1
    Email author
  • Hiroshi Hagino
    • 1
    • 2
  • Kunihiko Hayashi
    • 3
  • Yuki Ideno
    • 4
  • Takashi Wada
    • 1
  • Toru Ogata
    • 5
  • Masami Akai
    • 6
  • Atsushi Seichi
    • 7
  • Tsutomu Iwaya
    • 8
  1. 1.Rehabilitation DivisionTottori University HospitalYonago CityJapan
  2. 2.Faculty of Medicine, School of Health ScienceTottori UniversityYonago CityJapan
  3. 3.Faculty of Medicine, School of Health SciencesGunma UniversityMaebashi CityJapan
  4. 4.Gunma University Initiative for Advanced ResearchMaebashi CityJapan
  5. 5.Center for Sport Science and Health Promotion, Department of Rehabilitation for the Movement FunctionsNational Rehabilitation Center for Persons with DisabilitiesSaitamaJapan
  6. 6.Graduate School International University of Health and WelfareTokyoJapan
  7. 7.Department of Orthopaedic SurgeryMitsui Memorial HospitalTokyoJapan
  8. 8.Nagano University of Health & MedicineNagano CityJapan

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