title: The effect of sulphurous water in patients with osteoarthritis of hand. Double-blind, randomized, controlled follow-up study The effect of balneotherapy on C-reactive protein, serum cholesterol, triglyceride, total antioxidant status and HSP-60 levels The effect of spa therapy in chronic low back pain: a randomized controlled, single-blind, follow-up study Controlled trial of balneotherapy in treatment of low back pain. Effectiveness of Balneotherapy in Chronic Low Back Pain – a Randomized Single-Blind Controlled Follow-up Study The effect of the thermal mineral water of Nagybaracska on patients with knee joint osteoarthritis—a double blind study Spa therapy in the treatment of knee osteoarthritis: a large randomised multicentre trial Balneotherapy in elderly patients: effect on pain from degenerative knee and spine conditions and on quality of life. Evaluation of the effect of balneotherapy in patients with osteoarthritis of the hands: a randomized controlled single-blind follow-up study The effects of weightbath traction hydrotherapy as a component of complex physical therapy in disorders of the cervical and lumbar spine: a controlled pilot study with follow-up Balneotherapy versus paroxetine in the treatment of generalized anxiety disorder. Human physiological responses to immersion into water of different temperatures The therapeutic effects of Cserkeszölö thermal water in osteoarthritis of the knee: a double blind, controlled, follow-up study Effect of thermal water and adjunctive electrotherapy on chronic low back pain: a double-blind, randomized, follow-up study. A pragmatic randomized controlled trial on the effectiveness of low concentrated saline spa water baths followed by ultraviolet B (UVB) compared to UVB only in moderate to severe psoriasis. Effect of balneotherapy on the antioxidant system--a controlled pilot study. No significant change of plasma beta-endorphin levels of psoriasis patients after synchronous balneophototherapy. Double-Blind Trial on the Effectiveness of the Puspokladany Thermal Water on Arthrosis of the Knee-Joints Does balneotherapy with low radon concentration in water influence the endocrine system? A controlled non-randomized pilot study Clinical and microcirculatory effects of transcutaneous CO2 therapy in intermittent claudication. Randomized double-blind clinical trial with a parallel design.
abstract: The aim of the study was to demonstrate the effectiveness of sulphurous water in patients with osteoarthritis of the h and . Forty-seven patients with osteoarthritis of the h and were enrolled into the double-blind , r and omized , controlled study , satisfying ACR criteria . One group of the patients ( n = 24 ) received balneotherapy , bathing in sulphurous thermal water for 20 min per occasion , 15 times in all during a period of 3 weeks . The control group ( n = 21 ) had a bath exclusively in warm tap water . Assessment s were carried out in both groups on four occasions : at the beginning and at the end of the treatment , and 3 and 6 months after the beginning of the treatment . The parameters studied were the following : pain in the h and , morning stiffness in the joints , grip strength of both h and s , and Health Assessment Question naire Disability Index ( HAQ ) and AUSCAN H and Osteoarthritis Index and EuroQol quality of life question naire . At the end of treatment , the improvement was more pronounced in the patient group treated with the sulphurous water . After 3 months , significant improvement could be detected in all parameters , except the morning stiffness and EQ5D . After 6 months , the values of pain , HAQ and AUSCAN continued to be significantly better in comparison with the baseline values . The improvement in quality of life was significant only at the end of the treatment , 6 months later not any longer . The difference between the two groups was significant after 3 months in point of pain and EQVAS .  Balneotherapy and within this the sulphurous spa water alone may be effective for the attenuation of pain in patients with h and osteoarthrosis An increasing body of evidence substantiating the effectiveness of balneotherapy has accumulated during recent decades . In the present study , 42 ambulatory patients ( 23 males and 19 females , mean age 59.5 years ) with degenerative musculoskeletal disease were r and omised into one of two groups — bathing in tap water or in mineral water at the same temperature— and subjected to 30-min balneotherapy sessions on 15 occasions . Study parameters comprised serum levels of sensitised C-reactive protein ( CRP ) , plasma lipids , heat shock protein ( HSP-60 ) and total antioxidant status ( TAS ) . In both groups , CRP levels followed a decreasing tendency , which