Balneotherapy use and duration of stay depend largely on socio-economic factors, scale presentation formats significantly influence pain assessment results, and the lack of professional support at thermal facilities highlights the urgent need to integrate physiotherapists into a structured, evidence-based rehabilitation framework.
The majority of participants typically used balneotherapy for a duration of 1-2 weeks.
Higher educational level was moderately negatively correlated with pain intensity as measured by VAS scores.
Higher balneotherapy visit frequency and longer duration of stay were both negatively correlated with pain intensity.
Income level was strongly positively correlated with duration of stay at thermal facilities.
The large majority of participants had no previous experience with physiotherapy.
VAS scale presentation format was found to significantly influence pain assessment results.
This research studied 425 adults aged 45 and older who had chronic musculoskeletal (muscle and joint) pain and used balneotherapy — treatment using natural mineral or thermal waters — at spa or thermal facilities. The researchers looked at how long people stayed, how often they visited, how much pain they reported, and what their educational and income backgrounds were. They also tested whether the way a pain rating scale is presented (using numbers, no numbers, or displayed vertically) affects how people rate their pain. The study found that wealthier individuals stayed at thermal facilities much longer, with a very strong link between income and length of stay. People with higher education tended to report lower pain levels. More frequent and longer balneotherapy use was associated with lower reported pain, though these relationships were modest in strength. Strikingly, more than 8 in 10 participants had never worked with a physiotherapist before, suggesting that most people using these facilities are doing so without professional clinical guidance. This research suggests that while balneotherapy appears to be associated with reduced pain, access to it — particularly longer stays that may be more beneficial — is heavily shaped by how much money a person has. It also raises concerns that the format used to measure pain can affect the results, which matters for how studies and clinics interpret patient-reported outcomes. The near-total absence of physiotherapy experience among participants points to a gap in care, with the authors calling for trained rehabilitation professionals to be integrated into thermal and spa settings to make balneotherapy a more structured and evidence-based treatment.
Upload your bloodwork. We'll cross-reference your results against this study and 4,700 others.
Upload Your LabsErdeo F, Ceylan &, Yılmaz N. (2026). Balneoterapy habits and selection: a descriptive retrospective study.. International journal of biometeorology. https://doi.org/10.1007/s00484-026-03319-w