Can water therapy benefit rheumatoid arthritis patients with fibromyalgia?

This study investigated the benefits of water therapy for rheumatoid arthritis patients with fibromyalgia.

Fibromyalgia is a condition involving widespread pain and tenderness that occurs in roughly 2% of patients with rheumatoid arthritis. Patients may also experience other symptoms including fatigue, depression and sleep problems. The cause of fibromyalgia is unknown, but it may involve genetic, environmental and psychological factors.

Standard treatment plans for patients with fibromyalgia are lacking. Water therapy or spa therapy is sometimes recommended. Two commonly used forms of water therapy are hydrotherapy and balneotherapy. Hydrotherapy generally involves bathing in tap water, while heated mineral water is used for balneotherapy. Balneotherapy is usually practiced in spas and can involve additional treatments, such as mud or hay. Whether or not water therapy benefits patients with fibromyalgia remains unclear. 

This study analyzed results from 24 previous studies that assessed the effect of water therapy in patients with fibromyalgia. 12 of the studies examined the effects of hydrotherapy alone or combined with exercise. 12 studies examined the effect of balneotherapy (mineral water therapy, sulfur baths, salt water, mud baths or warm hay baths). The effect of water therapy on pain, health-related quality of life, depression and adverse events was assessed after treatment.

Adverse events were reported in four studies. These adverse events did not cause any interruption in treatment or dropouts from the studies. Seven studies reported that there were no adverse events. The remaining 13 studies did not report on adverse events.

Hydrotherapy

The duration of treatment with hydrotherapy lasted between 5 weeks and 32 weeks. There was evidence for a small reduction in pain after treatment with hydrotherapy and pool-based exercises. There was also evidence for a small improvement in health-related quality of life at the end of the treatment. No significant improvement in symptoms of depression were found after the therapy.

Balneotherapy

The duration of treatment was shorter for patients receiving balneotherapy, lasting between 1.5 and 12 weeks. There was evidence of a large reduction in pain at the end of treatment. This was regardless of whether the treatment was done in a spa center or not. There was also evidence of improvement in health-related quality of life. There was no significant effect of treatment on depressive symptoms.

The authors concluded that these results support the potential value of water therapies for patients with fibromyalgia. However, they highlight that further studies are needed to confirm the benefits of these treatments.

Over 96% of the participants were women, it is unclear whether the same results would be seen in male patients.