still persisted 3 months later . At 3 months after balneotherapy , serum cholesterol levels were still decreasing in patients who had used medicinal water , but exhibited a trend towards an increase in the control group . Triglyceride levels followed a decreasing trend in both patient groups . TAS showed a declining tendency in both groups . No changes of HSP-60 levels were observed in either group . Balneotherapy with the thermal water from Hajdúszoboszló spa had a more pronounced physiological effect compared to that seen in the control group treated with tap water in a 3 month period Effect of thermal water with high mineral content on clinical parameters and quality of life of patients with chronic low back pain was studied . In this r and omized controlled , single-blind , follow-up study , 60 patients with chronic low back pain were r and omized into two groups . The treatment group received balneotherapy with thermal-mineral water , and the control group bathed in tap water . Changes of the followings were evaluated : visual analogue scale ( VAS ) for pain , range of motion for the lumbar spine , Oswestry index , EuroQol-5D and Short Form-36 question naires . In the treatment group , the mobility of the lumbar spine , the Oswestry index , the VAS scores and the EuroQoL-5D index improved significantly . SF-36 items improved significantly in the treated group compared with baseline except for two parameters . Our study demonstrated the beneficial effect of balneotherapy with thermal mineral versus tap water on clinical parameters , along with improvements in quality of life Three treatments for non-specific lumbar pain -- balneotherapy , underwater traction bath , and underwater massage -- were assessed in a r and omised prospect i ve controlled trial in 158 out patients . Each group was treated for four weeks and patients were review ed at the end of this period and at 12 months after entry to the trial . The prescription of analgesics and the pain score were significantly reduced in all three treated groups , but there was no difference between the three groups . No significant change occurred in spinal motion and the straight leg raising test . After one year only the analgesic consumption was significantly lower than in the control group Objective : Balneotherapy , a domain of medical science , focuses on utilizing the beneficial effects of medicinal waters . Low back pain is among the most prevalent musculoskeletal disorders affecting a large proportion of the population during their lifetime . Although small in number , all controlled studies published on this subject have demonstrated the benefits of balneotherapy . This present study was undertaken to compare the effects of hydrotherapy with mineral water vs. tap water on low back pain . Patients and Methods : A single-blind clinical study was carried out to appraise the therapeutic efficacy of reduced sulphurous water on 60 patients with low back pain . 30 subjects took baths in reduced sulphurous mineral water  , whereas the other 30 patients used modified tap water of matching odor . Parameters determined at baseline , after balneo-/hydrotherapy , and at the end of the 3-month follow-up period included the results of the Visual Analogue Scale ( VAS ) score , the modified Oswestry index , mobility of the spine , antalgic posture , tenderness of the paravertebral muscles on palpation , the dose requirements for analgesics , and the efficacy assessed by the investigators and by the patients . Results : Bathing in mineral water result ed in a statistically significant improvement . This was reflected by the VAS ( p < 0.01 ) and manifested by the mitigation of muscle spasm ( p < 0.01 ) , the alleviation of local tenderness ( p < 0.01 ) , the enhanced flexion-extension and rotation of the spine ( p < 0.01 ) as well as by the improvement of the Schober ’s index ( p < 0.01 ) . All these beneficial changes persisted as long as 3 months after the completion of balneotherapy . By contrast , hydrotherapy with tap water result ed only in the temporary improvement of just a single parameter : the VAS score improved significantly ( p < 0.01 ) . Conclusions : Balneotherapy in itself can alleviate  low back pain . As demonstrated by this study , the analgesic efficacy and improvement of mobility accomplished by the use of mineral water is significantly superior to that afforded by hydrotherapy with tap water . Our results clearly establish the beneficial effects of mineral water . Moreover , it is a valuable adjunct to other forms of physical treatment as well as to pharmacotherapy To study the effect of thermal mineral water of Nagybaracska ( Hungary ) on patients with primary knee osteoarthritis in a r and omized , double-blind clinical trial , 64 patients with nonsurgical knee joint osteoarthritis were r and omly selected either into the thermal mineral water or into the tap water group in a non-spa resort village . The patients of both groups received 30-min sessions of bathing , 5 days a week for four consecutive weeks . The patients were evaluated by a blind observer immediately before and at the end of the trial using Western Ontario and McMaster Osteoarthritis ( WOMAC ) indices and follow-up assessment 3 months later . Twenty-seven patients of the 32 patients who received thermal mineral water and 25 of the 32 of those treated with tap water completed the trial . The WOMAC activity , pain , and total scores improved significantly in the thermal mineral-water-treated group . The improvement remained also at the end of the 3-month follow-up . The WOMAC activity , pain , and total scores improved significantly also in the tap water group at the end of the treatment course , but no improvement was detected at the end of the 3-month follow-up period . The treatment with the thermal mineral water of Nagybaracska significantly improved activity , pain , and total WOMAC scores of patients with nonsurgical OA of the knee . Even after 3 months , significant improvement was observed compared to the scores before the treatment or to tap water treatment Objective To determine whether spa therapy , plus home exercises and usual medical treatment provides any benefit over exercises and usual treatment , in the management of knee osteoarthritis . Methods Large multicentre r and omised prospect i ve clinical trial of patients with knee osteoarthritis according to the American College of Rheumatology criteria , attending French spa resorts as out patients between June 2006 and April 2007 . Zelen r and omisation was used so patients were ignorant of the other group and spa personnel were not told which patients were participating . The main endpoint criteria were patient self-assessed . All patients continued usual treatments and performed daily st and ardised home exercises . The spa therapy group also received 18 days of spa therapy ( massages , showers , mud and pool sessions ) . Main Endpoint The number of patients achieving minimal clinical ly important improvement ( MCII ) at 6 months , defined as ≥19.9 mm on the visual analogue pain scale and /or ≥9.1 points in a normalised Western Ontario and McMaster Universities osteoarthritis index function score and no knee surgery . Results The intention to treat analysis included 187 controls and 195 spa therapy patients . At 6 months , 99/195 ( 50.8 % ) spa group patients had MCII and 68/187 ( 36.4 % ) controls ( χ2=8.05 ; df=1 ; p=0.005 ) . However , no improvement in quality of life ( Short Form 36 ) or patient acceptable symptom state was observed at 6 months . Conclusion For patients with knee osteoarthritis a 3-week course of spa therapy together with home exercises and usual pharmacological treatments offers benefit after 6 months compared with exercises and usual treatment alone , and is well tolerated . Trial registration number NCT00348777 BACKGROUND Balneotherapy is an established treatment modality for musculoskeletal disease , but few studies have examined the efficacy of spa therapy in elderly patients with degenerative spine and joint diseases . OBJECTIVES To assess the effects of balneotherapy on chronic musculoskeletal pain , functional capacity , and quality of life in elderly patients with osteoarthritis of the knee or with chronic low back pain . METHODS The 81 patients in the study group underwent a 1 day course of 30 minute daily baths in mineral water . Changes were evaluated in the following parameters : pain intensity , functional capacity , quality of life , use of non-steroidal anti-inflammatory or analgesic drugs , subjective disease severity perceived by the patients , investigator-rated disease severity , and severity of pain perceived by the patients . We analyzed the results of 76 subjects as 5 did not complete the study . RESULTS Compared to baseline , all monitored parameters were significantly improved by balneotherapy in both investigated groups . Moreover , the favorable effect was prolonged for 3 months after treatment . CONCLUSIONS This study showed that balneotherapy is an effective treatment modality in elderly patients with osteoarthritis of the knee or with chronic low back pain , and its benefits last for at least 3 months after treatment Objective : To evaluate the effectiveness of thermal mineral water compared with magnetotherapy without balneotherapy as control , in the treatment of h and osteoarthritis . Design : R and omized controlled single-blind follow-up study . Setting : Rheumatology