Bulletin of Rehabilitation MedicineBulletin of Rehabilitation MedicineВестник восстановительной медицины2078-19622713-2625National Medical Research Center for Rehabilitation and Balneology71368810.38025/2078-1962-2026-25-4-114-122ArticlesСтатьиReview ArticleBalneotherapy and Persian Medicine: a narrative comparative review of concepts, mechanisms, and therapeutic applicationsБальнеотерапия и персидская медицина: нарративный сравнительный обзор концепций, механизмов и терапевтического примененияhttps://orcid.org/0000-0003-3158-1250JaladatAmir M.ДжаладатАмир Мохаммад
Iran, Islamic Republic of

Professor, Research Center for Traditional Medicine and History of Medicine, Department of Persian Medicine, School of Medicine

mehdipasalar@yahoo.comhttps://orcid.org/0000-0003-4301-5918HeydariradGhazalehХейдарирадГазали
Iran, Islamic Republic of

Professor, Traditional Medicine and Materia Medica Research Center and Department of Traditional Medicine, School of Traditional Medicine

mehdipasalar@yahoo.comhttps://orcid.org/0000-0002-3632-9356TavakoliAliТаваколиАли
Iran, Islamic Republic of

Professor, Research Center for Traditional Medicine and History of Medicine, Department of Persian Medicine, School of Medicine

mehdipasalar@yahoo.comhttps://orcid.org/0000-0003-1886-124XMarchenkovaLarisa A.МарченковаЛариса Александровна
Russian Federation

D.Sc. (Med.), Associate Professor, Head of the Office of Scientific Research, Chief Researcher, Unit of Somatic Rehabilitation, Reproductive Health and Active Longevity, Professor at the Department of Restorative Medicine, Physical Therapy and Medical Rehabilitation

mehdipasalar@yahoo.comhttps://orcid.org/0000-0003-2458-2626PasalarMehdiПасаларМехди
Iran, Islamic Republic of

Professor, Traditional, Complementary, and Integrative Medicine Research Network Groups (TCIM-RNG)

mehdipasalar@yahoo.comShiraz University of Medical SciencesШиразский университет медицинских наукShahid Beheshti University of Medical SciencesУниверситет медицинских наук имени Шахида БехештиNational Medical Research Center for Rehabilitation and BalneologyНациональный медицинский исследовательский центр реабилитации и курортологииQatar UniversityКатарский университет250820262541141222406202608072026Copyright ©; 2026, Jaladat A.M., Heydarirad G., Tavakoli A., Marchenkova L.A., Pasalar M.Copyright ©; 2026, Джаладат А.М., Хейдарирад Г., Таваколи А., Марченкова Л.А., Пасалар М.2026Jaladat A.M., Heydarirad G., Tavakoli A., Marchenkova L.A., Pasalar M.Джаладат А.М., Хейдарирад Г., Таваколи А., Марченкова Л.А., Пасалар М.https://creativecommons.org/licenses/by-nc-sa/4.0https://journals.eco-vector.com/2078-1962/article/view/713688

INTRODUCTION. Balneotherapy — defined as the therapeutic use of mineral-rich water, thermal baths, mud, and gases — has been practiced across cultures for centuries. Persian Medicine (PM), a holistic traditional medical system dating back more than a millennium, also incorporates extensive water-based therapies, medicinal clays, and thermal practices.

AIM. To compare balneotherapy with related therapeutic modalities described in classical PM texts, highlighting historical foundations, mechanisms of action, clinical applications, and potential opportunities for integrative research.

MAIN CONTENT OF THE REVIEW. A narrative review was conducted using scholarly databases (PubMed, Scopus, and Google Scholar) and classical PM sources, including works of Avicenna (Ibn Sina), Rhazes (Al-Razi), and Jorjani. Modern clinical evidence on balneotherapy was compared with PM concepts and historical applications. Significant conceptual and practical parallels exist between balneotherapy and PM. Both utilize hot and cold bathing, mineral waters, vapors, and medicinal muds for musculoskeletal disorders, dermatologic conditions, gastrointestinal dysfunctions, and mental well-being. Mechanistic overlaps include hydrostatic pressure, thermoregulation, mineral absorption, detoxification, and modulation of humoral balance (PM theory). PM contributes additional insights related to temperament (Mizaj), organ-specific bath prescriptions, and detailed therapeutic protocols.

