Balneotherapy is the use of heated (thermal) mineral water, containing different types of minerals or gases, for the treatment of medical conditions. Sometimes, other activities associated with "spa" treatments, including water baths, mineral baths, mud baths, drinking mineral waters, and other activities, are included. Minerals in the water can include sulfur, sodium, bicarbonate, magnesium, and many others.

Balneotherapy is used for back pain, fibromyalgia, and osteoarthritis. It is also used for other conditions, but there is no good scientific evidence to support these other uses.
Balneotherapy is LIKELY SAFE when used appropriately. There are no known safety concerns. Adverse effects are generally mild.

Special Precautions & Warnings:

Pregnancy: Balneotherapy that involves sudden or prolonged exposure to hot temperatures is POSSIBLY UNSAFE during pregnancy. Pregnant women are generally discouraged from using hot water baths or saunas. Not enough is known about the use of balneotherapy at lower temperatures during pregnancy. Stay on the safe side and avoid use.

Breast-feeding: There isn't enough reliable information to know if balneotherapy is safe to use when breast-feeding. Stay on the safe side and avoid use.

Children: Balneotherapy is POSSIBLY SAFE when used appropriately. Serious side effects have not been reported in scientific studies.


NatMed Pro rates effectiveness based on scientific evidence according to the following scale: Effective, Likely Effective, Possibly Effective, Possibly Ineffective, Likely Ineffective, Ineffective, and Insufficient Evidence to Rate.
Likely effective Effectiveness definitions
Possibly effective Effectiveness definitions
  • Back pain. Most research shows that balneotherapy using mineral baths or showers reduces low back pain. It is also beneficial when used with physiotherapy.
  • Fibromyalgia. Most research shows that balneotherapy involving mineral baths reduces pain, fatigue, stiffness, and tender points in patients with fibromyalgia. Mudpacks were sometimes used in addition to mineral baths.
  • Osteoarthritis. Most research shows that balneotherapy can reduce pain and improve quality of life in people with osteoarthritis. Benefits might last for up to 1 month after stopping treatment. People with osteoarthritis of the hands, knees, and other body parts seem to experience some relief with balneotherapy. Balneotherapy is often added to other treatment regimens such as exercise.
Likely ineffective Effectiveness definitions
Possibly ineffective Effectiveness definitions
Insufficient evidence Effectiveness definitions
  • A type of arthritis that mainly affects the spine (ankylosing spondylitis). There is some evidence that balneotherapy with mineral baths plus an exercise program reduces pain and improves function better than the exercise program alone. But the benefit doesn't seem to last; it is noticeable after treatment but not 6 months later. Another study shows that balneotherapy, with or without non-steroidal anti-inflammatory drugs (NSAIDs), reduces symptoms more than NSAIDs alone. These benefits were noticeable at the end of therapy and lasted at least 6 months.
  • Eczema (atopic dermatitis). Early research shows that balneotherapy might reduce the severity of eczema in children.
  • Poor circulation that can cause the legs to swell (chronic venous insufficiency or CVI). Early research shows that balneotherapy might reduce pain in people with CVI. But it doesn't seem to reduce swelling or the development of leg sores.
  • A type of persistent anxiety marked by exaggerated worry and tension (generalized anxiety disorder or GAD). Early research shows that balneotherapy might reduce feelings of anxiety.
  • Neck pain. Early research shows that using balneotherapy with physical therapy helps to reduce neck pain more than physical therapy alone.
  • Scaly, itchy skin (psoriasis). Some research shows that Leopoldine spa water, which is rich in sulfate, might reduce the area of the skin affected by psoriasis.
  • Joint swelling (inflammation) in people with psoriasis. Early research shows that balneotherapy in the Dead Sea mineral baths might reduce tender points and active joints in patients with fibromyalgia and psoriatic arthritis.
  • Rheumatoid arthritis (RA). It is unclear if balneotherapy is beneficial for people with RA. While balneotherapy baths seem reduce pain and swollen joints, mud packs do not seem be beneficial. Other early research shows that balneotherapy is no different than doing water exercises or relaxation therapy. Finally, some research shows that balneotherapy is less effective than using the drug cyclosporine for RA.
  • Shoulder pain. Early research shows that balneotherapy reduces pain and disability related to medium- or long-term shoulder pain from various conditions. It might help to reduce pain even more in people also using physical therapy.
  • Painful conditions caused by overuse of tendons (tendinopathy). Early research shows that balneotherapy with physical therapy might help to reduce shoulder pain in people with tendinopathy near the shoulders.
  • Acne.
  • An inflammatory condition that causes rash or sores on the skin or mouth (lichen planus).
  • Anxiety.
  • Heart disease.
  • Chronic fatigue syndrome (CFS).
  • Depression.
  • Hardening of skin and connective tissue (scleroderma).
  • Headache.
  • Heart disease.
  • Injury.
  • Insomnia.
  • Muscle soreness.
  • Muscle spasms.
  • Spinal cord injury.
  • Stroke.
  • Other conditions.
More evidence is needed to rate the effectiveness of balneotherapy for these uses.

Dosing & administration

Balneotherapy involves spending time in a heated bath, which usually contains minerals. The length of time and number of bath sessions can vary substantially. There is no standard for treating certain conditions.

The appropriate or safe use of balneotherapy depends on several factors such as the condition being treated or the person administering the treatment. Be sure to seek and follow relevant directions from your physician or other healthcare professional before using this treatment.

Interactions with pharmaceuticals

It is not known if this treatment interacts with any medicines. Before using this treatment, talk with your health professional if you take any medications.

Interactions with herbs & supplements

There are no known interactions with herbs and supplements.

Interactions with foods

There are no known interactions with foods.


Balneotherapy means "bath therapy." It is used to describe many of the activities associated with "spa" treatments including water baths, mineral baths, mud baths, drinking mineral waters, and other activities. Balneotherapy is thought to have several effects including reducing swelling (inflammation), affecting the function of the immune system, and others.

Some people believe that the benefits of balneotherapy are due to the absorption of bath minerals through the skin. Others believe that it helps with blood flow to the muscles. But there is no scientific evidence to support this theory.

Balneotherapy may reduce pain because the water can reduce the pull of gravity on painful joints. Also, the warmth and calming effects of the water are thought to reduce stress and painful sensations. has licensed monographs from TRC Healthcare.
This monograph was last reviewed on 07/12/2023 11:00:00 and last updated on 30/12/2020 00:43:18. Monographs are reviewed and/or updated multiple times per month and at least once per year.
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