Effect of Balneotherapy on Chronic Low Back Pain at Hot Springs in Southern Ethiopia: Perceived Improvements from Pain

Beyond the Bony Fragment: A Review of Limbus Vertebra

Vertebral limbus is a condition characterized by the intraspongious herniation of a portion of the nucleus pulposus. It is often asymptomatic, but it can sometimes cause nonspecific symptoms such as local pain and muscle spasm, or, in rare cases, radiculopathies, which is why it can be confused with vertebral fractures, spondyloarthropathies, infectious or tumoral processes. Early recognition of this pathology is preferable for a correct diagnosis and adequate treatment, the latter ranging from conservative approaches (such as personalized exercise programs and physical therapy) to surgical interventions reserved for severe cases with nerve compression.

Effect of Balneotherapy on Skin Lesion at Hot Springs in Southern Ethiopia: A Single-Arm Prospective Cohort Study

Background

Balneotherapy is the use of mineral water for the treatment of a wide range of diseases including skin lesions. Even though Ethiopia has a large number of places with natural hot springs, their therapeutic value has not been thoroughly studied. The aim of this study was to determine the effect of balneotherapy among patients with skin lesions at hot springs in southern Ethiopia.

Methods

A single-arm prospective cohort study design was used to assess patient's progress from their skin lesion complaint after using the hot water for at least three consecutive days or more. An individual visiting the hot springs site and staying there for at least three days or more was included in the study. From four hot springs sites in Southern Ethiopia, 1320 study participants who were 18 years of age or older were enrolled. The data were gathered using a standardized questionnaire and a physical examination. A descriptive analysis was made.

Results

Of the total, 142 (10.8%) of them had various skin lesions. Flexural lesions accounted 87 (61.3%), non-specific skin conditions 51 (35.9%), co-lesions at the scalp, external ear canal, trunk, and various locations, and psoriatic lesions comprised 4.8%. There were 72 (82.8%) typical eczematous lesions among the total number of flexural lesions. After using balneotherapy for 3-7 days once daily, 69 (95.2%) cases of eczematous dermatitis and 30 (58.8%) cases of non-specific skin issues showed improvement from the lesion. Additionally, after 30 days of bathing once daily, the PASI score of more than 90% of the psoriatic cases dropped to a score of one.

Conclusion

Patients with skin lesions benefit significantly from balneotherapy when it lasts for three or more days. In order to improve skin lesions, proper application for at least a week or longer is highly beneficial.

The effects of immersion in 42℃ radon, natrium, calcium, bicarbonate content thermal-mineral water on chronic low back pain. Controlled, follow-up study

In our minimized follow-up trial with 137 participants with chronic low back pain, one group of participants received regular outpatient care, and the other group received balneotherapy by immersion in 42℃ thermal-mineral water in addition to regular outpatient care on 15 occasions for 3 weeks. Pain on movement and at rest on the 0-100 mm visual analogue scale (VAS), Oswestry index, the number of participants evaluating the symptoms clinically acceptable (Patient Acceptable Symptom State, PASS) and the EuroQol-5D-5L (EQ-5D-5L) quality of life questionnaire were assessed at basal time (at week 0) and after balneotherapy (at weeks 3 and 12). The VAS pain scores, the Oswestry index, the EQ-5D-5L index and the EQ-VAS significantly improved in the balneotherapy group after treatment at week 3 (p < 0.001) and week 12 (p < 0.001) compared to baseline, with a significant between group difference at week 3 (p < 0.001) and week 12 (p < 0.001). The pain VAS score on movement was 66.82 ± 11.48, 26.69 ± 21.49, and 20.09 ± 23.29 in the balneotherapy group, and 63.67 ± 14.77, 67.35 ± 15.44, and 70.23 ± 18.26 in the control group at the consecutive visits. The PASS increased in both groups at week 3 and week 12 compared to the baseline, with a significant between-group difference at week 3 and week 12 for the balneotherapy group. Our results suggest the therapeutic efficacy of immersion in 42℃ thermal mineral water on chronic low back pain.ClinicalTrials.gov Identifier: NCT05342051.

Effects of complex spa therapy in patients with osteoarthritis of the spine receiving treatments in health resorts in south-eastern Poland

Management of patients with degenerative diseases commonly comprises health-resort based treatment programs, including spa therapies, balneotherapy as well as terrain therapy making use of microclimate factors. The study was designed to assess short- and long-term effects of spa therapy administered to patients with osteoarthritis of the spine who received treatment in health resorts located in Poland. The study involved 102 patients receiving treatment in health resorts, a group of subjects receiving outpatient treatment (100 patients) and a group receiving no therapy (100 patients). The assessment survey included: Pain VAS and Laitinen, LISAT-9 and HAQ-20 questionnaires. The assessments were carried out three times: at the start of the therapy program, as well as one month and six months after the end of the program. Short-term effects showed statistically significant improvement in all the outcome measures in spa group and outpatient treatment group. The long-term effects showed statistically significant improvement in all the outcome measures in spa group only. In conclusion spa therapy reduces pain, improves functional efficiency and increases the level of life satisfaction in patients with osteoarthritis of the spine. Its effects are sustained for at least six months. Spa therapy is more effective long-term, than outpatient treatment.

Trial registration: The study was registered at Clinical Trials: NCT03974308. First registration: 04/06/2019.

The economic and social value of spa tourism: The case of balneotherapy in Maresme, Spain

The aim of this article is to assess both the economic and social value of balneotherapy and spa tourism, being the first paper in carrying out this analysis. The study has been conducted in Maresme, a region of Catalonia, Spain. On the one hand, an Input-Output (IO) model with a Social Accounting Matrix (SAM) has been carried out to assess the economic value. On the other hand, a Cost-Benefit Analysis (CBA) has been used to monetise the social value in this region, taking into account, among other concepts, direct and indirect health profits, given that balneotherapy helps to alleviate various diseases. The results show that whereas the economic multiplier is 1.529 considering the direct and indirect effects and 1.712 taking into account also the induced effects, which are similar to health and medical tourism multipliers, social value generates additional positive value, given that the cost-benefit ratio is 1.858. The theoretical implications of the paper as well as the findings' implications for policy so as to encourage investments in spa tourism are discussed.