specialist clinic of Gunaras Health Spa . Subjects : Patients between 50 and 70 years of age with h and osteoarthritis , r and omly assigned into three groups . Interventions : The subjects in the first two groups bathed in thermal mineral water of two different temperatures ( 36 ° C and 38 ° C ) for three weeks five times a week for 20 minutes a day and received magnetotherapy to their h and s three times weekly . The third group received only magnetotherapy . Outcome measures : Visual analogue scale scores , h and grip strength , pinchgrip strength , the number of swollen and tender joints of the h and , the duration of morning joint stiffness , Health Assessment Question naire , and Short Form-36 question naire . The study parameters were administered at baseline , immediately after treatment and after 13 weeks . Results : The study included 63 patients . Statistically significant improvement was observed in several studied parameters after the treatment and during the follow-up study in the thermal water groups versus the control group . The 38 ° C thermal water treatment significantly improved the pinch strength of the right h and ( 0.6 ( 95 % confidence interval ( CI ) 0.2 to 1.1 ) vs. 0.03 ( 95 % CI −0.3 to 0.4 ) , P < 0.05 ) and the Health Assessment Question naire parameters ( −0.4 ( 95 % CI −0.6 to −0.2 ) vs. −0.1 ( 95 % CI −0.2 to 0.1 ) , P < 0.01 ) even in the long term . Conclusions : Balneotherapy combined with magnetotherapy  improved the pain and function as well as the quality of life in patients with h and osteoarthritis The therapeutic modalities available for the conservative management of chronic cervical and lumbar pain include underwater traction , the usefulness of which is not universally acknowledged . No reports have been published on clinical trials evaluating underwater traction . This study was intended to ascertain any beneficial impact of weightbath therapy on the clinical parameters and quality of life of patients with cervical/lumbar discopathy . The study population comprised 72 subjects . Two groups of 18 patients each received underwater traction therapy of the cervical or lumbar spine with add-on McKenzie exercises and iontophoresis . The remaining two groups , treated with exercises and iontophoresis , served as controls . VAS and SF36 scores , range of motion were monitored to appraise therapeutic efficacy in cervical discopathy , whereas these parameters were supplemented by the Oswestry index in lumbar discopathy . A MRI scan was done at baseline and after 3 months of follow-up . Underwater cervical or lumbar traction therapy for discopathy achieved significant improvement of all study parameters , which was still evident 3 months later . Among the controls , significant improvement of just a single parameter was seen in patients with lumbar , and of two parameters in those with cervical discopathy . Underwater traction therapy effectively mitigates pain , enhances joint flexibility , and improves the quality of life of  patients with cervical or lumbar discopathy . The equipment required to administer weightbath therapy is simple to install and treatment technique is straightforward INTRODUCTION Preliminary studies have suggested that balneotherapy ( BT ) is an effective and well-tolerated treatment for  generalized anxiety disorder ( GAD ) and psychotropic medication withdrawal syndrome .  We carried out a study in 4 spa resorts to assess the efficacy of BT in GAD . METHOD We compared BT to paroxetine in terms of efficacy and safety in a r and omized multicentre study lasting 8 weeks . Patients meeting the diagnostic criteria of GAD ( DSM-IV ) were recruited . Assessment s were conducted using the Hamilton Rating Scale for Anxiety ( HAM-A ) and other scales , by a specifically trained and independent physician . The primary outcome measure was the change in the total HAM-A score between baseline and week 8 . RESULTS A total of 237 out patients were enrolled in four centres ; 117 were assigned r and omly to BT and 120 to paroxetine .  