Imagine going to your primary care doctor to be treated for nagging knee pain and receiving a prescription for soaking in warm, mineralized water once a week for several weeks. Imagine going to a spa in your community that’s staffed by medically trained therapists who could monitor the effects of your treatment. Imagine experiencing less pain and more mobility — and having your health insurance pay for it. It’s a common scenario in Hungary, where physicians can prescribe therapeutic soaking, mud baths, massage or physical therapy in the country’s mineral-rich waters. But the effects of balneotherapy have yet to be sanctioned by the American medical community.
A study published in the 2008 issue of the Israeli Medical Journal indicated that a course of balneotherapy can relieve pain and improve motor function in elderly adults suffering from chronic lower back pain and arthritis of the knee. Study participants were prescribed fifteen 30-minute balneotherapy sessions at a spa in Debrecen, Hungary. The participants who completed the study showed increased mobility and a reduced need for anti-inflammatory medications for three months after the study. Could studies like bring balneotherapy into the medical mainstream in the US? When it comes to validating the therapeutic properties of mineralized water, the American medical community is still waiting for proof.
Healing Waters in the United States
Balneotherapy is nothing new in North America. Native Americans used geothermal springs for therapeutic and ceremonial purposes for over 10,000 years. Native Americans considered the springs to be sacred, and that even during times of conflict, members of warring tribes could bathe without fearing for their safety. By the turn of the 19th century, the medicinal properties of geothermal water had taken on a faddish popularity. “Taking the waters” became a widely accepted ritual, and claims of the curative powers of geothermal water reached outlandish proportions. By the 1940s, US law prohibited these claims, and business in the classic spa towns declined.
Today, the use of hot springs for therapeutic purposes in the US is largely limited to health spas, where rejuvenation and stress reduction are the primary goals. While many spas publicize the mineral content of their waters and promote their healing benefits, there is no medical organization in the US that establishes standards for the mineral concentration of medicinal waters. There is also no clinical body dedicated to the study of the therapeutic effects of healing springs. The majority of the clinical literature on balneotherapy comes from Europe and Japan, where the use of mineralized waters for medicinal purposes is widely practiced.
In Japan and Europe, legally regulated standards for medicinal waters have been in place for years. But in the US, the use of medicinal water has yet to be widely accepted as a therapeutic practice. Is it possible to validate the effects of balneotherapy in the United States, so that medical treatment through mineralized water can be prescribed by medical practitioners, clinically monitored and possibly even covered by health insurance?
Looking to the Future
In the 21st century, a renewed focus on alternative therapies has led to a revival of interest in hot springs bathing. But in North America, this interest is still marginalized, and there is little exploration of the specific benefits of balneotherapy. Nathaniel Altman points out that the difficulty of applying accepted standards of clinical testing, such as the double-blind study, to balneotherapy has been an obstacle to research in this area in the US.
When we praise the benefits of balneotherapy for joint and muscle pain, skin disorders, respiratory conditions and digestive ailments, how do we know which elements of bathing produce these benefits? In an article published in the September 2010 issue of Health, Csaba Varga of the University of Pecs in Hungary discusses the challenges of classifying medicinal waters according to their therapeutic effects. Although medicinal waters contain specific salts that have been linked to specific health benefits, it’s difficult to isolate the properties that make these waters beneficial. Along with the therapeutic benefits of heat, which improves circulation and eases musculoskeletal pain, geothermal waters contain a combination of mineralized salts and organic compounds that are difficult to reproduce in a clinical scenario.
Water has been used as a therapeutic medium for centuries, and many US physicians write prescriptions for water therapy. In some cases, insurance providers will even pay for treatment if it involves a form of heat therapy, physical therapy or massage in the water. But will the medical community credit the water itself, and the minerals it contains, with easing the symptoms of arthritis, psoriasis, or fibromyalgia? In a 2004 issue of Rheumatology International, Dr. Tamas Bender and co-authors propose that the therapeutic effects of balneotherapy, or bathing for therapeutic purposes, be studied separately from hydrotherapy and spa therapy, so that the benefits of each form of treatment can be accurately assessed.
Varga calls for a reclassification of medicinal waters based on 21st century water analytics, including a consideration of the organic compounds present in spa waters. Without a new body of clinical data, persuading the American medical community to take a stronger interest in the therapeutic potential of balneotherapy will be challenging. And while your body may respond positively to the effects of soaking in mineral-rich geothermal waters, convincing insurance companies to pay for treatment may require more clinical evidence.
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Altman, Nathaniel: Healing Springs: The Ultimate Guide to Taking the Waters. Healing Arts Press: 2000.
Geo-Heat Center: “Historical Impacts of Geothermal Resources on the People of North America“: John W. Lund.
Health: “Problems with classification of spa waters used in balneology“; Csaba Varga; Vol. 2, No. 11; September 2010.
Israeli Medical Association Journal: “Balneotherapy in Elderly Patients: Effect on Pain from Degenerative Knee and Spine Conditions on Quality of Life“; J. Gaal, M.D., et al; May 2008.
Rheumatology International: “Hydrotherapy, Balneotherapy and Spa Treatment in Pain Management“; Tamas Bender, et al.; July 15, 2004.