Science or no science, the sick keep taking the waters

October 8, 1999
Web posted at: 3:06 PM EDT (1906 GMT)

In this story: The ancient cure Testing the tradition RELATEDS

By Laird Harrison

(WebMD) -- Mary Bolton is traveling a lot these days to places like Versailles and Nice, France, where she stays in beautiful hotels and spends hours soaking in hot baths. But no one who knows her is envious. Six years ago, the Hyannis, Massachusetts, resident came down with an excruciatingly painful disease that has crippled her with swelling and pain.

Doctors don't know the cause of her condition. No matter what drugs they give her, she can barely walk. So instead, Bolton travels thousands of miles every year for a type of therapy that dates back to ancient times: spa bathing. "It's just wonderful," says Bolton, a retired government worker. "I feel a lot better."

	ALSO
The science of healing with water

More and more Americans are turning to an increasing variety of spa treatments, from massage to bone-density scans, spa owners say. At the core of the spa business -- what distinguishes spa treatment from massage therapy or standard medicine -- remain the baths.

But while patients have "taken the cure" in hot springs for thousands of years, scientists are only beginning to sort out which ailments can truly be treated with water and which cannot. In the September 16 New England Journal of Medicine, for example, researchers reported the first small study using hot tubs to help treat diabetes.

The ancient cure

Using water to treat illness predates Hippocrates. Physicians in his time used hydrotherapy (which relies on the pressure or temperature of water) and balneotherapy (which relies on chemicals in the water) to treat practically every ailment. That practice continued in the United States until the beginning of the 20th century, when increasingly sophisticated drugs and surgery pushed water therapies aside.

Today's consumers, however, alienated by modern medicine and under the stresses of contemporary life, are flocking to spas. Ten years ago, Guy Jonkman, publisher of the trade journal Spa Management, estimated that there were 200 spas in the United States and Canada. Today, he counts more than 8,000.

While most spa visitors go for relaxation, some 3 percent seek treatment for specific maladies, according to an International Spa Association poll. "More and more people are seeing the power of water," says Jonathan Paul De Vierville, a psychologist and owner of the Alamo Plaza Spa in San Antonio.

In the United States, it's hard to find a doctor who prescribes balneotherapy, says Dr. John Klippel, medical director of the Arthritis Foundation, a national organization. Many physical therapists, though, use hydrotherapy almost exclusively to treat arthritis and injuries.

"Water is the ideal environment for active physical therapy," researchers at the University of Hawaii concluded in a 1999 article in the Journal of Clinical Sports Medicine.

While the Arthritis Foundation recommends hydrotherapy for arthritis, there's little actual research to show it works, Klippel says.

Until recently, this lack of data didn't bother doctors in Europe. Though national health insurance administrators are beginning to challenge claims for weeks of spa treatments, European spas continue to offer therapies for skin and heart diseases, chronic pain, premenstrual syndrome, osteoporosis, gastrointestinal disorders and a host of other ailments.

Testing the tradition

Even many European spa advocates admit that water treatments haven't passed the litmus test of scientific medicine for treating much of anything. That will take a large, randomized, double-blind, placebo-controlled trial. But they argue that hydrotherapy and balneotherapy don't lend themselves to that kind of scrutiny.

In the first place, water treatments are designed to work not by themselves but in conjunction with massage, improved nutrition and other therapies. Secondly, it would be almost impossible to find a "placebo" that would fool patients into thinking they were getting water therapy when they really were not.

Still, a few small studies have begun to examine the ancient treatments, with intriguing results (see "The science of healing with water").

Meanwhile, naturopaths, health care providers who offer therapies such as herbal remedies, stress management and other care, still rely heavily on hydrotherapy and balneotherapy in their practice. According to Patrick Barron, a naturopath who teaches hydrotherapy in Florida, some physicians are also becoming interested in the water approach. "I know physicians who do almost exclusively hydrotherapy to treat everything from indigestion to AIDS," he says.

Barron is satisfied that years of experience, combined with a good understanding of physics and physiology, is a strong enough basis for doctors to continue treating diseases with water. Likewise, De Vierville, who is translating European spa studies into English, believes that scientific medicine will eventually confirm the usefulness of water treatments.

Until then, he notes, "the fact of the matter is that people keep coming back."

RELATEDS AT :

The Natural Medicine Collective on Hydrotherapy
Physical medicine and rehabilitation

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RELATED SITES:

Spa Finders travel service
Hydrotherapy.com
Arthritis Foundation

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