Thermal Bath

The therapeutic use of water as a drink, in accordance with the uses prescribed subsequent to a medical visit, is one of the most important forms of thermal treatment. This is because it encourages and stimulates metabolic balance and the functional regeneration of the body which is all too often run down by the stress of modern living.

Nowadays mineral water drinking treatments are often done at home as a way of rounding off therapeutic treatments undergone at thermal spas. Nevertheless, it must be pointed out that, based on experience, the consumption of water at the springs themselves is undoubtedly a more successful form of therapy for a number of reasons.

In the first place, the use of water in the proximity of the s prings means there is no risk of deterioration including the dispersion or disappearance of important chemical components from the water.

Secondly, spas are usually located in particularly pleasant climatic settings and so the drinks’ therapeutic effect is enhanced by the quality of the surrounding environment. Thermal parks offer the possibility of pleasant walks and routes which foster a general sense of wellbeing which in turn helps pave the way for a successful treatment result.

Lastly mineral water drinking treatments at thermal spas are carried out with the assistance of qualified medical staff. Not only do they supervise conditions and make sure that the water is consumed in the best way possible, but they also supply additional services which form a back-up to thermal therapy including dietary and nutritional prescriptions.

In various cases, mineral water drinking treatments are combined with other thermal treatments such as hydrofango-balneotherapy where consumption of wat er is combined with mud treatments focused on the liver followed by balneotherapy

The jet can be used on all the body or directed at specific (also very small) areas of the body as is the case with ‘filiform’ showers. Not only does the jet work directly on the treated area but also works to stimulate the body in general and in particular the cardiovascular organs and nervous system.

The area which the jet treats is linked to both the surface tissues and the deep tissues and organs via nervous endings which are affected by the stimulation’s efficacy.

This is the reason why jet showers have proved useful as support therapies for treating mental problems and mood disorders (treatment of anxiety creating and depressive factors), and in cosmetic treatments especially as far as cellulite and other types of cosmetic problems are concerned.

The use of jet showers can differ in a large number of ways depending on the type of jet, water temperature (hot and cold showers, scotch showers and alternating temperatures) and jet pressure.

There is a wide range of types of showers which differ depending on the jet type (column, shower, horizontal) and particular mention must be made of filiform showers which emit a perpendicular jet of water measuring about half a millimetre in diameter. These types of shower which are particularly useful for treating skin problems are also used for their ‘abrasive’ properties and are extremely useful in treating acne.

Lastly the type of method used makes it possible to classify the showers according to the organ treated and the showers available include skin, liver and epigastric, perineal and plantar jet showers.

The thermal water used for this purpose is collected in specific containers (called irrigators) where it is brought to the temperature and density needed for the various types of use and any medication added.

This preparation is placed in contact with the membranes to be treated by using probes which allow for perfusion of the membranes, stillicidium (‘drop by drop’ irrigation to allow the thermal water to be properly absorbed) and internal distribution via jet using a micronised shower which is particularly suitable for treating endotympanic disorders.

Irrigation has proved particularly useful in treating inflammation of the female genital organs, especially with regard to the cleansing and aseptic properties of the water used.

Regular functioni ng of the ovaries and regularisation of menstrual cycles is one of the results obtained from irrigation using water containing salt, iodine and bromide.

Irrigation of the oro-rhino-pharyngeal cavity makes it possible to treat an extremely wide range of ailments and the use of ‘micronised nasal showers’ which ensure a high level of penetration of the water used, allows for a highly advanced therapy to treat many problems connected with the nasal and pharyngeal membranes in addition to traditional methods. Thermal water is atomised and once in this state is placed in contact with the nasal cavities using specific equipment.

Irrigation of the guns and oral cavity has been acknowledged as having a definite benefit in the treatment of paradontosis (i.e. in diseases of gum tissues). Irrigation stimulates both the tissues’ blood and lymphatic circulation, encouraging the regression of inflammatory processes.

Irrigatory methods are also used to treat intestinal disorders for which thre e types of treatments are available – rectal shower, proctoclysis and micro-enema. Treatments for various chronic colon disorders and to normalise constipation problems are possible depending on the chemical composition of the water used.

The caves used are grouped into hot or cold caves depending on the internal temperature and only the former have a therapeutic use. These can be split into humid-hot caves (known as thermal caves) and dry-hot caves called steam caves. Inside the latter, the steam is released through cracks found in the cave floor or walls.

Therapy carried out inside natural thermal and steam caves depends on the presence of hot thermal water or steam produced by active volcanic phenomena. A particular micro-climate can be found inside the thermal and steam caves due to a combination of factors (water temperature and chemical composition, humidity level, composition of any thermal gases, rock composition and level of ionisation in air ) which patients are exposed to.

Obviously thermal treatments concern the whole body and therefore we can say that they require a general reaction from the patient to the environmental conditions he/she is exposed to, and in particular ‘thermal pressure’.

