Balneoterapy habits and selection: a descriptive retrospective study

This study aimed to: (1) evaluate balneotherapy usage habits, duration of stay, and physical activity patterns among individuals with chronic musculoskeletal pain, analyzing their association with pain intensity and socioeconomic status (Primary Objective); and (2) compare pain scoring behaviors across three Visual Analogue Scale (VAS) presentation formats. In this descriptive retrospective study, data from 425 individuals (aged ≥ 45 years) with chronic mechanical musculoskeletal pain were analysed. Pain intensity was assessed using three VAS formats (numerical, non-numerical and vertical) and the McGill Pain Questionnaire. The results showed that 51.1% of participants typically used balneotherapy (BT) for a duration of 1-2 weeks. Moderate negative correlations were found between educational level and VAS scores (r = - 0.406, p < 0.01) and between BT visit frequency (r = - 0.115, p < 0.05), the duration of the BT stay (r = -0.252, p < 0.01) and pain intensity. Furthermore, a strong positive correlation was found between income level and duration of stay in the thermal facilities (r = 0.816, p < 0.01). A significant finding was that 83.3% of participants had no previous experience of physiotherapy. Scale presentation formats are among the factors that significantly influence pain assessment results. Although balneotherapy is associated with lower reported pain intensity, its use and duration of stay depend largely on socio-economic factors. The lack of professional support at thermal facilities highlights the urgent need to integrate physiotherapists in order to transform balneotherapy into a structured, evidence-based rehabilitation framework.