scientific evidences of the sulfur water effects in the osteoarthritis treatment
TRANSCRIPT
-
7/29/2019 Scientific Evidences of the Sulfur Water Effects in the Osteoarthritis Treatment
1/25
CLINICA BALNEARIA
Author: MD Rosa Martnez Lpez, Termas de Cuntis
Leonardo Proyect:Thermal Baths for Active Ageing
Montecatini Terme
October, 22th 2011
-
7/29/2019 Scientific Evidences of the Sulfur Water Effects in the Osteoarthritis Treatment
2/25
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.
-
7/29/2019 Scientific Evidences of the Sulfur Water Effects in the Osteoarthritis Treatment
3/25
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.
-
7/29/2019 Scientific Evidences of the Sulfur Water Effects in the Osteoarthritis Treatment
4/25
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).
-
7/29/2019 Scientific Evidences of the Sulfur Water Effects in the Osteoarthritis Treatment
5/25
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.
-
7/29/2019 Scientific Evidences of the Sulfur Water Effects in the Osteoarthritis Treatment
6/25
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.
-
7/29/2019 Scientific Evidences of the Sulfur Water Effects in the Osteoarthritis Treatment
7/25
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
-
7/29/2019 Scientific Evidences of the Sulfur Water Effects in the Osteoarthritis Treatment
8/25
CHEMICAL PHYSICAL PORPERTIES
Conductivity: 427,05 S/cm a 20 CTemperature: 25 C to 63,10 C
Turbidity: 0,60 NTU
pH: 9,30
-
7/29/2019 Scientific Evidences of the Sulfur Water Effects in the Osteoarthritis Treatment
9/25
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
-
7/29/2019 Scientific Evidences of the Sulfur Water Effects in the Osteoarthritis Treatment
10/25
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.
-
7/29/2019 Scientific Evidences of the Sulfur Water Effects in the Osteoarthritis Treatment
11/25
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
-
7/29/2019 Scientific Evidences of the Sulfur Water Effects in the Osteoarthritis Treatment
12/25
6273
2875
Patients treated per year
Women
Men
-
7/29/2019 Scientific Evidences of the Sulfur Water Effects in the Osteoarthritis Treatment
13/25
0% 20% 40% 60% 80% 100%
ARTHROPATHY
HTA
OSTEOPOROSIS
DYSLIPIDEMIA
DIABETES
WOMEN >75
WOMEN 55-75
Patients diseases
Women
-
7/29/2019 Scientific Evidences of the Sulfur Water Effects in the Osteoarthritis Treatment
14/25
0% 20% 40% 60% 80% 100%
ARTHROPATHY
HTA
OSTEOPOROSIS
DYSLIPIDEMIA
DIABETES
MEN >75
MEN 55-75
Patients diseases
Men
-
7/29/2019 Scientific Evidences of the Sulfur Water Effects in the Osteoarthritis Treatment
15/25
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
16/25
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.
-
7/29/2019 Scientific Evidences of the Sulfur Water Effects in the Osteoarthritis Treatment
17/25
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
-
7/29/2019 Scientific Evidences of the Sulfur Water Effects in the Osteoarthritis Treatment
18/25
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
-
7/29/2019 Scientific Evidences of the Sulfur Water Effects in the Osteoarthritis Treatment
19/25
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
-
7/29/2019 Scientific Evidences of the Sulfur Water Effects in the Osteoarthritis Treatment
20/25
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
-
7/29/2019 Scientific Evidences of the Sulfur Water Effects in the Osteoarthritis Treatment
21/25
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
-
7/29/2019 Scientific Evidences of the Sulfur Water Effects in the Osteoarthritis Treatment
22/25
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)
-
7/29/2019 Scientific Evidences of the Sulfur Water Effects in the Osteoarthritis Treatment
23/25
Clinical results
Gonarthrosis
Improvement of symptoms (VAS score)
Improvement in functionality status (WOMAC index)
Improvement of Quality of life (NHP index)
-
7/29/2019 Scientific Evidences of the Sulfur Water Effects in the Osteoarthritis Treatment
24/25
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.
-
7/29/2019 Scientific Evidences of the Sulfur Water Effects in the Osteoarthritis Treatment
25/25
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.