300 Section - Gender-specific responses to spa-based interventions in osteoarthritis

Objectives : Osteoarthritis (OA) is one of the leading causes of chronic pain and disability worldwide, with a well-documented higher prevalence and clinical burden in women. Female patients account for approximately 60% of individuals with OA and often experience greater pain severity, functional impairment, and reduced quality of life, particularly after midlife. These differences are thought to be related to hormonal changes, anatomical characteristics, and biomechanical factors.
Among non-pharmacological interventions, balneotherapy, using thermal mineral-rich waters for therapeutic and rehabilitative purposes, is widely adopted due to thermal, chemical, and pharmacological effects. However, gender-related differences in treatment response remain insufficiently explored.
The aim of this study was to explore gender-related differences in clinical outcomes following spa-based rehabilitation and balneotherapy interventions in patients with OA.

Design: Available clinical evidence on spa-based interventions for OA was examined with a focus on gender distribution. Data were considered regarding OA localization, characteristics of spa treatments, treatment intensity and duration, and functional outcomes.

Results:

Across the analyzed evidence, female patients represented a substantial proportion of treated individuals. Women with OA consistently demonstrated clinically meaningful improvements in pain, physical function, psychological status, and overall quality of life. In several cases, these benefits persisted for months after treatment completion.

Conclusion: Spa-based rehabilitation appears to be a valuable complementary intervention for OA, particularly in women, who frequently present with more severe symptoms and greater disability. These effects may be partly explained by gender-related differences in thermoregulatory responses, immune modulation, and pain processing mechanisms induced by thermal mineral exposures.
Therefore, a gender-oriented approach to spa-based rehabilitation may enhance treatment personalization and effectiveness in managing age-related musculoskeletal conditions.