Antrotherapy is a suitable treatment for rheumatic and articular problems and is also useful for treating respiratory disorders.

Specific equipment is used for humid-hot inhalations in order to allow the active agents contained in the thermal water to come into contact with the respiratory system (high and low tracts) and the middle ear.

As with other thermal treatments, the therapeutic purpose is conditioned by many factors including water temperature and pressure, the dimension of the water particles, the type of instruments used and its technological features as well as the chemical co mposition of the thermal water used.

The instruments used allow for a more or less high level of breaking down of the thermal water particles which the patient must inhale. This is of great importance insofar as only the heavily micronised particles can reach the thinner and more peripheral bronchial branches.

Once water vapour of the required temperature and density has been obtained, it is inhaled through the mouth and/or nose using specific mouthpieces or masks.

Radioactive and in particular gaseous water contains the highest level of gaseous emanations.

Humages are useful for treating respiratory problems and can be used by both individuals and groups. When used collectively, thermal spas set aside a specific room or area for the inhalation of thermal gases.

The medical condition treated consists of otitis with tubaric dysfunction. Thermal gases are introduced into the nasal passages using a specific compressor (Politzer’s manoeuvre) in order to re-establish sufficient ventilation of the middle ear. This type of insufflation is known as ‘tympanic tube insufflation’.

Instead, nasal-pharyngeal insufflation is performed directly inside the nasal cavities using catheters or probes.   

As far as the heat component is concerned, it should be said that since water has the highest specific heat, a low conductivity coefficient and the possibility of being used in large quantities, it has a high heat retention capacity. Bodies with a high heat retention capacity are very useful in therapeutic practice since they can transmit heat in its best form – gradually without any sharp changes thus avoiding sudden and immediate heat charges in the tissues they come into contact with.

From a practical point of view, there are 3 types of baths - low mineralization or hypotonic, medium mineralization and high mineralization or hypertonic. The division is made according to the temperature and saline concentration of the mineral water used. In particular, three specific actions depend on the level of salt in the water. The first concerns the increase in the caloric action in accordance with the direct relationship between the specific weight and the heat and heat retention capacity.

The second strengthens the hydromechanical actionwhile the third is performed on the skin mantle, especially by hypertonic baths, with nervous stimulation, alteration of osmotic currents, etc. which cause internal stress of the body.

Thermal therapy is an indispensable treatment for many types vascular problems especially venous related conditions. Thermal balneotherapy at temperatures of between 32 and 36° with alkaline carbonic and bicarbonate water (carbon-gaseous baths) and also sulphated and sulphurous water and water containing salt and salt and bromide is the main focus of this treatment. Both for the hydrostatic effect and above all for the distinctive physical and chemical action contained in the composition of the mineral water.

The results obtained with this treatment are clearly different from the results obtained by taking a bath in normal tap water. Ozone therapy, underwater massage, vascular gymnastics and postural drainage are all included in balneotherapy together with hygienic-dietary therapies which find a complete use in the concept of integral flebopathy thermal therapy.

Balneotherapy can be performed in both individual and collective baths and in thermal pools and also in special tubs where it is possible to perform physiotherapy and rehabilitation activities.

In particular it must be noted that immersion in thermal water can be combined with hydromassage treatment which consists in directing jets of different intensities onto the body while immersed in thermal water in order to stimulate blood circulation. In many spas hydromassage is als o combined with walking in order to further stimulate the cardiocirculatory system.

Balneotherapy can also be performed in sand therapy resorts, i.e. in thermal resorts located near the sea where sand bath therapy is performed. In this case, obviously sea water is used and baths can be taken either in pools (with water heated to a maximum of 36°) or directly in the sea (cold baths). Generally motor exercises are performed while in the water, either independently or directly (e.g. swimming) or various forms of kinestherapy where the patient remains immobile.

Immersion in seawater also boasts the massage effect produced by the movement of the waves which is of great benefit in stimulating the body in general.

‘Hay baths’ represent a particular type of balneotherapy. This ancient tradition of the valleys of the Trentino and Alto Adige regions has its origins in the farmers’ habit of resting from a hard day's work by ‘sleeping in the hay cut for the cows. This grass, apart from giving a creamy milk and eccellent butter, also relieved the exhaustion of a day's work in the fields and gave the farmers their strength back.

In some areas in Trentino (and neighbouring Alto Adige) this peasant custom been rationally exploited for an important specific therapeutical purposes. This has happened for example in the Viote valley on Mount Bondone, where the grass is grown in abundance and specifically cut for the hay baths.

The grass, which contains a very particular mix of aromatic plants and medicinals such as thyme, arnica, creeping cinquefoil, gentian and many others, is cut and gathered at dawn or late evening (in some cases it is gathered during the day, provided the hay is still damp with dew). It is then stored in large basins where it is left to ferment for a few day.

