Abstract
Objective: The aim of this study was to compare the serum paraoxonase (PON 1) levels between patients with fibromyalgia syndrome (FMS) and healthy control subjects, and to investigate the possible effect of balneotherapy (BT) on PON 1 enzyme activity in FMS patients.
 Methods: The study included 45 female patients with FMS, and 35 healthy female volunteers. To measure PON 1 enzyme activity, venous blood samples were taken twice from the FMS group, before and after BT, and once from the control group. The Visual Analogue Scale (VAS) and Fibromyalgia Impact Questionnaire (FIQ) scales were applied to the FMS patients before and after BT.
 Results: There was no difference between the FMS group and healthy control group in terms of serum PON1 activity (p>0.05). The comparison of the serum PON 1 activity of the FMS group before and after BT revealed a statistically significant increase after BT (p=0.001). A statistically significant decrease was determined in the VAS and FIQ scores of the FMS group after BT compared to the pre-treatment values (p=0.002, p=0.001, respectively).
 Conclusion: BT is an effective non-pharmacologic method in the treatment of FMS. There was an increase in serum PON 1 activity in patients with FMS after BT. BT may have a regulatory effect on the antioxidant system of patients with FMS.
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