[Critical evaluation of phytothermotherapy ("hay baths") in degenerative arthropathies]

It is a traditional practice of the Alpine region of Trentino and Alto Adige to use phytothermotherapeutic treatment with fermenting grass ("hay baths") for chronic degenerative arthropathies. A marked lack of clinical validation is however to be found in current literature as to its efficacy and tolerability. To verify these two aspects 27 patients (mean age 59 +/- 8.7 years, range 43-82) with osteoarthritis (15 of them with a generalized form) were evaluated before and after a ten-day treatment with immersion of the whole body in a bed made with fermenting grass according to the traditional method. The following clinical features were considered: pain in affected joints evaluated by visual analog scale, presence of global subjective improvement (or lack of it) immediately and 6 months after treatment, degree of global functional impairment, stiffness duration, handgrip strength. The mean score at the affected joints (on the visual analog pain scale) was 2.51 +/- 0.71 before and 1.83 +/- 0.89 after treatment (p < 0.001), with improvement in 68% of patients. Morning stiffness was reduced from 38.9 +/- 30.5 to 17.5 +/- 17.2 minutes (p < 0.05), with improvement in 57% of patients. Grip strength measure went from 136 +/- 59.7 to 147 +/- 51 mmHg (p < 0.01), with improvement in 77% of patients. Forty-eight percent of the patients were reassigned to better class of functional capacity (p < 0.001). Patient general assessment signaled improvement in 72% of cases immediately after treatment, and in 80% after six months. Tolerability was high in 23 out of 25 patients, nobody was taken off treatment because of side effects, in two cases a one day interval due to asthenia was introduced. In conclusion, improvement rates were found higher when compared with controlled trials on efficacy of nonsteroidal antiinflammatory drugs. Noteworthy is also the persistence of improvement 6 months after treatment compared to the above mentioned drugs and usual physiokinesitherapeutic treatments.