Dr. Mine Karagülle

Istanbul University, Istanbul Medical Faculty, Department of Medical Ecology & Hydroclimatology

16.Espa Congress

24-27 May 2011

Ela Quality Resort Hotel, Belek-Turkey

Health aspects of thermal

waters in Turkey

Turkey lies between the northern 36-42

latitudes and the eastern 26-45 longitude

Healing with water

• In the ancient world, the use of water for treatment in spas (watering places or health resorts) became very popular when large quantities of warm water for bathing and immersion was rarely available.

The use of spring and thermal water for health also dates back to

ancient times in the main land of Turkey i.e. Anatolia (Asia Minor).

The tradition of Turkish bath (hamam) and thermal spa bath (kaplıca)

can be traced back to when the Turks arrived in Anatolia where they

were confronted with the existing bathing traditions of the Romans.

The Ottomans built a special kind of Turkish bath-

“kaplıca” or “spa hamam” in those areas where

thermal and mineral waters emerge and can be

found in great abundance. Turkish “kaplıca” was

built directly over or nearby hot water springs.

The Ottomans not only built baths in the

capital of Istanbul but also constructed

countless baths across the wide sweep of

their empire.

Bursa Yeni Kaplıca, Kanuni Sultan Süleyman, 1552

Turkish Kaplıcas-Spa Baths

Thermal and Mineral Water Springs

of Turkey

• The tradition of healing with water at kaplıca hamams (spas) is still vivid and widely used in the treatment of chronic disorders especially rheumatic diseases through Turkey.

• This widespread tradition is mainly empiric and intuitive in character

• It is only recently that attempts were being placed increasingly in the study of water on a scientific basis.

• A total of 15 published studies have been found and analyzed.

• The investigations have been carried out in 8 different spa resorts in Turkey.

Balneotherapy and Spa Therapy of Rheumatic Diseases in

Turkey: A Systematic Review

M.Z. Karagülle, M. Karagülle

Research in Complementary and Classical Natural Medicine 2004;11:33-41

• In these studies the effectiveness and efficacy of different balneological and spa therapies on a variety of rheumatic diseases such as

– Osteoarthritis

– Rheumatoid arthritis

– Fibromyalgia

– Ankylosing spondylitis and

– Low back pain

could be shown

Balneotherapy and Spa Therapy of Rheumatic

Diseases in Turkey: A Systematic Review

M.Z. Karagülle, M. Karagülle

Research in Complementary and Classical Natural Medicine 2004;11:33-41

• It could be concluded that nearly all forms

of spa therapy and balneotherapy used for

the treatment of rheumatic diseases in

Turkey are effective.

Balneotherapy and Spa Therapy of Rheumatic

Diseases in Turkey: A Systematic Review

M.Z. Karagülle, M. Karagülle Research in Complementary and Classical Natural Medicine 2004;11:33-41

Karagülle Z, Dönmez A. Balneotherapy for fibromyalgia at the

Dead Sea. Rheumatol Int. 2002;21:210-1.

Karagülle MZ, Karagülle M. Balneotherapy and spa therapy

of rheumatic diseases in Turkey: a systematic review. Forsch

Komplementarmed Klass Naturheilkd 2004;11:33-41.

Bender T, Karagulle Z, Balint GP, Gutenbrunner C, Balint PV,

Sukenik S. Hydrotherapy, balneotherapy, and spa treatment

in pain management. Rheumatol Int. 2005;25:220-4.

Pittler MH, Karagülle MZ, Karagülle M, Ernst E. Spa therapy

and balneotherapy for treating low back pain: meta-analysis

of randomized trials. Rheumatology (Oxford). 2006;45:880-4.

Odabaşı E, Karagülle MZ, Karagülle M, Turan M, Karagülle O :

Comparison of two traditional spa therapy regimens in patients

with knee osteoarthritis. Phys Med Rehab Kuror 2002;12:337-341.

Dönmez A, Karagülle MZ, Tercan N, Dinler M, İşsever H,

Karagülle M, Turan M. SPA therapy in fibromyalgia: a randomised

controlled clinic study. Rheumatol Int 2005;26:168-72.

Karagülle M, Karagülle MZ, Karagülle O, Dönmez A, Turan M. A

10-day course of SPA therapy is beneficial for people with severe

knee osteoarthritis. A 24-week randomised, controlled pilot study.

Clin Rheumatol. 2007;26:2063-71.

Şen U, Karagülle MZ, Karagülle M. The efficacy of peloidotherapy

on knee osteoarthritis. Romatizma 2007;22:55-9

Şen U, Karagülle MZ, Karagülle M. Erkorkmaz Ü. Effectiveness of

Peloidotherapy in chronic low back pain. Turk. J. Clin. Scie. 2008;

23:17-22

Ay A, Yurtkuran M. Evaluation of hormonal response and ultrasonic changes in

the heel bone by aquatic exercise in sedentary postmenopausal women. Am J

Phys Med Rehabil. 2003;82:942-9.

Altan L, Bingöl U, Aykaç M, Koç Z, Yurtkuran M. Investigation of the effects of

pool-based exercise on fibromyalgia syndrome. Rheumatol Int. 2004;24:272-7.

Ay A, Yurtkuran M. Influence of aquatic and weight-bearing exercises on

quantitative ultrasound variables in postmenopausal women. Am J Phys Med

Rehabil. 2005;84:52-61.

Yurtkuran M, Ay A, Karakoç Y. Improvement of the clinical outcome in

Ankylosing spondylitis by balneotherapy. Joint Bone Spine. 2005;72:303-8.

Yurtkuran M, Yurtkuran M, Alp A, Nasırcılar A, Bingöl U, Altan L, Sarpdere G.

Balneotherapy and tap water therapy in the treatment of knee osteoarthritis.

Rheumatol Int. 2006;27:19-27.

Ozçelik S, Polat HH, Akyol M, Yalçin AN, Ozçelik D, Marufihah M. Kangal

hot spring with fish and psoriasis treatment. J Dermatol. 2000;27:386-90.

Yilmaz B, Goktepe AS, Alaca R, Mohur H, Kayar AH. Comparison of a

generic and a disease specific quality of life scale to assess a

comprehensive spa therapy program for knee osteoarthritis. Joint Bone

Spine. 2004;71:563-6.

Cimbiz A, Bayazit V, Hallaceli H, Cavlak U. The effect of combined

therapy (spa and physical therapy) on pain in various chronic diseases.

Complement Ther Med. 2005;13:244-50.

Ardiç F, Ozgen M, Aybek H, Rota S, Cubukçu D, Gökgöz A. Effects of

balneotherapy on serum IL-1, PGE2 and LTB4 levels in fibromyalgia

patients. Rheumatol Int. 2007;27:441-6.

Evcik D, Kizilay B, Gökçen E. The effects of balneotherapy on

fibromyalgia patients. Rheumatol Int. 2002;22:56-9.

Evcik D, Kavuncu V, Yeter A, Yigit I. The efficacy of balneotherapy and

mud-pack therapy in patients with knee osteoarthritis. Joint Bone Spine.

2007;74:60-5.

Turkish Spas, Scientific Evidence

Thank you for your attention !