The mean change in HAM-A scores showed an improvement in both groups with a significant advantage of BT compared to paroxetine ( -12.0 vs -8.7 ; p<0.001 ) . Remission and sustained response rates were also significantly higher in the BT group ( respectively 19 % vs 7 % and 51 % vs 28 % ) . CONCLUSION BT is an interesting way of treating GAD . Due to its safety profile it could also be tested in resistant forms of generalized anxiety and in patients who do not tolerate or are reluctant to use pharmacotherapies Abstract To differentiate between the effect of cold and hydrostatic pressure on hormone and cardiovascular functions of man , a group of young men was examined during 1-h head-out immersions in water of different temperatures ( 32 ° C , 20 ° C and 14 ° C ) . Immersion in water at 32 ° C did not change rectal temperature and metabolic rate , but lowered heart rate ( by 15 % ) and systolic and diastolic blood pressures ( by 11 % , or 12 % , respectively ) , compared to controls at ambient air temperature . Plasma renin activity , plasma cortisol and aldosterone concentrations were also lowered ( by 46 % , 34 % , and 17 % , respectively ) , while diuresis was increased by 107 % . Immersion at 20 ° C induced a similar decrease in plasma renin activity , heart rate and systolic and diastolic blood pressures as immersion at thermoneutrality , in spite of lowered rectal temperature and an increased metabolic rate by 93 % . Plasma cortisol concentrations tended to decrease , while plasma aldosterone concentration was unchanged . Diuresis was increased by 89 % . No significant differences in changes in diuresis , plasma renin activity and aldosterone concentration compared to subjects immersed to 32 ° C were observed . Cold water immersion ( 14 ° C ) lowered rectal temperature and increased metabolic rate ( by 350 % ) , heart rate and systolic and diastolic blood pressure ( by 5 % , 7 % , and 8 % , respectively ) . Plasma noradrenaline and dopamine concentrations were increased by 530 % and by 250 % respectively , while diuresis increased by 163 % ( more than at 32 ° C ) . Plasma aldosterone concentrations increased by 23 % . Plasma renin activity was reduced as during immersion in water at the highest temperature . Cortisol concentrations tended to decrease . Plasma adrenaline concentrations remained unchanged . Changes in plasma renin activity were not related to changes in aldosterone concentrations . Immersion in water of different temperatures did not increase blood concentrations of cortisol . There was no correlation between changes in rectal temperature and changes in hormone production . Our data supported the hypothesis that physiological changes induced by water immersion are mediated by humoral control mechanisms , while responses induced by cold are mainly due to increased activity of the sympathetic nervous system Abstract . The effects of thermal water from Cserkeszölö in Hungary were appraised in a r and omised , double blind study conducted on 58 patients with osteoarthritis of the knee .  Balneotherapy was delivered as a 15-day course of 30-min daily sessions performed with thermal water ( active treatment ) or tap water of similar colour and odour ( placebo treatment ) . The musculoskeletal status of participants was evaluated at baseline , at the end of the balneotherapy course , and 3 months later . Study endpoints ( initial pain , range of motion , tenderness on palpation , stair climbing , physicians ' opinion and subjective rating by patients , and ambulation ) were assessed using visual analogue scales and symptom scores . Both groups improved ; however , the magnitude of improvement was significantly greater in patients treated with thermal water from Cserkeszölö OBJECTIVE The aim of this study was to evaluate the effectiveness of thermal mineral water , compared with tap water in the treatment of  low back pain .  METHODS This r and omized , double-blind , controlled , follow-up study included 71 patients who underwent 20-minute daily treatment sessions with medicinal water or with tap water , both at a temperature of 34 degrees C , on 21 occasions . Both groups underwent additional adjunctive electrotherapy . Outcome measures were visual analogue scale scores , Schober 's sign , Domján 's signs , Oswestry disability and Short Form-36 question naire . The study parameters were administered at baseline , immediately after treatment , and after 15 weeks . RESULTS After treatment , there was a significant improvement in all parameters in the thermal water group . This improvement was still evident after 15 weeks . The improvement in the control group was less substantial compared with baseline values . Comparison of the 2 treatments revealed a statistically significant difference in 3 outcome parameters ( visual analogue scale scores III , IV and Schober 's index ) . In the subset of patients who completed the study according to the protocol , the greater efficacy of treatment with thermal water was also confirmed by the other study parameters . CONCLUSION In the group treated with thermal water , improvement occurred earlier , lasted longer and was statistically significant OBJECTIVE To evaluate whether low concentrated saline spa water baths followed by ultraviolet B ( LC-SSW-UVB ) are superior to UVB alone in moderate to severe psoriasis .  