Scientific Evidences of the Sulfur Water Effects in the Osteoarthritis Treatment

7/29/2019 Scientific Evidences of the Sulfur Water Effects in the Osteoarthritis Treatment

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CLINICA BALNEARIA

Author: MD Rosa Martnez Lpez, Termas de Cuntis

Leonardo Proyect:Thermal Baths for Active Ageing

Montecatini Terme

October, 22th 2011


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Termas de Cuntis is one ofthe most traditional thermal

resorts of Galicia. During the lastdecade it has became one of thelargest complex dedicatedto balneotherapy in Spain.


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This wide space includes more than 40 individual treatment cabins:

Air baths - hydromassage baths.

Thermal pool.

Jacuzzi, jets, showers, Vichy shower, para-muds.

Massage, esthetic, electrotherapy, physiotherapy.Breathing room with inhalers and nebulizer, vapor stoves,

vaporarium, bio sauna, foot baths and hand

baths static, dynamic foot baths, thermarium circuit, etc) .

The thermal-leisure area is called "Acquaform" includes twopools (one outdoor), areas of back and foot jets, massage tables,

counter-current, swan necks, waterfalls, swimming

areas... and "Vital Club" endowed with Finnish

sauna, steam heaters, bio sauna, Jacuzzis, and walk-in ice.


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The resort has two hotels:

Hotel La Virgen(****): It is the most

important building in the quiet spa

town of Cuntis.

(Original design of the famous

architect Antonio Palacios).


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Hotel Castro do Balneario (****): Galician

traditional restored house which retains all of

its unique elements and it is considered as a

"charming hotel.

In addition, the entire complex is surrounded

by over 50,000 m of private parks.


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Our mineral-medicinal waters

Temperature: Hyperthermal. We haveseveral springs with temperatures

ranging between 25 C and 63,1 C. Composition: Sulfurous alkaline water.

Predominant ions:

Carbonate, sodium, chloride, fluoride,silica and lithium.


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Sulfur

8,9 mg/L

Carbonate

36,60 mg/L

Chloride

60,00 mg/L

Silica

48,90 mg/L

Sodium109,10 mg/L

CHEMICAL COMPOSITION


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CHEMICAL PHYSICAL PORPERTIES

Conductivity: 427,05 S/cm a 20 CTemperature: 25 C to 63,10 C

Turbidity: 0,60 NTU

pH: 9,30


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0,67 mg/L

1,60 mg/L

12,00 mg/L

0,02 mg/L

7,80 mg/L

1,80 mg/L

0,00 mg/L

31,00 mg/L

0,11 mg/L

0,60 mg/L

4,00 mg/L

Boron (B)

Calcium (Ca)

Carbonates (CO3)Strontium (Sr)

Fluorides (F-)

Phosphates (PO4)

Iron (Fe)

Sufates (SO4)

Lithium (Li)

Magnesium (Mg)

Potassium (K)

COMPLETE CHEMICAL COMPOSITION


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ActionsRespiratory system:

- Improvement of the local circulation.- Improvement of the tropism of the mucous cells.- Improvement of the mucolytic action.- Improvement of cilia mucous cell movement.- Antiinflammatory action.

Skin:- Antiinflammatory.- Antipruriginous effects.- Antibacterial and antifungal.- Keratoplastic action.At systemic level:- Desensitizes, it improves the allergy and anaphylacticresponses.- Decrease colesterol total and the LDL-col in serum.- Increase hemogoblin in serum.


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Indications

The diseases that are treated with our water are:

Rheumatic chronic diseases: Osteoarthritis, rheumatoid arthritis,

ankylosing spondylitis,

Respiratory diseases : Asthma, bronchitis, emphysema, bronchiectasis ,

Otorhinolaryngology diseases: Chronic pharyngitis, chronic laryngitis,rhinitis,

Dermatology diseases: Psoriasis, dermatitis,

Rehabilitation: Recovery from sports injuries (Constusions, fibrilar

rupture, sprain, overload, etc), Recovery from fractures, sequels from

traumatisms and accidents, luxationsPsychological syndromes: Psychosomatic disorders, anxious stages,

depressive stages, physical and intellectual exhaustion, stress


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6273

2875

Patients treated per year

Women

Men


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0% 20% 40% 60% 80% 100%

ARTHROPATHY

HTA

OSTEOPOROSIS

DYSLIPIDEMIA

DIABETES

WOMEN >75

WOMEN 55-75

Patients diseases

Women


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0% 20% 40% 60% 80% 100%

ARTHROPATHY

HTA

OSTEOPOROSIS

DYSLIPIDEMIA

DIABETES

MEN >75

MEN 55-75

Patients diseases

Men


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Scientific evidences of

the sulfur water effects

in the osteoarthritis

treatment.


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In relation with the treatment of the

osteoarthritis with sulfur waters, some authorsapplies mud therapy and/or hydropinotherapy as

well as/instead of the inmersion .

The conclusions of our bibliographic review triesto unify the common effects of the substances

present in all of these thermal techniques, mainly

the sulfur which main forms are SO and HS

The HS is proposed by the majority of experts asthe main responsible for the antioxidative and

antiinflammatory effects of the thermal waters.


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Cartilaginous matrix

destruction

Mechanical

articular overload

Main mechanism underlying to the

physiopathology of osteoarthritis

Chondrocyte NOIL Cell apoptosis

SynovitisIL, TNF-

Synthesis and activation

MMP

Oxidative stress


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Biochemical effects of sulfur water in

osteoarthritis

Antioxidative effects Lipids oxidation biomarkers (MDA)

Proteins oxidation biomarkers (protein carbonyles)

Thiols (SH )

Changes in serum activity of SOD and CAT

Antiinflammatory effects

TFN-

NO

Effects on proteolytic enzymes

Several types of MMP

Other effects

Adiponectin

PGE, LTB, IL-1 demostrated in fibromyalgia patients


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6

7

8

9

10

11

12

Controls Before therapy On 5 day After therapy

Malondialdehyde concentration (xSD) in the

controls and in the patients group before and after

the sulfur baths therapy and on the day 5 during

the therapy

M/ml


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1000

1500

2000

2500

3000

Controls Before therapy On 5 day After therapy

Superoxide dismutase activity (xSD) in the controls

and in the patients group before and after the sulfur

baths therapy and on the day 5 during the therapy

U/gHb


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0

10

20

3040

50

60

70

8090

100

Before

treatment

Day 5 End treatment

Pain intensity in the patients before and after the sulfur baths

therapy and on the day 5 during the therapy

Days

VAS


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Clinical results

Low back pain

Improvement of pain (VAS score).

Improvement of flexibility (SCHOBER index).

Less analgesic consumption.

Improvement of Quality of life (Oswestry low back

pain disability index)


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Clinical results

Gonarthrosis

Improvement of symptoms (VAS score)

Improvement in functionality status (WOMAC index)

Improvement of Quality of life (NHP index)


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Clinical results

Hip osteoarthritis

Possible improvement of pain (VAS score).

Possible improvement of functionality status(WOMAC index).

Future specific randomized control trials for

coxarthrosis are needed to guarantee the stadistic

results of the beneficts in pain and functionality

provided by sulfur waters therapies.


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Acknowledgments

To the organization, Terme di Montecatini, for thekind welcome and the invitation to participate in

this interesting project to impluse the practice of a

better balneotherapy.

Documents

Scientific Evidences of the Sulfur Water Effects in the Osteoarthritis Treatment