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Thermal Spa Therapy – Medical Observations and Applications. Benefits of Thermalism and Hydrotherapy.

By thermal bath therapy we mean the application of thermal waters in the healing of human. This type of treatment is part of physiotherapy, ie the use of natural remedies in therapy.

Hydrotherapy includes the following forms: bath therapy, positherapy, inhalation therapy, sludge therapy or mud therapy (mud baths), as well as thalassotherapy.

Spa therapy is based on the following main properties of the thermal water: the thermal stimulus, the mechanical stimulus, and finally, the effect of the physicochemical components of the thermal water. This type of treatment is part of physiotherapy, ie the use of natural remedies in therapy.

Medical Observations

There are general rules that follow spa therapy, based on general medical observations.

More detail:

  • Before the start of the treatment, the coexistence of other diseases that exclude or limit the thermal bath therapy in terms of duration, temperature, methods of application, etc. will be studied.
  • Rheumatic disease will be studied and the duration, temperature, type of treatment will be determined accordingly (ie bath, hydromassage, steam baths, mud baths, hydrokinesiotherapy), as well as their area of ​​application (such as neck, waist, shoulder, arms, hip, knee, etc.).
  • It is examined if the patient is receiving any treatment that usually should not be stopped.
  • Finally, a review is performed in the middle of the three-week treatment and at the end. The patient is provided with a letter from the bath doctor with his remarks about the treating doctor.
  • The various treatments are usually done in the morning and last from a few minutes to an hour depending on the type.


The ways of using the thermal water are based on the action factors of the thermal water. That is:

By inhalation, radon penetrates the body.

In positherapy with hypotonic (oligometallic) and isotonic waters, diuretic, cholagogue and metabolism in general appear. Positherapy is also of interest to many rheumatic diseases, such as gout and possibly degenerative arthropathy. The waters of Loutraki, Kaiafa, Platistomou, Nigrita, Sariza, Souroti, Xinou Nero, etc. are used.

With external techniques, which find great application in rheumatic diseases.

More specifically:

  • The bath is full body, semi-bath, local, at temperatures 34 – 36 ° C. It is performed in an individual bath, ordinary or spacious, but also in a swimming pool. It can be combined with sprinkling or hydromassage, which stimulate the muscles.
  • The steam bath that can be local or universal.
  • The mud bath that is also all over or more usually local (poultice) in the affected area (joints). The action of the mud is mainly attributed to the high temperatures of 40 – 46οC and more. Heat inducers are known, that solid bodies retain heat for a long time and that then the human body tolerates it more easily.
  • This is why mud is used for action on deep organs (hip, etc.). But thermal mud is not a simple mixture of solid substrate and thermal water. The soil is selected from volcanic soils, from alluviums and swamps. It is cultivated with thermal water for many months or years and undergoes fermentation treatments. Thus, it acquires physicochemical properties in the presence of living organisms that facilitate the absorption of sulfur and radon, inflammatory elements and the reduction of pain.
  • A remarkable way of applying the thermal water is its use in swimming pools, which is the currently accepted by everyone hydrokinesiotherapy. This method exploits all three factors of thermal water – chemical, thermal and mechanical. Hydrokinetic therapy is highly valued for the prevention of permanent damage (such as pathological lesions, atrophies, deformities, ankylosis) but also for their restoration as much as possible.


The beneficial effect usually comes a few weeks after the end of the thermal bath therapy but often during it. Some recommend partial spa therapy at the beginning and end of the bath period.

Bath Reaction

Complementary physiotherapy may sometimes be needed, such as mechanotherapy or laboratory examination of the patient. The person dealing with the object must be aware of the possible bath reaction. This may occur during the first 5 to 10 days of spa treatment and consists of a few days and a temporary clinical deterioration of the patient’s general condition, possibly with fever, anorexia, headaches and insomnia. The bath reaction may be local with worsening of local symptoms and has nothing to do with the final outcome of treatment. Especially in cases of gout can cause a new crisis despite taking colchicine. The patient who is going to undergo thermal bath therapy must be informed about these phenomena.


Angelidis Z., (2007). Thermal natural resources and thermalism, Eleftherios Kordelios Environmental Education Center, Thessaloniki.

Boleti P., (2006). Thermal Tourism: The Greek perspective with the emphasis on education and training. International Conference of Trends, Impacts and Policies on Tourism, Edipsos.

Gerbod P., (2004). Loisirs and santé: the thermalisms in Europe of the origins of our days, Paris: Honoré Champion.

Hare J.P., Corrall R.G.M., Dieppe P.A., Evans J.M., Heywood A., Lunn G., Summerhayes C., & Walters G., (1985). Observations on the effects of immersion in Bath spa water, British Med., J. 291: 1747 – 1751.