SPA Therapy For Rheumatoid Arthritis (RA)

SPA Therapy for
Rheumatoid Arthritis
(RA)
This visual presentation is about Rheumatoid Arthritis
(RA) and its treatment through one form of Spa
Therapy called the Balneotherapy (BT).
It includes the following:
 RA’s Aetiology and Pathology;
 Categorisation of RA as Clinical Features; and
 A brief reference to:
◦ conventional treatment,
◦ effects on lifestyle, and
◦ compliance with treatment prognosis.
 Rheumatoid Arthritis (RA) refers to an autoimmune
disorder (of or relating to the body immune response against
substance normally present in the body) of unknown
characterised by symmetric erosive synovitis and
sometimes, extraarticular involvement. (Forestier, Erol-
Forestier and Francon, 2017)
 1% of the adult population is affected by RA (Forestier,
Erol-Forestier and Francon, 2017).
 The immune system of human beings normally fights
infection, but when you have RA the lining of joints are
inflamed by your immune system, which make them very
painful, stiff (not moving or operating freely) and swollen
(Ablin, Häuser and Buskila, 2013).
 Usually, the first affected areas are small joints of your

hands and feet.
 No cure for this health condition is known at the moment,

so therapies, such as Balneotherapy, aim to alleviate pain
while enhancing a person’s ability to move.
 As a Spa Therapy, Balneotherapy (BT) is for patients with arthritis and
one of the traditional forms of treatment involving the water-based
treatment (cold or hot) (Ablin, Häuser and Buskila, 2013).
 BT is for the treatment of a variety of health problems by bathing,

typically in hot springs. This spa therapy can assist treating not only
arthritis, but also respiratory disorders, sleep apnea syndrome and high
blood pressure (Latorre-Román et al., 2015).
 BT frequently takes place at centers with thermal baths or seawater

baths (Latorre-Román et al., 2015).
 Majority of the patients experience a chronic fluctuating course of
disease that, regardless of therapy, may lead to progressive joint
damage, distortion, disorder, disability, and even early death, due to
RA, a systemic inflammatory disease
 Disability due to RA leads to substantial economic loss and can have a

major impact on families as well.
 As an autoimmune disorder RA causes chronic inflammation of joints.
 RA tends to start gradually with trivial symptoms that come and go,
typically on both sides of the body, and movement forward over a
period of weeks or months. (Benedetti and Miossec, 2014)
Various symptoms of this chronic disease vary from one
person to another and can change on daily basis (Dains,
2016) :
 Fatigue: You may feel strangely fatigued well before any other symptoms
become obvious.
 Morning Stiffness: Morning stiffness is frequently an early sign, which lasts for
a few minutes that indicates a symptom of a degenerative form of arthritis.
 Joint Stiffness: Another common early sign of RA is the stiffness in one or

more of the smaller joints, which can occur at any time of day, whether you are
active or not.
 Joint Pain: Joint pain and stiffness is frequently followed by joint softness or
pain when you move or while at rest, affecting both sides of the body equally.
 RA is an autoimmune health condition, meaning that it
is caused by the immune system that attacks healthy
tissue of the body (Dains, 2016)
 Nevertheless, it is not yet known what triggers this.
 Usually, the immune system makes antibodies that

attack bacteria and viruses, and helps in fighting
infection (Dains, 2016).
Criteria for the Classification of RA
 Morning stiffness in and around the joints lasting at least 1 hour
prior to maximum improvement
 Up to three joint areas, at the same time, have had soft tissue
swelling or fluid (not bony overgrowth only) observed by a
physician. The other 14 possible places include right or left PIP,
MCP, wrist, elbow, knee, ankle, and MTP joints
 Instantaneous participation of the same joint areas on the body’s

both sides (bilateral involvement of PlPs, MCPs, or MTPs is
acceptable without absolute symmetry)
Criteria for the Classification of RA
 A physician observes subcutaneous nodules over bony
prominences, extensor surfaces, or in juxta-articular areas
 Exhibition of irregular amounts of serum rheumatoid factor by

any procedure for which the outcome has been positive in less
than 5% of normal control subjects
 Radiographic alterations typical of RA on posteroanterior hand

and wrist radiographs, which must integrate erosions or
unequivocal bony decalcification localised in or most marked
nearby the joints involved (osteoarthritic alterations alone do not
qualify)
 Class I: Fully capable of performing normal daily living
activities
 Class II: Fully capable of performing normal self-care and

occupational activities, but limited in avocational activities
 Class III: Fully capable of performing normal self-care

activities, instead of vocational and avocational activities
 Class IV: Limited in capability of performing normal self-

care, vocational, and avocational activities. (Information et
al., 2018)
Balneotherapy as Conventional SPA Therapy
 Balneotherapy is a SPA therapeutic approach and one

of the aims is relieving the pain, improving joint
motion and as a consequence relieve people who suffer
and make them healthy and fit (Santos, Cantista and
Vasconcelos, 2015).
 The BT designates all the thermal treatments and the

care carried out by baths.
 Relieves inflammation and oxidative stress in the body.
 Assists the joints’ swelling and tenderness.
 Helps in naturally alleviating arthritis-related pain.
 Assists in relaxing muscles by improving the joints’
functioning.
 Prevents Microbial Infections
 Very effective in case of septic arthritis and Psoriatic
arthritis. (Santos, Cantista and Vasconcelos, 2015)
 BT involving mineral baths appears more beneficial, when compared to no
therapy or treatment, concerning pain related to arthritis, quality of life, and
analgesic intake.
 In people with RA, the BT helps improve the quality of life by enhancing
overall functional capacity, morning stiffness, and handgrip strength as
well.
 This medicated or therapeutic water-based spa therapy allows you to relax,

