Balneotherapy, Immune System, and Stress Response: A Hormetic Strategy?

Int J Mol Sci. 2018 Jun 6;19(6):1687. doi: 10.3390/ijms19061687.


Balneotherapy is a clinically effective complementary approach in the treatment of low-grade inflammation- and stress-related pathologies. The biological mechanisms by which immersion in mineral-medicinal water and the application of mud alleviate symptoms of several pathologies are still not completely understood, but it is known that neuroendocrine and immunological responses—including both humoral and cell-mediated immunity—to balneotherapy are involved in these mechanisms of effectiveness; leading to anti-inflammatory, analgesic, antioxidant, chondroprotective, and anabolic effects together with neuroendocrine-immune regulation in different conditions. Hormesis can play a critical role in all these biological effects and mechanisms of effectiveness. The hormetic effects of balneotherapy can be related to non-specific factors such as heat—which induces the heat shock response, and therefore the synthesis and release of heat shock proteins—and also to specific biochemical components such as hydrogen sulfide (H₂S) in sulfurous water and radon in radioactive water. Results from several investigations suggest that the beneficial effects of balneotherapy and hydrotherapy are consistent with the concept of hormesis, and thus support a role for hormesis in hydrothermal treatments.

Keywords: heat shock proteins; hormesis; hydrotherapy; immune response; inflammation; mud therapy; oxidative stress; pain; rheumatic diseases; spa therapy.

Publication types

  • Review

MeSH terms

  • Animals
  • Balneology / methods*
  • Hormesis
  • Humans
  • Hydrotherapy / methods
  • Immunity*
  • Stress, Physiological*
  • Treatment Outcome