Evaluation of the additive effects of balneotherapy to early physical therapy in subacute supraspinatus tendinitis

The most common pathology in patients presenting with shoulder pain is rotator cuff lesions. Shoulder pain is defined as acute for 6 weeks, subacute for 6-12 weeks, chronic for 12 weeks. Rotator cuff lesions are found in a wide spectrum from tendinitis to complete tears. Neer described these lesions in 3 clinical and pathological stages. In this spectrum, the most common condition is supraspinatus tendinitis. Tendinitis treated greatly with conservative treatments. Balneotherapy is applied in many musculoskeletal diseases in addition to conservative treatments. In this study, it was aimed to investigate the early contribution of balneotherapy to physical therapy in the treatment of subacute supraspinatus tendinitis. The study included 90 patients with complaints of 6 to 12 weeks and with the diagnosis of supraspinatus tendinitis. Patients were randomized and divided into 2 equal groups. In the first group (N=45), TENS, Hotpack, US treatments, Codman and EHA exercises were applied to the affected shoulder. In the second group (N=45) TENS, Hotpack, US treatments, Codman with EHA exercises for the affected shoulder and in addition balneotherapy were applied. In both groups, shoulder active ROM was measured with goniometer and hand grip strength was measured with Jamar hand dynamometer. The evaluation of pain was performed with VAS (rest, sleep, movement), functional assessment with Quick Dash questionnaire and quality of life assesment with SF 36 form. Evaluations were made before treatment and after 15 sessions of treatment. There was no difference between two groups regarding of demographic variables and the positivity for specific diagnostic tests (p> 0.05). There was a statistically significant difference between all values except SF-36 General Health Perception, SF-36 Mental Health sub-parameters and hand grip strength in the first group (p<0.05). In the second group, there was a statistically significant difference between all values before and after treatment (p <0.05). In the analysis of the differences between the two groups, all variables except SF36 Emotional Role Difficulty and SF36 Mental Health sub-parameters showed statistically significant improvement in the second group. In conclusion, balneotherapy, which is added to physical therapy and exercise applications in the treatment of subacute supraspinatus tendinitis, has an additional contribution to shoulder ROM, hand grip strength, functional status and quality of life.