OBJECTIVE: To evaluate the effectiveness of thermal mineral water compared with magnetotherapy without balneotherapy as control, in the treatment of hand osteoarthritis. DESIGN: Randomized controlled single-blind follow-up study. SETTING: Rheumatology specialist clinic of Gunaras Health Spa. SUBJECTS: Patients between 50 and 70 years of age with hand osteoarthritis, randomly assigned into three groups. INTERVENTIONS: The subjects in the first two groups bathed in thermal mineral water of two different temperatures (36 degrees C and 38 degrees C) for three weeks five times a week for 20 minutes a day and received magnetotherapy to their hands three times weekly. The third group received only magnetotherapy. OUTCOME MEASURES: Visual analogue scale scores, handgrip strength, pinchgrip strength, the number of swollen and tender joints of the hand, the duration of morning joint stiffness, Health Assessment Questionnaire, and Short Form-36 questionnaire. The study parameters were administered at baseline, immediately after treatment and after 13 weeks. RESULTS: The study included 63 patients. Statistically significant improvement was observed in several studied parameters after the treatment and during the follow-up study in the thermal water groups versus the control group. The 38 degrees C thermal water treatment significantly improved the pinch strength of the right hand (0.6 (95% confidence interval (CI) 0.2 to 1.1) versus 0.03 (95% CI -0.3 to 0.4), p < 0.05) and the Health Assessment Questionnaire parameters (-0.4 (95% CI -0.6 to -0.2) versus -0.1 (95% CI -0.2 to 0.1), p < 0.01) even in the long term. CONCLUSIONS: Balneotherapy combined with magnetotherapy improved the pain and function as well as the quality of life in patients with hand osteoarthritis.

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