Balneotherapy for Fibromyalgia Pain

Why Water, Minerals, and Mud Might Make You Feel Better

Balneotherapy involves therapeutic baths to treat a wide variety of illnesses. It’s been practiced for thousands of years and has a growing body of research confirming its benefits for fibromyalgia (FM), along with several kinds of arthritis, some skin conditions, and a multitude of other diseases.

A lot of people with fibromyalgia say hot baths help control their pain and muscle spasms, so it stands to reason that balneotherapy would get some attention for this condition.

As with a lot of complementary and alternative (CAM) treatments, balneotherapy hasn’t had the same level of research as pharmaceutical treatments, but the research that has been done is promising.

Balneotherapy is sometimes referred to as hydrotherapy.

Conditions Balneotherapy Might Help

Verywell / Theresa Chiechi

What is Balneotherapy?

In the United States, balneotherapy is considered a “spa” treatment. In other words, it’s done at places like health spas, resorts, and wellness centers instead of medical facilities. Beyond just a hot bath, balneotherapy involves mineral-rich water, such as that from natural hot springs. Commonly used minerals include:

  • Silica
  • Sulfur
  • Magnesium
  • Selenium
  • Radium

Mud bath or mud pack therapy, also called fangotherapy, is a type of balneotherapy that uses mineral-rich mud or clay, often from beds of ancient lakes or seas (like the Dead Sea) or from hot springs, especially those that contain volcanic ash.

With water, balneotherapy usually involves full-body immersion and soaking for a while. Mud baths can be fully immersive, but it’s more common to soak a body part, like a foot, or pack the mud around a joint that would be awkward to soak, such as a knee or elbow.

A certain amount of balneotherapy’s effect comes from the heat (or in the case of cold mineral baths, the cold). It’s long-established that heat and ice can help ease pain. Cold lowers inflammation levels and heat relaxes muscles.

However, some of the effects do appear related to the minerals in the water or mud. Studies have shown some water-soluble minerals can permeate the skin, which is necessary for them to have an effect on anything other than the outer-most skin layer.

Additionally, the treatment has been found to change the levels of immune system cells that regulate inflammation, psychological and physiological stress. It may possibly reduce oxidative stress.

Used Around the World

In Europe and some Middle Eastern and Asian countries, balneotherapy is considered an important part of traditional medicine, and it’s a relevant aspect of many public health systems worldwide.

Research suggests that balneotherapy is effective at causing certain beneficial changes in the body that make it an effective complementary treatment for:

  • Diseases featuring low-grade inflammation
  • Stress-related diseases
  • Neurological conditions
  • Digestive disease
  • Endocrine (hormonal) disorders
  • Rheumatic conditions (osteoarthritis, rheumatoid arthritis)
  • Skin conditions
  • Heart disease
  • Respiratory disease

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Balneotherapy for FM

Research suggests that balneotherapy can help alleviate the symptoms of fibromyalgia, which is sometimes described as a rheumatic condition and also as a neuro-immune or neuro-endocrine-immune condition.

The treatment’s known effects seem to be a good match for the pathology of fibromyalgia, which is known or believed to involve:

While there’s a need for larger, well-designed studies to confirm early results, numerous clinical trials and reviews of literature say this preliminary work does suggest that’s it’s effective:

  • A 2016 review says the evidence is strong enough for bigger trials to move forward.
  • A 2013 review found “consistently positive results” for balneotherapy.

Reported results include:

  • Reduction in pain
  • Improvement in health-related quality of life
  • Improving function
  • Lower tender point count
  • Lower overall symptom load and severity

As with many complementary treatments (e.g., acupuncture, massage therapy), you need periodic treatments to maintain the effects. However, one study found that improvements appeared to linger for between three and six months after the conclusion of treatment.

Balneotherapy appears to be a very safe treatment. Some studies report no negative side effects. Others report transient side effects—including rash, skin irritation, and worsening psoriasis—that were minor and didn’t cause people to withdraw from the study.


Because the mineral content of balneotherapy waters and muds varies, it’s hard to compare studies and results. Also, when it comes to what works best for any particular illness, research hasn’t identified:

  • The most effective minerals
  • The ideal temperature range
  • The ideal length of a treatment
  • The ideal frequency of treatments

Since it’s a spa treatment, insurance companies are unlikely to cover balneotherapy (although you should check, just to be sure.) Spas and resorts aren’t financially or geographically realistic for many people with FM, as they can be expensive and may not be available close to home.

DIY Spa Treatments

You can give balneotherapy a try at home with Epsom salt or other commercially available mineral bath soak products, muds, and clays. Sodium, magnesium, and sulfur are commonly used in these products.

A Word From Verywell

Balneotherapy shouldn’t replace other fibromyalgia treatments suggested by your healthcare provider, but it may be an effective addition to your treatment regimen. Be sure to discuss any complementary treatments with your practitioner first to ensure you’re not doing something potentially dangerous.

13 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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By Adrienne Dellwo
Adrienne Dellwo is an experienced journalist who was diagnosed with fibromyalgia and has written extensively on the topic.