Relevance of balneotherapy for back pain — a systematic literature review covering the past 5 years

Systematic review published in the Wiener medizinische Wochenschrift (2025), examining balneotherapy evidence for back pain over the 2019–2025 period. The companion paper to Keilani 2025 (osteoarthritis), from the same Vienna research group, this review extends the systematic coverage to spinal conditions.

Why Back Pain Is a Distinct Area

Knee osteoarthritis dominates peloid therapy research because it is the easiest joint to treat topically and outcomes are easy to measure. Back pain is different: the affected structures are deeper, thermal penetration is less direct, and the mechanism of benefit relies more heavily on systemic effects — muscle relaxation, inflammation reduction, circulatory changes — than on local joint contact. The existence of a positive systematic review for back pain is therefore a meaningful finding: it suggests balneotherapy’s benefits extend beyond direct joint contact.

What It Found

Positive outcomes were reported for chronic low back pain across the studies reviewed. Balneotherapy is supported as a complementary therapy for spinal conditions — not a replacement for physiotherapy or pain medication, but an adjunct with measurable benefit. The review covers the same five-year window as Keilani 2025, reflecting the most current published evidence.

Limitations and Caveats

Back pain is a heterogeneous condition — causes range from disc herniation to muscle spasm to chronic non-specific pain. The studies reviewed likely include different patient populations with different underlying pathologies. Balneotherapy’s mechanism for back pain is less characterised than for joint OA. This review establishes that it works in the settings studied; why it works and which back pain subtypes benefit most remains an open question.