OBJECTIVE: To assess the overall effectiveness of spa therapy compared with usual routine drug therapy in chronic low back pain (LBP). METHODS: One hundred and twenty-one patients were randomly allocated to treatment (n = 59) and control (n = 62) groups. In the treatment group, patients underwent routine drug therapy and spa therapy 6 days/week for 3 consecutive weeks in Saint-Nectaire, France. In the control group, patients received routine drug therapy. Effectiveness was assessed based on clinical measures, duration and intensity of pain, Roland and Morris' disability questionnaire, the patient's overall evaluation of back health, and drug consumption (analgesic and antiinflammatory). Groups were compared using analysis of covariance with repeated measures. RESULTS: At 3 weeks, patients in the treatment group had significant improvement in all outcome variables (p < 0.0001) except for the Schober index and analgesic and antiinflammatory drug consumption. At 6 months, improvement was still significant for the same outcome variables (p < 0.0001), plus a significant reduction in analgesic consumption. CONCLUSION: This study suggests both immediate and 6 month effectiveness of spa therapy in chronic LBP. Spa therapy may be beneficial in the management of chronic LBP.

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