In contrast, Becker has attributed the main effect to a decrease in joint loading, relaxation,and an increase in general physical conditioning. There have been studies showing beneficialeffects of balneotherapies on several factors such as reduction in pain and grip strength.Effectiveness of balneotherapy is not only associated with hot water but also with theminerals contained in the water. It has been claimed that mineral waters have some positiveeffects in balneotherapy. Water has mechanical, chemical, and physical action mechanisms.Its mechanical action occurs during the bath when the body weight decreases by 50% to90% depending on the type of bath. In cases of muscle weakness or widespread painful jointinflammation, this action allows the patients to perform their exercise programs. Inaddition, various studies have shown that balneotherapy leads to muscle, tendon, andligament relaxation and a feeling of well-being. Here the action mechanism providesexponential benefits. Decreasing perception of pain by increasing the pain thresholds at freenerve endings, relieving muscle spasm by effecting gamma muscle fibers, peripheralvasodilatation, and removal of painful mediators are among these mechanisms. In addition,balneotherapy has a sedating effect by increasing acetylcholine release from the centralnervous system through activation of parasympathetic nervous system. Endorphin releasethroughout the therapy also contributes to improved action mechanisms.Effects of balneotherapy on the immune system have recently become a subject of interest.There are some speculations about its immunostimulatory and inhibitory effects. Inparticular, alterations in release of interleukin-1 and interleukin-6, tumor necrosis factor-alpha, and gamma-interferon, which have a role in etiopathogenesis of inflammatoryarthritis, have been reported.Environmental changes while at balneotherapy should also be considered. Physical andmental comfort, cessation of home duties, and vacation atmosphere are among positivefactors that may also contribute to the healing process.In conclusion, although the effects of balneotherapy are currently not clarified, it is apalliative treatment in rheumatoid diseases through various mechanisms. There is need forfurther appropriately designed studies encompassing assessment of quality of life as anoutcome measure.Physiotherapy treatment is important in helping patients with Arthritis manage theirdisease. In conjunction with occupational therapists, physiotherapists educate patients in joint protection strategies, use of assistive devices, and performance of therapeuticexercises.
Joint Protection Strategies
Joint protection strategies, such as rest and splinting, using compressive gloves, assistivedevices, and adaptive equipment, have beneficial effects in managing Arthritis symptomsand deformities.