title: [The possible uses of balneotherapy in treating chronic venous insufficiency of lower limbs].
abstract: The Chronic Venous Insufficiency (CVI) of inferior limbs is a widespread disease, with an increasing incidence as a consequence of longer life expectance, life-style, obesity, smoking, use of drugs as oestrogens and progestins and working conditions. Medical therapy is still lacking for evidence of efficacy, and compression therapy is useful only in preventing a worsening of this condition. Surgical treatment is the only radical therapy effective for the advanced phases of the disease. In this context spa balneotherapy can be considered as a possible chance to improve some subjective and objective symptoms of CVI of inferior limbs, and to prevent worsening of this condition. The authors performed a review of the relevant scientific literature concerning the treatment of CVI of inferior limbs with mineral water balneotherapy, in order to evaluate its effects on objective and subjective symptoms and its effectiveness to prevent further worsening. We searched the PubMed/Medline, Cochrane Library, Embase, Web of Science databases for articles published between 1990 and 2011 on this topic. To this end, the authors selected few clinical-controlled and case-controlled studies; patients affected from CVI of inferior limbs were treated with balneotherapy at health spas with sulphureous, sulphate, salsojodic or salsobromojodic mineral waters. Baths in mineral waters were often associated with idromassotherapy and vascular pathway. Effects of spa balneotherapy are related to some aspecific properties, like hydrostatic pressure, osmotic pressure and water temperature, partly related with specific chemico-physical properties of the adopted mineral water. The controlled clinical studies on spa therapy showed significant improvement of subjective (such as itch, paresthesias, pain, heaviness) and objective symptoms (namely edema and skin discromias). These studies suggest that spa balneotherapy may give a good chance of secondary prevention and effective therapy of CVI of inferior limbs, but also that it needs of other clinical controlled trials.
authors.affiliation: Dipartimenti di Medicina Interna e Specialità Mediche, UOC Medicina Interna E, Terapia Medica e Medicina Termale. Scuola di Specializzazione in Medicina Termale, Sapienza Università di Roma, Italia.
authors.forename: L
authors.initials: L
authors.lastname: Petraccia
authors.forename: G
authors.initials: G
authors.lastname: Mennuni
authors.forename: M
authors.initials: M
authors.lastname: Fontana
authors.forename: S
authors.initials: S
authors.lastname: Nocchi
authors.forename: F
authors.initials: F
authors.lastname: Libri
authors.forename: S
authors.initials: S
authors.lastname: Conte
authors.forename: A
authors.initials: A
authors.lastname: Alhadeff
authors.forename: B
authors.initials: B
authors.lastname: Romano
authors.forename: F
authors.initials: F
authors.lastname: Messini
authors.forename: M
authors.initials: M
authors.lastname: Grassi
authors.forename: A
authors.initials: A
authors.lastname: Fraioli
mesh_terms: D001452:Balneology; D002908:Chronic Disease; D006801:Humans; D035002:Lower Extremity / Q000098:blood supply*; D014689:Venous Insufficiency / Q000628:therapy*