Abstract
Arthritic diseases are the most frequent causes of chronic pain and disability. Rheumatoid arthritis (RA) is an autoimmune disease characterized by synovial inflammation and progressive structural joint damage. Osteoarthritis is a degenerative process of the articular cartilage associated with hypertrophic changes in the bone. The aim of the present study was to investigate the anti-inflammatory and analgesic effects of Hévíz thermal water and mud in monosodium iodoacetate- (MIA-) (25 mg/ml, 20 μl i.a.) induced osteoarthritis and Complete Freund's adjuvant- (CFA-) (1 mg/ml, 50–50 μl s.c) induced rheumatoid arthritis murine models. The mechanonociceptive threshold of female NMRI mice (n=6– 8 mice/ group) was measured by aesthesiometry, and paw volume was monitored with plethysmometry, knee joint diameter with digital micrometer, and dynamic weight bearing on the hind limbs with a Bioseb instrument. Periarticular bone destruction was assessed by SkyScan 1176 in vivo micro-CT. Inflammatory cytokines were detected by ELISA in plasma samples. Treatments (30 min, every working day) with tap water, sand, and a combined therapy of tap water and sand served as controls. Hévíz medicinal water and combined treatment with water and mud significantly decreased the mechanical hyperalgesia and knee oedema in MIA-induced osteoarthritis model. However, balneotherapy did not influence mechanical hyperalgesia, weight bearing, or oedema formation induced by CFA. Neither medicinal water nor mud treatment ameliorated deep structural damage of the bones or the joints in the animal models. On the basis of the present findings, we conclude that balneotherapy is an effective complementary treatment to reduce the pain sensation and swelling in degenerative joint diseases such as osteoarthritis. Our experimental data are in agreement with the previous human studies that also confirmed antinociceptive and anti-inflammatory effects of thermal water and Hévíz mud treatments.
Highlights
Balneotherapy (BT) traditionally means bathing in mineral and/or thermal waters from natural springs; besides them treatments with gas molecules (e.g., CO2, H2S), peloids and other natural compounds can be listed into the balneological interventions [1]
The thermal water and mud were formed in the ancient Pannonic-sea tens and they are suitable for complex physiotherapy treatments
Administered MIA (20 μl, 25 mg/ml i.a.) induced an approximately 30-40% mechanical hyperalgesia after 2 days in all groups (Figures 2(a), 2(b), and 2(c)). This mechanical hyperalgesia was gradually decreased in tap water-treated group and from day 9 it was significantly higher compared to the Hevız water-treated group (-48.90 ± 5.82 versus 20.60 ± 4.10)
Summary
Balneotherapy (BT) traditionally means bathing in mineral and/or thermal waters from natural springs; besides them treatments with gas molecules (e.g., CO2, H2S), peloids (mud) and other natural compounds (e.g., hay) can be listed into the balneological interventions [1]. The bottom of the largest European thermal lake named Hevız is covered by a special mud, which can be useful for medical prospects [2]. The water of Lake Hevız contains solid and gaseous compounds its composition joins the beneficial forces of carbonate, sulfur, calcium, magnesium, and hydrogen carbonate-containing waters [3]. The thermal water and mud were formed in the ancient Pannonic-sea tens and they are suitable for complex physiotherapy treatments. The effective substances of the Hevız mud were described previously [4,5,6]. BT is widely used to amplify the effects of drug treatments and recommended for a broad spectrum of diseases, such as arthritis, dermatitis, and fibromyalgia [7,8,9]
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