title: Contribution of individual spa therapies in the treatment of chronic pain.
abstract: OBJECTIVE
  The aim of the present study was to evaluate the contribution of individual spa therapies administered during a period of 3 weeks on measures of well being and pain in a sample of patients with chronic back pain.
  
  
  METHODS
  One hundred fifty-three patients with chronic back pain undergoing inpatient spa therapy in Bad Tatzmannsdorf, Austria, participated in the study. According to the prescription of their spa physician, patients underwent two or more of the following treatments: mud packs, carbon dioxide baths, massages, exercise therapies, spinal traction, and electrotherapy. The outcome measures were general pain, back pain, negative mood, and health satisfaction. Regression analyses were conducted to predict the 4 outcome measures at the end of spa therapy and at 6 weeks' follow-up for all therapies applied. The pretreatment outcome measure, age, and sex were controlled for by entering them into the analysis.
  
  
  RESULTS
  Patients showed significant improvements in all 4 outcome measures. The prediction of improvement was generally small: only 1% to 11% of the change of the outcome measures could be explained by the type and number of therapies received. On a short-term basis, mud packs and exercise were found to be associated with a greater improvement in mood, whereas a greater frequency of massage therapy and carbon dioxide baths was associated with a smaller improvement in health satisfaction. On a long-term basis, exercise therapy and spinal traction were associated with a greater reduction in back pain.
  
  
  CONCLUSIONS
  The results indicate that, in addition to the individual therapies, other factors relating to spa therapy as a whole must contribute to overall treatment outcome. In addition, the results support the efficacy of exercise therapy for chronic back pain.
authors.affiliation: Department of Physiology, University of Vienna, Australia. gerhard.strauss-blasche@univie.ac.at
authors.forename: Gerhard
authors.initials: G
authors.lastname: Strauss-Blasche
authors.forename: Cem
authors.initials: C
authors.lastname: Ekmekcioglu
authors.forename: Gerda
authors.initials: G
authors.lastname: Vacariu
authors.forename: Herbert
authors.initials: H
authors.lastname: Melchart
authors.forename: Veronika
authors.initials: V
authors.lastname: Fialka-Moser
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Marktl
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001294:Attitude to Health; D001317:Austria; D001416:Back Pain / Q000523:psychology* / Q000534:rehabilitation*; D001452:Balneology / Q000379:methods*; D002908:Chronic Disease; D004599:Electric Stimulation Therapy / Q000379:methods; D005081:Exercise Therapy / Q000379:methods; D005260:Female; D006294:Health Resorts; D006801:Humans; D006875:Hydrotherapy / Q000379:methods; D008297:Male; D008405:Massage / Q000379:methods; D008875:Middle Aged; D010147:Pain Measurement / Q000379:methods* / Q000523:psychology; D026741:Physical Therapy Modalities / Q000379:methods*; D013223:Statistics as Topic; D014143:Traction / Q000379:methods; D016896:Treatment Outcome