Effectiveness of Balneotherapy versus Paraffin Wax Bath in Patients with Rheumatoid Arthritis: A Randomized Controlled Trial

Background: Rheumatoid arthritis refers to a chronic autoimmune disease that causes inflammation and dysfunctional joints. Balneotherapy and paraffin wax baths have gained attention due to their potential to reduce symptoms and enhance quality of life. Objective: To compare the effectiveness of balneotherapy and paraffin wax bath therapy among rheumatoid arthritis patients. Methodology: A single-blinded, randomized controlled trial that followed the guidelines of the CONSORT, which had received ethical approval from the Institutional Review Board. The trial was conducted in Sehat Medical Complex and Hamid Latif Hospital and took place. Out of 60 participants, 54 who met the inclusion criteria were randomly allocated to two groups on the basis of a concealed-envelope design. Group A was treated with balneotherapy along with standard physical therapy, and Group B was treated with paraffin wax baths and standard physical therapy. Participants included both males and females aged between 30 to 50 years, for at least three months and the ability to walk independently or with minimal assistance. Patients with severe cardiovascular, neurological, or dermatological conditions, as well as those with cognitive impairments or other contraindications to either intervention, were excluded. This treatment was administered five times per week over six weeks. Outcome evaluations were carried out at the baseline, 4th and 8th weeks. Pain severity was assessed with the visual analogue scale, functional mobility was assessed by the timed up and go, and disability by means of the health assessment questionnaire disability index. Mixed model and repeated measure ANOVA were used to detect the differences between the groups and within the groups, respectively. Results: Both groups showed significant improvements (p<0.001) in pain, mobility and functional scores. However, Group A showed greater improvement, with a mean pain score reduction of 4.6±1.0, mobility score improvement of 4.91±1.32 seconds, and functional improvement of 1.41±1.78. Conclusion: Balneotherapy is a more effective adjunctive intervention than paraffin wax bath in reducing pain, enhancing mobility, and improving functional outcomes in patients with rheumatoid arthritis.