Jadwiga Kuciel-Lewandowska, Małgorzata Paprocka-Borowicz, Wojciech Laber, Mateusz Kowal, Krzysztof Szarejko, Krzysztof Aleksandrowicz

J. Kuciel-Lewandowska, M. Paprocka-Borowicz, W. Laber, M. Kowal, K. Szarejko, K. Aleksandrowicz – Assessment of the level of anxiety, depression and pain intensity in patients with osteoarthritis of the limbs through spa treatment. FP 2016;16(2);64-72

Abstract
Introduction. Chronic pain as a consequence of osteoarthritis of the limbs  is one of the factors provoking anxiety-depressive disorder. Both pain and the anxiety-depressive disorders are factors mutually escalating, which at the same time significantly restrict the mobility and quality of life. Musculoskeletal system diseases represent a serious therapeutic problem. Chronic condition, the lack of improvement in treatment of negative symptoms and inability to return not only to social life but also to work is also a serious economic problem.
The aim of the study was to evaluate the effect of the spa treatment on the anxiety, depression and the pain perception level in patients with degenerative joint disease and osteoarthritis of the spine.
Materials and  methods. The research was conducted before the introduction of complex therapy and after its completion. The range of observations included:
– Assessing the level of anxiety and depression using a standard Hospital Anxiety and Depression Scale HADS,
– Assessing pain – VAS pain scale,
– medical and socio-demographic history.
The observation comprised 120 patients suffering from osteoarthritis of the limbs in the Przerzeczyn-Zdroj spa. The study also included  observation of the control group consisting of 21-persons treated on an outpatient basis. During the 21-day stays at the spa there were physical treatments, physiotherapy and natural healing materials used such as peloid mud and medicinal radon-sulphide water. Patients treated in the Rehabilitation Clinic did not undergo balneotherapy.
Results. As a result of the spa therapy and treatments performed on an outpatient basis the levels of anxiety and  depression were lowered whereas the pain intensity level was decreased.
Conclusions. 1. Spa treatment and the treatment conducted on an outpatient basis, lowers the level of pain, anxiety and depression in patients with osteoarthritis of the limbs.
2. As a result of the research it was found that more effective, in terms of reducing the level of pain, anxiety and depression, was the treatment carried out at the spa.

Key words:
osteoarthritis of the limbs, anxiety, depression, spa therapy, HADS scale and VAS