When this natural boiling process is complete, one can begin the bathing process. The patient is almost completely immerged: at the beginning of the course of treatment for 15 minutes gradually increa sing to half an hour. The hay beds are 50-60 centimetres wide and reach a superficial temperature of 40 degrees, while a temperature of 70 degrees has been measured below the surface. The patient, wrapped in a sheet and immerged in the hay bath at constant heat, sweats excessively and continues sweating for a few hours after termination of the treatment.

The discovery of said minerals surely made for a better understanding of the mud's ‘maturation process’ which lasts from 1 to 2 years. An enrichment of vegetable and animal micro-organic substances occurs during this process and at the same time the various fractions that make up the mud become more closely mixed. According to their special structure, thermal muds act in a curative manner through specific stimuli – heat action, mechanical stress and physical-chemical and chemical action.

As far as the heat component is concerned, there is no other substance quite l ike mud which has the physical and physical-chemical properties needed to generate so much heat and slowly release it on the section covered in mud without causing any inconvenience.

The mud used can be natural (i.e. mud as it is found in nature without any subsequent modification or addition of substances) or artificial where specific processes are used to decide the mud’s chemical components and properties.

Mud packs using thermal mud created by combining the solid component (claylike) and liquid component obtained from the springs are particularly suitable for treating dermatological, arthro-rheumatic (osteoarthritis) and locomotion problems, gout and also gynaecological complaints using a particular method of applying mud directly to the pelvis area in the form of ‘underwear’.

The solid and liquid components of the mud used, their chemical composition and their organic and inorganic characteristics can vary considerably which leads to a great selection of muds.

In muds , the liquid component can also be seawater while the solid component consists of mainly mineral components which generally come from the floors of lakes or lagoons or from the accumulation of detritus on the riverbed.

In peat, (which also come mainly from lakes or marshes) there is also a significant organic component due to the slow transformation process of the vegetable organisms which produced the peat.

Mildews (the use of which at the Vinadio and Valdieri thermal spas is well-known) result from a combination of water (mainly sulphurous) with a solid component with a base of algae or other organic marine components.

Fangotherapy is practised in many Italian spas and there is a particular tradition in the Euganei Hills (Abano and Montegrotto) where application of a mud pack is followed by bathing, a perspiratory reaction and a massage session. These are four successive stages, each of which is important for obtaining all the benefits from a thermal treatment session. A particu lar type of fangotherapy is performed at Recoaro which uses ochre mud. This is the natural deposit that forms in tanks with water containing iron and is of a distinctive colour. It is particularly suitable for treating degenerative and post-traumatic arthropathy and fractures.

Sand therapy often forms part of a more complex therapy where it is combined with seawater balneotherapy and other specific thermal treatments.

It is generally performed at thalassotherapy institutes where thermal treatments (sand and seawater baths) are combined with the climatic and environmental advantages of seaside locations.

These advantages depend on the particular ‘climatic environment’ of the places where treatments are performed and from this point of view, the Mediterranean climate (with its thermal stability, average humidity and atmospheric pressure levels) is optimal. Seaside locations offer the advantage of a natural aerosol insofar as the wind transports ions and mine ral salts coming from the seawater.

While sand baths are a specific treatment for rheumatic and osteoarthritic conditions, the combination of climatic factors and thermal practices means that thalassotherapy is particularly suitable for treating a wide range of medical conditions including skin problems (such as psoriasis) respiratory problems, immune deficiencies and infantile rickets.

First and foremost, all the methods where thermal treatment is closely combined with physical activity, practised both actively and passively, form part of creno-physio kinestherapy where the aim is rehabilitation or functional re-education, or improvement of muscle tone and breathing ability.

Some of these techniques involve specific applications as is the case with vascular walking where patients walk inside tubs filled with thermal water for a maximum of twenty minutes at a time, often combining this with motor activities and water workouts.

Various massage techniques (massotherapy and pressotherapy) can form part of specific thermal treatment sessions as is the case when massage sessions follow on from the application of mud packs. Massage techniques can also be used for the benefits that they alone produce (general stimulation of the nerve centres, stimulation and relaxation of muscle tone) which help create a state of wellbeing.

Lymphatic drainage, a particular type of massage aimed at rapidly eliminating retained liquids and toxins, can also be performed. In a healthy body, liquids and toxins are eliminated naturally but various types of medical conditions can mean that lymph drainage must be done using external mechanical devices. Computerised lymphatic drainage is often available which allows for physiological drainage without increasing external pressure by using the physical principle of sound resonance. Lymphatic drainage is particularly recommended for all types of swelling (lymphedema) and for the treatment of varicose veins and peripheral vascular problems and cellulite.

A wide range of cosmetic and medical beauty services is also available with specific treatments for the epide rmis and exercise programmes to be done in equipped gyms in order to get back into shape and fight the muscle relaxation which is typical of a sedentary lifestyle.