The Impact of Hot Spring Hydrotherapy on Pain Perception and Dysfunction Severity in Patients with Chronic Low Back Pain: A Systematic Review and Meta-Analysis

BACKGROUND: Chronic Low Back Pain (CLBP) is a prevalent global health issue, leading to prolonged discomfort and functional limitations. Hot spring hydrotherapy, which utilizes mineral-rich, warm spring water, offers a unique physical therapy that holds promise in alleviating CLBP symptoms. OBJECTIVE: This meta-analysis aims to assess the effectiveness of hot spring hydrotherapy in improving CLBP symptoms, encompassing pain intensity, functional disability, quality of life, and medication usage. METHODS: A systematic review and meta-analysis were conducted by searching relevant literature in multiple databases. Included studies compared hot spring hydrotherapy with control interventions or other treatments. Standardized mean differences (SMD) with 95% confidence intervals (CI) were calculated for pain intensity, functional disability, medication usage, and quality of life. RESULTS: A total of 16 studies met the inclusion criteria, involving 1656 participants with chronic low back pain across various countries. The meta-analysis demonstrated that hot spring hydrotherapy was effective in reducing pain intensity (SMD = −0.901, 95% CI [−1.777, −0.025], P < 0.05) and improving functional disability (SMD = −3.236, 95% CI [−4.898, −1.575], P < 0.0001) in CLBP patients. Hot spring hydrotherapy also resulted in a significant reduction in medication usage (P < 0.05). Subgroup analysis showed that the effects of hot spring hydrotherapy were more pronounced in patients aged 60 and above, while no significant differences were observed in patients below 60 years of age, single hot Spring Hydrotherapy help improve patients’ quality of life. CONCLUSION: Hot spring hydrotherapy is an effective intervention for improving CLBP symptoms, including pain intensity, functional disability, and medication usage. It is particularly beneficial for CLBP patients aged 60 and above. These findings support the integration of hot spring hydrotherapy into the treatment approach for CLBP, although further research is needed to determine its efficacy in younger patients and to explore the underlying mechanisms of its therapeutic effects. PROSPERO ID: CRD42023430860.