Water-based interventions in rheumatic diseases: mechanisms, benefits, and clinical applications

Chronic pain and restricted mobility, hallmark features of rheumatic diseases, substantially affect patients' quality of life, often resulting in physical disability and emotional distress. Given the long-term nature of these conditions, there is a growing interest in complementary therapeutic approaches, emphasizing the need to explore non-pharmacological treatments. Hydrotherapy, balneotherapy, and mud therapy have emerged as effective interventions to alleviate pain, reduce inflammation, improve joint mobility, and enhance overall physical and mental well-being. These therapies utilize water's thermal, mechanical, and chemical properties to regulate blood circulation, metabolism, inflammatory processes, and patients' psycho-emotional states. This narrative review evaluates the multifaceted effects of water-based treatments on patients with rheumatic diseases, including rheumatoid arthritis, osteoarthritis, ankylosing spondylitis, and fibromyalgia syndrome. Special attention is given to these therapies' synergistic effects, underlying mechanisms, and impacts on patients' physical and emotional health. In conclusion, the integrated use of water-based therapies represents a promising adjunctive treatment for improving the quality of life in patients with rheumatic diseases. However, further research must refine and individualize these therapeutic approaches for optimal outcomes.