Evaluation of the spa-balneotherapy effectiveness on quality of life in patients with low back pain

Purpose: The aim of this study was to evaluate efficacy of spa-balneotherapy; the combination of thermal water, mud therapy, and massage; on the quality of life of patients with chronic low back painMaterial and methods: Eighty seven patients with chronic low back pain were included in the study. The patients were randomized either to spa-balneotherapy group (n=45 ) or to exercise therapy group (n=42Spa-balneotherapy group received total body bath with thermal water and mud therapy to lomber region, which were applied at 40 ° C and for 15 minutes duration. Additionally, this group received classic massage to lomber region for 20 minutes duration. The therapies were applied once a day, five times per week and a total of 14 session. Both exercise therapy and spa-balneotherapy groups performed home exercise program once a day for 20 days periodAll the patients were assessed before treatment, at the third week after treatment and at the third month after treatment. The evaluation parameters were finger-floor distance (cm), Schober?s test (mm), Visual Analogue Scala (VAS), Roland?Morris Disability Questionnaire (RDQ), Oswestry Disability Index (ODI), and Short Form-36 (SF-36) questionnaire. Independent Samples t-test, Friedman test and Chi-square test were used for statistical analysisResults: There were no significant differences for all measurement parameters between spa-balneotherapy group and exercise group at baseline. At the third week after treatment; VAS, RDQ, and ODI values were significantly lower and pain, general health perception, and social function subscales of SF-36 were significantly higher in the spa-balneotherapy group compared to exercise therapy group. At the third month after treatment, VAS and ODI values were lower and general health subscale of SF-36 was higher in the spa-balneotherapy group compared to exercise therapy groupAt the third week, the reductions in VAS, RDQ and ODI scores and increases in Schober?s test, physical function, pain, general health perception, and social function scores of SF-36 were significantly more in spa-balneotherapy group compared to exercise therapy group. At the third month, the reductions in finger-floor distance, VAS, RDQ and ODI scores and increases in Schober?s test, physical function and pain scores of SF-36 were significantly more in spa-balneotherapy group compared to exercise therapy groupWhen repeated measurements of before treatment, at the third week after treatment and at the third month after treatment were evaluated within the groups, improvement was observed in finger-floor distance, VAS, RDQ, ODI, and scores of all subscales of SF-36 except role limitations attributed to physical problems and mental health in the spa-balneotherapy group. Futhermore; improvement was observed in VAS, RDQ, ODI, and scores of physical function, pain and vitality subscales of SF-36 in the exercise therapy groupConclusion: In conclusion, combination therapy of thermal water, mud therapy, and massage in patients with chronic low back pain increases the quality of life much more when compared exercise therapy alone.