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22/04/2025 - Covid-19

Balneotherapy Improves Various Symptoms of Long COVID

A study led by the Hospital del Mar Research Institute, in collaboration with the Caldes de Montbui City Council, has validated the use of thermal waters to reduce some symptoms in people affected by long COVID.
Balneotherapy helped improve pain and fatigue, with benefits that persisted after treatment ended. Improvements were also observed in sleep quality and anxiety, although these did not last over time.
People with long COVID who underwent a one-month thermal water treatment program were twice as likely to improve their symptoms compared to those who did not receive the treatment.

Balneotherapy, the use of thermal waters for health improvement, may be useful for treating symptoms of long COVID. The results of a clinical trial published in BMC Complementary Medicine and Therapies, conducted by a team from the Hospital del Mar Research Institute, physicians from Hospital del Mar, and researchers from the Frailty and Healthy Aging Area of CIBER (CIBERFES) and the Infectious Diseases Area (CIBERINFEC), in collaboration with the Caldes de Montbui City Council, show that patients who followed a thermal water exercise program were twice as likely to reduce symptoms as those who did not receive balneotherapy.

"Balneotherapy helped them regain physical capacity. These are individuals whose condition severely limits them. Physical activity combined with thermal waters helped stimulate them," explains Dr. Natàlia Garcia-Giralt, researcher at the Musculoskeletal Research Group of the Hospital del Mar Research Institute and CIBERFES. To prove this, the study followed one hundred people with long COVID. Half followed a balneotherapy exercise program, and the other half continued their regular daily activities. At the start of the clinical trial, all participants exhibited similar symptoms: fatigue, pain, respiratory problems, anxiety, depression, and memory issues.

The program consisted of 12 sessions over four weeks at Termas Victòria in Caldes de Montbui. Participants-mostly women (88%) with an average age of 48-engaged in thermal water breathing exercises, circular showers to stimulate blood circulation, 15 minutes of light physical activity, and 15-20 minutes of pool relaxation.

Significant Improvement in Fatigue and Pain

Researchers tracked participants' progress through a series of tests administered at three points: the start of the study, one month later, and two months later. The most notable improvements were seen in fatigue and pain, with 75% of participants experiencing reductions in these symptoms. These improvements were sustained over time.

Other symptoms, such as anxiety and sleep quality, showed improvements in over half the participants, but the effects faded after the balneotherapy ended. No significant changes were observed in other symptoms.

"People finished the balneotherapy in very good condition, but a month after ending the treatment, without further intervention, some symptoms returned. However, improvements in pain and fatigue were sustained," Dr. Garcia-Giralt notes. Side effects from the thermal water activities were minimal.

Balneotherapy as a Treatment Alternative

Long COVID is characterized by the presence of symptoms three months after SARS-CoV-2 infection, lasting at least two months, with no alternative explanation. Symptoms vary widely, and it is estimated to affect 10-20% of people who have had COVID-19. No specific treatment currently exists.

Given this, Dr. Diana Ovejero, Postdoctoral Researcher with the Musculoskeletal Research Group at the Hospital del Mar Research Institute, points out: "Our data suggest that balneotherapy is a safe and well-tolerated rehabilitative approach that can alleviate many long COVID symptoms, particularly musculoskeletal pain and fatigue." The exact mechanism is still unknown.

Dr. Robert Güerri, Head of the Internal Medicine Service at Hospital del Mar and researcher at the Institute, emphasizes: "Balneotherapy should be considered a promising option for these patients, given the lack of specific treatments." It allows for a multidisciplinary, individualized therapeutic approach.

The team led by Dr. Garcia-Giralt has already begun a new study on the benefits of thermal waters, this time focusing on women with breast cancer undergoing double estrogen suppression, aiming to assess whether it can relieve treatment side effects.

Reference Article
Ovejero, D., Ribes, A., Villar-García, J. et al. Balneotherapy for the treatment of post-COVID syndrome: a randomized controlled trial. BMC Complement Med Ther 25, 37 (2025). https://doi.org/10.1186/s12906-025-04784-3

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