[How effective is spa treatment? A systematic review of randomized studies].

BACKGROUND AND

OBJECTIVE

In the context of general financial constraints within many national health services spa treatment is being looked at ever more critically in various European countries. An important argument against spa treatment has been the supposed lack of evidence for its efficacy. This analysis was undertaken to gather firm data bearing on this problem.

METHODS

Several data bases were searched systematically for randomized studies of spa treatment. Only those were included in which one patient cohort had received spa treatment, while the control cohort had been treated for the same ailment on an ambulant basis at home. Nonrandomized studies were excluded.

RESULTS

Only three randomized studies were found in which two patient cohorts, one with and one without spa treatment, were compared (postsalpingitis, back pain and osteoarthritis, respectively). In all three the evidence indicated some additional benefit from spa treatment.

CONCLUSIONS

The data are not sufficient to prove the benefit of spa treatment, nor are they adequate to disprove it. More evidence-based studies are necessary to arrive at rationally based decisions relating to the efficacy of spa treatment.