title: Short- and long-term effects of spa therapy in knee osteoarthritis.
abstract: OBJECTIVE
  To assess both the short- and long-term effectiveness of spa therapy in patients with primary knee osteoarthritis in a prospective, randomized, single-blinded, controlled trial.
  
  
  METHODS
  Eighty outpatients were enrolled in this study; 40 patients were treated with a combination of daily local mud packs and bicarbonate-sulfate mineral bath water from the spa center of Rapolano Terme (Siena, Italy) for 2 wks, and 40 patients continued regular, routine ambulatory care. Patients were assessed at baseline time; after 2 wks; after 3, 6, and 9 mos after the beginning of the study and were evaluated by Visual Analog Scale for spontaneous pain, Lequesne index, Western Ontario and McMaster Universities Index for gonarthrosis, Arthritis Impact Measurement Scale-1, and symptomatic drug consumption.
  
  
  RESULTS
  We observed a significant improvement of all evaluated parameters at the end of the cycle of spa therapy, which persisted throughout the whole of the follow-up period, whereas in the control group no significant differences were noted. This symptomatic effect was confirmed by the significant reduction of symptomatic drug consumption. Tolerability of spa therapy seemed to be good, with light and transitory side effects.
  
  
  CONCLUSIONS
  The results from our study confirm that the beneficial effects of spa therapy in patients with knee osteoarthritis lasts over time, with positive effects on the painful symptomatology and a significant improvement on functional capacities. Spa therapy can represent a useful backup to pharmacologic treatment of knee osteoarthritis or a valid alternative for patients who do not tolerate pharmacologic treatments.
authors.affiliation: Rheumatology Unit, Department of Clinical Medicine and Immunological Sciences, University of Siena, Siena, Italy.
authors.forename: Antonella
authors.initials: A
authors.lastname: Fioravanti
authors.forename: Francesca
authors.initials: F
authors.lastname: Iacoponi
authors.forename: Barbara
authors.initials: B
authors.lastname: Bellisai
authors.forename: Luca
authors.initials: L
authors.lastname: Cantarini
authors.forename: Mauro
authors.initials: M
authors.lastname: Galeazzi
mesh_terms: D000368:Aged; D001494:Baths; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008900:Mineral Waters; D009094:Mud Therapy; D020370:Osteoarthritis, Knee / Q000628:therapy*; D017060:Patient Satisfaction; D020127:Recovery of Function; D012720:Severity of Illness Index
chemical_list: D008900:Mineral Waters