BACKGROUND There is a lack of sufficiently large r and omized controlled clinical trial evaluating the additional benefit of saltwater baths followed by UVB compared to UVB only in psoriasis . STUDY DESIGN Partly evaluator blind , multicentre , pragmatic , r and omized controlled trial . SETTING Five German spa centres . SUBJECTS One hundred and forty-three adults with stable psoriasis during the last month and a Psoriasis Area and Severity Index ( PASI ) of > 10 and /or an affected body surface area of > 15 % . INTERVENTIONS LC-SSW-UVB or UVB thrice a week until remission ( PASI < 5 ) or for a maximum of 6 weeks . Sodium chloride concentrations of natural springs varied between 4.5 % and 12 % . Conventional UVB ( broadb and UVB or selective UVB phototherapy ) was used as irradiation source . MAIN OUTCOME Reduction of PASI and /or affected body surface area of 50 % at the end of the intervention period ( PASI-50 ) . Only participants receiving at least one intervention were included in the primary analysis . RESULTS Patients allocated to LC-SSP-UVB attained a statistically significantly higher rate of PASI-50 at the end of the intervention period than patients allocated to UVB [ 58/79 ( 73 % ) vs. 32/64 ( 50 % ) ; P = 0.01 ; NNT , 4.3 , 95 % CI , 2.4 - 18.1 ] . Benefit persisted until 3 months only for one of two secondary outcomes considered . CONCLUSIONS In routine clinical practice balneophototherapy using conventional UVB is superior to conventional UVB only at the end of a 6-week treatment course BACKGROUND Balneotherapy is among the most widely used modalities of physical therapy in countries rich in mineral waters . This trial was intended to ascertain whether balneotherapy ( i.e. , therapeutic bath in mineral water ) has any influence on the antioxidant system and whether there are any differences compared to bathing in tap water . METHODS The ten subjects in Group I bathed in alkaline thermal water , Group II  used alkaline , chlorine-containing mineral water , whereas Group III  bathed in tap water .  Catalase , superoxide dismutase , malondialdehyde protein and glutathione peroxidase levels were measured at baseline and after concluding the course of balneotherapy . RESULTS Balneotherapy with either of the two mineral waters reduced the activity of all four enzymes studied . Using tap water , however , had no influence on either catalase or superoxide dismutase activity after one session or glutathione peroxidase levels after a course of ten balneotherapy treatments . CONCLUSIONS Thermal water may have a beneficial effect on the formation of free radicals . The therapeutic efficacy of mineral vs. tap water is different , although bathing in hot water itself reduces enzyme activity BACKGROUND / PURPOSE Previous studies suggested that beta-endorphin has a pathogenic role in psoriasis : its increased plasma concentration may play a role in the neuroimmunological processes in the pathomechanism of the disease , and plasma beta-endorphin levels should reflect the changes in the patients ' skin status . The purpose of this study was to investigate the changes of peripheral blood beta-endorphin levels in psoriatic patients in conjunction with changes in their skin symptoms after synchronous balneophototherapy .  METHODS With synchronous balneophototherapy , 12 patients with extended skin symptoms of psoriasis were treated . The therapy followed the Regensburg protocol , consisting of a basic course of 35 sessions . Patients ' skin status was characterized by evaluating the Psoriasis Area and Severity Index score before and after the therapy course . Blood sample s were taken before treatment , and 1 day after the last session , with symptom-free skin . Plasma beta-endorphin levels were measured by a specific radioimmunoassay developed by the authors . RESULTS There was no significant change in plasma levels of beta-endorphin after clinical clearance of psoriatic skin symptoms . CONCLUSION In this non-r and omized , uncontrolled study no significant difference could be detected between plasma beta-endorphin levels before and after a basic course of synchronous balneophototherapy in patients with psoriasis . Although beta-endorphin has many neuroimmunological effects , the changes of its plasma level do not consistently reflect the skin status . Inflammation in psoriatic skin lesions is probably not mediated directly by circulating beta-endorphin THE AUTHORS examined the effectiveness of the thermal water of Puspokladany on 62 patients suffering from osteoarthritis of the knee in a double-blind , placebo controlled study . Thermal water decreased pain in movement and tenderness of the knee significantly compared to that of the control group . Bath-reaction ( increase of ESR , leukocyte number and spontaneous pain ) was observed only in the group treated