Background/Purpose: To determine whether spa therapy has a beneficial effect on pain and disability in the management of shoulder pain due to chronic rotator cuff lesions.

Methods: This multicentre randomized prospective clinical trial included patients with chronic shoulder pain due to rotator cuff tendinopathy who were attending French spa resorts as outpatients between March 2009 and April 2010. Subjects were randomized into two groups: spa therapy (18 days of standardized treatment) and control (spa therapy delayed for six months). All patients continued usual treatments during the 6-month follow-up period. The main endpoint was the mean change in the DASH score at six months. The effect size (ES) of spa therapy was calculated and the proportion of patients reaching minimal clinically important improvement (MCII) was compared between groups. Secondary endpoints were the mean change in SF-36 components, treatments use, and tolerance.

Results: 186 patients were included in the study (94 controls and 92 in the spa therapy group) and analyzed by intention to treat. At six months, the mean change in the DASH was statistically significantly greater among spa therapy patients than controls (-32.6% and -8.15%, respectively (p<0.001)) with an ES at 1.32 (95%CI: -1.68;-0.97). A significantly greater proportion of spa therapy patients reached MCII (59.3% versus 17.9%). Spa therapy was well tolerated, with a significant impact on SF-36 components but not on drug consumption.

Conclusion: Spa therapy provides a highly statistically significant beneficial effect on pain and function in patients with chronic shoulder pain after 6 months compared with usual treatment alone.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/spa-therapy-in-the-treatment-of-chronic-shoulder-pain-due-to-rotator-cuff-tendinopathy-rotatherm-a-large-randomized-multicentre-trial/