Outpatient balneological treatment of osteoarthritis in older persons

Objective To evaluate the effectiveness and safety of outpatient balneological treatment consisting of hydrotherapy and peloid therapy in elderly patients with osteoarthritis. Methods In this retrospective observational study all patients aged ≥65 years with any type of osteoarthritis who received balneological treatment (hydrotherapy and peloid therapy) at our clinic between 2007 and 2016 were included. Hydrotherapy was applied as head-out immersion in a tap water pool at 36–38 °C for 20 min and then peloid therapy was applied as a local peloid pack on the painful region or joint at 42–43 °C for 20 min, on each weekday for 2 weeks. Patients were evaluated before and after the treatment and outcome measurements were pain, patient’s global assessment, physician’s global assessment, Western Ontario and McMaster Universities index, Lequesne hip index, Waddell index, neck pain and disability scale, and health assessment questionnaire. Results In total, 235 osteoarthritis patients comprising 61 generalized, 91 knee, 6 hip; 32 lumbar, 12 cervical, 1 foot and 32 hand osteoarthritis, were included in the analysis. We found significant improvements in pain and function scores in generalized, knee, lumbar, cervical and hand osteoarthritis. Patient’s global assessment was also improved in all subtypes except hip ( p = 1.000) and hand ( p = 0.132) osteoarthritis subtypes. The majority of patients (59.1%) fulfilled the outcome measures in Rheumatology-Osteoarthritis Research Society International (OMERACT-OARSI) responder criteria. The treatment demonstrated a good safety profile. Conclusion Study results provide initial evidence for the potential beneficial effects and safety of outpatient balneological treatment (hydrotherapy and peloid therapy) in the management of older patients with osteoarthritis. Future randomized controlled studies are needed to confirm these results.