Sulfurized, sulfated, rich in calcium, magnesium, thermal cures attract nearly 600,000 people each year. Exercise in swimming pools, baths, ovens, poultices of mud, fumigations, massages, since the 19th century, the golden age of hydrotherapy, the principles of a cure are always the same. In more than one in two cases, spa patients come first to relieve a neck, a foot, a hip bruised by osteoarthritis, chronic low back pain, recalcitrant tendinitis.
"With the aging of the population, the management of chronic pain is becoming again the heart of hydrotherapy profession," observes Professor Christian-François Roques, president of Afreth (French Association for thermal research). Approaching the Thermalies fair is held from January 23 to 26 in Paris, at the Carrousel du Louvre du Louvre in Paris, here is how this body, which hurts, acts, this alternative medicine.
1. Break the vicious circle
"Mineralized hot water is a natural pain reliever, it relieves pain and immediately provides well-being, the Romans who had made thermal baths an art of living, had understood this, recalls Michel Duprat, general practitioner in Dax ( Landes), which works with 15 centers in this region renowned for the management of rheumatology.
Relaxing, sedative, the spa treatment is not, however, a medicine that cures: "It relieves symptoms, explains the practitioner, because pain is a gear: when it hurts, the body stiffens, which further increases the feeling pain because the muscles contract and tighten the traumatized or damaged area. The point of a cure is to break this vicious circle ”
2. A "click" to become active again
The psychological aspect of the treatment is just as important as the care, explain the thermal spa doctors. “Going on a cure for 18 days is anything but a vacation, struggling to regain some degree of amplitude at the level of the cervical and spinal column is very tiring, stresses Michel Duprat, but it also encourages patient not to give in to his pain. "
"The cure will help him regain all the more confidence as he will rub shoulders with people who are experiencing the same difficulties as him, no longer feeling alone in the face of the disease," he explains. Often, moreover, the cures have a trigger effect: we find that after people start yoga, gardening, they are much more active. "
3. A lasting effect?
"Yes, and more and more, we are starting to have scientific proof," says Christian-François Roques. Over the past twenty years, nearly 150 publications, mainly in Anglo-Saxon journals, have shown their therapeutic interest. For its part, to date Afreth has published only 12 studies. It is still very little. "But 24 others will come out, specifies its president, and whether it is our studies or the others, all show that in the months following a cure, the quality of life of the patient has been improved."
In the case of rheumatology (especially osteoarthritis of the knee), a clinical trial carried out by Afreth showed that a cure even had an effect superior to conventional treatments, he explains. “We compared the case of 462 knee patients. The result ? Nine months later, those who had undergone a cure, in three different thermal centers, suffered half as much as those who had treated themselves in the classic way, by infiltration, anti-inflammatory or by infiltration.
4. More and more indications
In addition to rheumatology, the bulk of curists (250,000 patients per year), pain killers are aimed at multiple other pathologies: venous insufficiency, including heavy legs syndrome, for which there is hardly any solution other than compression stockings, but also fibromyalgia, this pathology which causes diffuse and very disabling muscle pain, or certain gynecological pain.
"Again, after a year, the effects are still there," said Christian François Rocques. Cures are also increasingly recommended after breast cancer. “After surgery and radiotherapy, the operated breast and the region have painful fibrous and scarred areas that sometimes limit the movements of the shoulder. It has been shown that after two years, after a cure, women regain the use of their shoulder, good sleep, optimism and an active life more quickly, ”explains the professor of medicine.
5. A drug break
A patient who is less affected by pain often has less tablets of ibuprofen, paracetamol or tramadol. “Each year, I see a former handball athlete, who suffers terribly from the back, testifies Michel Duprat. At the start of her treatment, she is at 50 mg per day of opioid painkiller, when she leaves, she takes only 5 mg. ”
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In the six months after a cure, it would be 2% less of drugs, consultations, physiotherapy sessions prescribed to patients, according to a survey which was carried out between 2006 and 2001, by the professionals of hydrotherapy with 10 500 spa guests.