with thermal water . The results indi cate , that the thermal water of Puspokladany is suitable for treating patients suffering from degenerative arthopathies . In a previous announcement , Varga and his colleagues had established that a 20-days bath treat ment in the thermal water of Puspokladany signifi cantly reduced the pain of spondylosis patients when the treatment was applied in the undiluted thermal water . Bath reaction was shown on the patients who were treated in the undiluted thermal water , which was proved by the significant increase of the leucocyte number . The present paper deals with the study and tests we conducted to establish the effect of Puspokla dany 's thermal water on patients with osteoarthritis of the knee Radon bath is a well-established modality of balneotherapy for the management of degenerative musculoskeletal disorders . The present study was conducted to ascertain whether baths of relatively low ( 80 Bq/l ) radon concentration have any influence on the functioning of the endocrine system . In the study , a non-r and omized pilot study , 27 patients with degenerative musculoskeletal disorders received 30-min radon baths ( of 31–32 ° C temperature and 80 Bq/l average radon concentration ) daily , for 15 days . Twenty-five patients with matching pathologies were subjected to balneotherapy according to the same protocol , using thermal water with negligible radon content ( 6 Bq/l ) . Serum thyroid stimulating hormone , prolactin , cortisol , adrenocorticotropic hormone , and dehydroepi and rosterone levels were measured before and after a balneotherapy course of 15 sessions . Comparison of the accumulated data using the Wilcoxon test did not reveal any significant difference between pre- and post-treatment values or between the two patient groups . It is noted that while the beneficial effects of balneotherapy with radon-containing water on degenerative disorders is widely known , only few data have been published in the literature on its effect on endocrine functions . The present study failed to demonstrate any substantial effect of thermal water with relatively low radon content on the functioning of the endocrine system BACKGROUND This r and omized , double blind trial determined the short and long-term clinical and hemodynamic vasodilator effects induced by percutaneous applications of natural CO2 gas in patients with moderate Fontaine stage II . PATIENTS AND METHODS 62 patients with intermittent claudication ( 100 - 500 meters ) were r and omized to 18 consecutive days of CO2 treatment or placebo ( air ) . The gas fluids were applied at a constant temperature of 30 degrees C on pre-humidified skin . The effects of the treatment were evaluated by total distance walked ( primary criterion ) and hemodynamic and microcirculatory findings . Patients also answered a quality of life question naire . RESULTS The Str and ness test showed a significant increase in total distance walked ( + 131 meters , 66 % ; p = 0.001 ) and pain-free distance ( + 81 meters , 73 % ; p = 0.02 ) after 18 days of CO2 treatment . The improvement was maintained 3 and 12 months later . The systolic pressure index ( ABI ) increased by 37 % ( p = 0.001 ) 1 minute after treadmill walking and ABI recovery time decreased significantly by 38 % ( p = 0.002 ) . Microcirculatory findings showed an increase in systolic pressure of the great toe ( 13 % ; p < 0.0001 ) , in baseline pO2 ( 20 % ; p = 0.01 ) and in vasomotion ( 78 % ; p = 0.001 ) in the treatment group . The improvement in total walking distance was correlated with the increase in ABI and peripheral cutaneous oxygenation . Patients ' subjective assessment s corroborated the benefits . No significant change was observed in the placebo group . CONCLUSIONS This study demonstrates that 18 consecutive days of percutaneous CO2 treatment significantly increases walking distance in patients with moderate intermittent claudication . This effect , which was associated with an increase in peripheral systolic pressure and pO2 , is evidence of a better ability to withst and effort
target: A similar effect has been found in chronic pelvic inflammatory disease .
  The review also revealed that  balneotherapy has some beneficial effects on antioxidant status , and on metabolic and inflammatory parameters .
  Based on the results , we conclude that balneotherapy with Hungarian thermal-mineral waters is an effective remedy for  lower back pain  , as well as for knee and h and osteoarthritis
background: Balneotherapy is appreciated as a traditional treatment modality in medicine .
  Hungary is rich in thermal mineral waters .
  Balneotherapy has been in extensive use for centuries and its effects have been studied in detail .