assists prevent even severe illness, and maintain good health.
 Along with the treatment of pain and stiffness, you can improve your
lifestyle through BT that increases blood circulation, relaxes muscles and
increases cellular fluids.
 You just need to let your body or the affected body area to stay in the water
for a specific time period, which provides a calming and soothing effect.
 The compliance rate is increasing dramatically. Many countries prefer BT and
account for 85% of revenues. With its longstanding and mature industry of
health resorts, and thermal centers using the BT for pain management,
treatment, rehabilitation, and prevention (with major government support and
regulation), majority of the countries are in Europe.
 BT is effectively not only for rheumatoid arthritis and osteoarthritis, but also
for fibromyalgia, cardiovascular disease, chronic fatigue syndrome, depression,
anxiety, insomnia, psoriatic arthritis, ankylosing spondylitis, spinal cord injury,
spasticity, stroke, acne, dermatitis, psoriasis, eczema, lichen planus and
scleroderma.
 The BT is more likely to improved as researchers exploring more botanical

substances to integrate in this therapy for the pain management, acceleration of
collateral blood circulation, elevation of cellular fluids, muscle relaxation and
other healing benefits from the absorption of minerals and botanical
substances.
In the following health conditions, you need to consult with
doctor and therapist if you want to use balneotherapy:
 Open cuts/sores/wounds or recent injury

 Hypertension or high blood pressure
 Cardiovascular disease
 Arteriosclerosis
 Allergies to particular herbs/oils/salts
 Diabetes
 Pregnancy
 An effective alternative therapy revealing positive results in
people having RA.
 Bathing in mineral and salt based water can have therapeutic

benefits by reducing many symptoms of RA.
 Reduces the swelling, inflammation, soreness, and pain related to

joints.
 Relaxes and soothes the muscles.
 Helps in improving the quality of life by enhancing joints’

functionality and movement.
 Ablin, J., Häuser, W. and Buskila, D. (2013). Spa Treatment (Balneotherapy) for
Fibromyalgia—A Qualitative-Narrative Review and a Historical Perspective. Evidence-
Based Complementary and Alternative Medicine, 2013, pp.1-5.
 Benedetti, G. and Miossec, P. (2014). Interleukin 17 contributes to the chronicity of
inflammatory diseases such as rheumatoid arthritis. European Journal of Immunology,
44(2), pp.339-347.
 DAINS, J. (2016). Advanced health assessment and clinical diagnosis in primary care. St.
louis: Elsevier mosby.
 Forestier, R., Erol-Forestier, F. and Francon, A. (2017). Current role for spa therapy in
rheumatology. Joint Bone Spine, 84(1), pp.9-13.
 Information, D., Arthritis, R., Arthritis, P., Spondylitis, A., Disease, L., News, R., News,
P., News, A., News, O., News, G., News, O., News, L., News, F., Corner, P., Sheets, A.,
Arthritis, M., Patients, E., Expert, A., Question, A., Corner, P., Conference, R., Rounds,
R., Rounds, C., Rounds, R., Diseases, P., Research, O., Research, P., Studies, R., Fund,
T., Us, A., Information, A., Us, C., Faculty, O., Staff, O., Centers, R., Corner, P. and
Physicians, E. (2018). ACR Diagnostic Guidelines. [online] Arthritis Information.
Available at: https://www.hopkinsarthritis.org/physician-corner/education/arthritis-
education-diagnostic-guidelines/ [Accessed 10 Jan. 2018].
 Latorre-Román, P., Rentero-Blanco, M., Laredo-Aguilera, J. and García-Pinillos, F.
(2015). Effect of a 12-day balneotherapy programme on pain, mood, sleep, and
depression in healthy elderly people. Psychogeriatrics, 15(1), pp.14-19.
 Santos, I., Cantista, P. and Vasconcelos, C. (2015). Balneotherapy in rheumatoid
arthritis—a systematic review. International Journal of Biometeorology, 60(8), pp.1287-
1301.

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SPA Therapy for

 Usually, the first affected areas are small joints of your

 No cure for this health condition is known at the moment,

 BT is for the treatment of a variety of health problems by bathing,

 BT frequently takes place at centers with thermal baths or seawater

 Disability due to RA leads to substantial economic loss and can have a

 As an autoimmune disorder RA causes chronic inflammation of joints.

 Joint Stiffness: Another common early sign of RA is the stiffness in one or

 Nevertheless, it is not yet known what triggers this.

 Usually, the immune system makes antibodies that

 Instantaneous participation of the same joint areas on the body’s

 Exhibition of irregular amounts of serum rheumatoid factor by

 Radiographic alterations typical of RA on posteroanterior hand

 Class II: Fully capable of performing normal self-care and

 Class III: Fully capable of performing normal self-care

 Class IV: Limited in capability of performing normal self-

 Balneotherapy is a SPA therapeutic approach and one

 The BT designates all the thermal treatments and the

 This medicated or therapeutic water-based spa therapy allows you to relax,

 The BT is more likely to improved as researchers exploring more botanical

 Open cuts/sores/wounds or recent injury

 Bathing in mineral and salt based water can have therapeutic

 Reduces the swelling, inflammation, soreness, and pain related to

 Relaxes and soothes the muscles.

 Helps in improving the quality of life by enhancing joints’

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