title: Balneotherapy at the Dead Sea area for patients with psoriatic arthritis and concomitant fibromyalgia.
abstract: BACKGROUND
  Balneotherapy has been successfully used to treat various rheumatic diseases, but has only recently been evaluated for the treatment of fibromyalgia. Since no effective treatment exists for this common rheumatic disease, complementary methods of treatment have been attempted.
  
  
  OBJECTIVE
  To assess the effectiveness of balneotherapy at the Dead Sea area in the treatment of patients suffering from both fibromyalgia and psoriatic arthritis.
  
  
  METHODS
  Twenty-eight patients with psoriatic arthritis and fibromyalgia were treated with various modalities of balneotherapy at the Dead Sea area. Clinical indices assessed were duration of morning stiffness, number of active joints, a point count of 18 fibrositic tender points, and determination of the threshold of tenderness in nine fibrositic and in four control points using a dolorimeter.
  
  
  RESULTS
  The number of active joints was reduced from 18.4 +/- 10.9 to 9 +/- 8.2 (P < 0.001). The number of tender points was reduced from 12.6 +/- 2 to 7.1 +/- 5 in men (P < 0.003) and from 13.1 +/- 2 to 7.5 +/- 3.7 in women (P < 0.001). A significant improvement was found in dolorimetric threshold readings after the treatment period in women (P < 0.001). No correlation was observed between the reduction in the number of active joints and the reduction in the number of tender points in the same patients (r = 0.2).
  
  
  CONCLUSIONS
  Balneotherapy at the Dead Sea area appears to produce a statistically significant substantial improvement in the number of active joints and tender points in both male and female patients with fibromyalgia and psoriatic arthritis. Further research is needed to elucidate the distinction between the benefits of staying at the Dead Sea area without balneotherapy and the effects of balneotherapy in the study population.
authors.affiliation: Department of Medicine D, Soroka University Medical Center and Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel. ssukenik@mail.bgu.ac.il
authors.forename: S
authors.initials: S
authors.lastname: Sukenik
authors.forename: R
authors.initials: R
authors.lastname: Baradin
authors.forename: S
authors.initials: S
authors.lastname: Codish
authors.forename: L
authors.initials: L
authors.lastname: Neumann
authors.forename: D
authors.initials: D
authors.lastname: Flusser
authors.forename: M
authors.initials: M
authors.lastname: Abu-Shakra
authors.forename: D
authors.initials: D
authors.lastname: Buskila
mesh_terms: D000328:Adult; D000368:Aged; D015535:Arthritis, Psoriatic / Q000150:complications* / Q000534:rehabilitation*; D001452:Balneology / Q000379:methods*; D005260:Female; D005356:Fibromyalgia / Q000150:complications* / Q000534:rehabilitation*; D005500:Follow-Up Studies; D006801:Humans; D007557:Israel; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D011336:Probability; D011446:Prospective Studies; D016059:Range of Motion, Articular / Q000502:physiology; D016896:Treatment Outcome