title: Phytothermotherapy in osteoarthritis: a randomized controlled clinical trial.
abstract: OBJECTIVE
  The aim of this study was to assess the efficacy of adding a cycle of phytothermotherapy (a traditional treatment with fermenting grass used in Trentino-Alto Adige, Italy) to the usual drug treatment, in patients with primary symptomatic osteoarthritis (OA) of the knee, hip, or lumbar spine.
  
  
  METHODS
  In this randomized, single-blind, controlled trial, 218 outpatients were enrolled; 109 patients were treated with a cycle of phytothermotherapy at the thermal resort of Garniga Terme (Trento, Italy) for 10 days; the other 109 patients continued regular outpatient care. Patients were assessed at baseline, after 2 weeks, and after 3 months from the beginning of the study and were evaluated using a visual analogue scale (VAS) for spontaneous pain, a Health Assessment Questionnaire, the Lequesne index for hip and knee osteoarthritis, and the Rolland Morris Questionnaire for lumbar spine OA and symptomatic drug consumption.
  
  
  RESULTS
  In patients treated with phytothermotherapy, a significant improvement of VAS and a reduction of nonsteroidal anti-inflammatory drug consumption at the end of treatment and 3 months later were observed. In the control group, no significant differences were noted. The analyses performed separately for each subgroup for OA localization showed that the best results were evident in lumbar spine OA. Concerning tolerability, in the group treated with phytothermotherapy 10% of patients presented side-effects due to treatment, but these were of low intensity and did not interrupt the therapy.
  
  
  CONCLUSIONS
  In conclusion, the results show beneficial effects of a cycle of phytothermotherapy in patients with OA of the hip, knee, or lumbar spine. Phytothermotherapy may therefore be a useful aid alongside the usual pharmacologic and physiokinesic therapies, or may be used as a valid alternative for patients who do not tolerate pharmacologic treatments.
authors.affiliation: Rheumatology Unit, Department of Clinical Medicine and Immunology, University of Siena, Viale Bracci 1, Siena, Italy. fioravanti7@virgilio.it
authors.forename: Antonella
authors.initials: A
authors.lastname: Fioravanti
authors.forename: Barbara
authors.initials: B
authors.lastname: Bellisai
authors.forename: Francesca
authors.initials: F
authors.lastname: Iacoponi
authors.forename: Patrizia
authors.initials: P
authors.lastname: Manica
authors.forename: Mauro
authors.initials: M
authors.lastname: Galeazzi
mesh_terms: D000368:Aged; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D003131:Combined Modality Therapy; D005260:Female; D005285:Fermentation; D006801:Humans; D006979:Hyperthermia, Induced; D008297:Male; D008875:Middle Aged; D010003:Osteoarthritis / Q000150:complications / Q000628:therapy*; D010146:Pain / Q000209:etiology; D059408:Pain Management; D010147:Pain Measurement; D008517:Phytotherapy; D006109:Poaceae; D016037:Single-Blind Method; D016896:Treatment Outcome
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal