Sauna therapy in rheumatic diseases: mechanisms, potential benefits, and cautions

Rheumatic diseases (RDs) present a major global health challenge, particularly in aging populations, due to chronic inflammation, progressive joint damage, and impaired mobility. While pharmacologic interventions, such as non-steroidal anti-inflammatory drugs (NSAIDs) and disease-modifying antirheumatic drugs (DMARDs), remain central to RDs management, concerns regarding their side effects and incomplete symptom relief have increased interest in complementary therapies. Sauna therapy, particularly its Finnish and infrared modalities, has emerged as a promising non-pharmacologic intervention with potential anti-inflammatory, musculoskeletal, and cardiovascular benefits. Heat exposure modulates inflammatory pathways by reducing pro-inflammatory agents (TNF-α, CRP, PGE2, LTB4) while promoting IL-10-mediated anti-inflammatory effects. Additionally, sauna therapy mitigates oxidative stress and enhances neuroendocrine regulation, contributing to systemic health benefits. Clinical evidence points to benefits of sauna therapy related to alleviating pain, reducing stiffness, and improving mobility in patients with rheumatoid arthritis (RA), ankylosing spondylitis (AS), and osteoarthritis (OA). Some studies have demonstrated reductions in pain scores and inflammatory markers, improved physical function, and disease stability following infrared sauna exposure. Moreover, cardiovascular advantages of regular sauna use are particularly relevant for RD patients with cardiovascular comorbidities. Given the growing body of evidence supporting its therapeutic potential, sauna therapy represents a viable adjunctive strategy for RD management. Further research is warranted to optimize treatment protocols, assess long-term safety, and delineate patient-specific benefits. Integrating sauna therapy into comprehensive RD care may enhance symptom control, improve quality of life, and reduce reliance on pharmacologic interventions.