Abstract
Natural therapy modalities such as thermal therapy and balneotherapy are commonly being practiced for the management of chronic aches and pain all over the world. Nepal has many such natural hot water springs among which few are famous for therapeutic purposes. Thousands of people with some musculoskeletal problem visit those places in the hope of getting rid of their problems. This study aimed to understand their belief in such therapies, expectations, and satisfaction after treatment along with their knowledge of the safety of hot spring water bath. Among 126 participants interviewed, 31% had inflammatory arthritis, followed by degenerative disorders in 29.4% and soft-tissue rheumatism in 12.7%. Around three-quarters believed that hot spring water has natural healing power and thus can improve their pain. Many even believed that water in natural springs is devoid of any chemicals. So, it is a safe treatment option. Regarding the expectation of cure, they had mixed opinions. Naïve participants hoped they might find a permanent cure in thermal baths. However, repeated visitors said that the effect usually lasted for a few months and they have to visit there regularly. Almost two-thirds of people thought that such natural treatment does not have any side effects. Few stated that they had faced certain problems after the treatment. The water tested from the study site showed that it contained a higher amount of chlorine and sulfate in comparison to other hot water springs in Nepal. The minerals present in water might be a cause of temporary relief of pain. Also, outbreaks of infection from common spring baths have to be considered as such cases have been reported in the past. In conclusion, the medicinal benefits of such natural hot water springs have to be studied further and awareness regarding safety should be given to the people seeking treatment.
Highlights
Musculoskeletal pain is very common in the general population affecting around 20% of the adults [1]
One of the most popular natural therapy options often pursued by them is the natural hot spring pool located in the central west region of Nepal. e location was chosen based upon the feedback and beliefs of many patients attending a tertiary care rheumatology center in Kathmandu where the primary investigator is affiliated
Ough there have been no prior studies on the patient perception about such natural therapies in Nepal, overall a few pieces of research are showing the effectiveness of hot water therapy [4, 5], balneotherapy, and sulfur bath therapy [18] for patients with various kinds of arthritis
Summary
Musculoskeletal pain is very common in the general population affecting around 20% of the adults [1]. People of all ages complain of musculoskeletal pain due to various reasons at some time during their life. Most of the inflammatory and degenerative problems persist for a long duration and people tend to seek various medical options for themselves. In addition to allopathic treatment, various alternative medicines and the natural therapies are sought by these patients [3]—one of them being a visit to natural hot spring pools [4,5,6]. In Nepal, though there are 23 natural hot springs [7], the one located at an altitude of 2474 meters above sea level at the Myagdi district is famous amongst people with musculoskeletal pains for its medicinal properties. It is well known that heat therapy and hydrotherapy are effective modes of pain alleviation in cases of arthritis [12]. Natural hot springs are a habitat for many free-living organisms which might be a potential health hazard, not to mention the risks of sharing a pool [13, 14]
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