CONCLUSION. Balneotherapy and PM share rich therapeutic traditions with considerable conceptual convergence. Bridging these systems through integrative research could expand therapeutic options and support culturally-informed healthcare models. Further comparative clinical and mechanistic studies are recommended.

ВВЕДЕНИЕ. Бальнеотерапия, определяемая как терапевтическое использование богатых минералами вод, термальных ванн, лечебных грязей и газов, практикуется в различных культурах на протяжении веков. Персидская медицина (ПМ) — целостная традиционная медицинская система, история которой насчитывает более тысячелетия, также включает в себя обширные водные процедуры, применение лечебных глин и термальные практики.

ЦЕЛЬ. Сравнить бальнеотерапию со смежными терапевтическими методами, описанными в классических текстах ПМ, уделив особое внимание историческим основам, механизмам действия, клиническому применению и потенциальным возможностям для интегративных исследований.

ОСНОВНОЕ СОДЕРЖАНИЕ ОБЗОРА. Был проведен нарративный обзор с использованием научных баз данных (PubMed, Scopus и Google Scholar) и классических источников по персидской медицине, включая труды Авиценны (Ибн Сины), Разеса (Ар-Рази) и Джурджани. Современные клинические данные о бальнеотерапии были сопоставлены с концепциями и историческим применением в персидской медицине. Между бальнеотерапией и ПМ существуют значительные концептуальные и практические параллели. В обеих системах используются горячие и холодные ванны, минеральные воды, пары и лечебные грязи при заболеваниях опорно-двигательного аппарата, дерматологических патологиях, желудочно-кишечных дисфункциях и для поддержания психического благополучия. Пересечения в механизмах действия включают влияние гидростатического давления, терморегуляцию, абсорбцию минералов, детоксикацию и модуляцию гуморального баланса (согласно теории ПМ). ПМ вносит дополнительный вклад в виде учения о темпераменте (Мизадж), предписаний по ваннам для конкретных органов и подробных терапевтических протоколов.

ЗАКЛЮЧЕНИЕ. Бальнеотерапия и ПМ опираются на богатые терапевтические традиции и имеют значительное концептуальное сходство. Интеграция этих систем посредством совместных исследований может расширить спектр терапевтических возможностей и способствовать развитию моделей здравоохранения, учитывающих культурные особенности. Рекомендуется проведение дальнейших сравнительных клинических и механистических исследований.

balneotherapyPersian Medicinehammam therapypelotherapyAvicennatraditional medicinewater-based therapyбальнеотерапияперсидская медицинахаммам-терапияпелотерапияАвиценнатрадиционная медицинаводная терапияNasermoaddeli A., Kagamimori S. Balneotherapy in medicine: A review. Environmental Health and Preventive Medicine. 2005; 10(4): 171–179. https://doi.org/10.1007/bf02897707Gutenbrunner C., Bender T., Cantista P., Karagülle Z. A proposal for a worldwide definition of health resort medicine, balneology, medical hydrology and climatology. International Journal of Biometeorology. 2010; 54(5): 495–507. https://doi.org/10.1007/s00484-010-0321-5Alipour H., Qaraaty M., Sepehrikia S., et al. A review of old baths and its benefit in maintaining health from the perspective of Persian medicine: Baths from the perspective of Persian medicine. Journal of Current Oncology and Medical Sciences. 2022; 2(3): 284–293.Hossain Hashemi Z., Kasiri M., Montazerghaem A., Zargaran A. Bath, Its Preventive and Therapeutic Approach in Iranian Medicine. Journal for the History of Science. 2019; 17(1): 135–155.Vakilinia S.R., Alizadeh Vaghasloo M., Asghari M. Abzan, a Simple and Effective Method for Prevention and Treatment of Diseases from the Perspective of Iranian Traditional Medicine. Qom University Medical Sciences Journal. 2019; 13(5): 53. https://doi.org/10.29252/qums.13.5.53Protano C., Vitali M., De Giorgi A., et al. Balneotherapy using thermal mineral water baths and dermatological diseases: a systematic review. International Journal of Biometeorology. 2024; 68(6): 1005–1013. https://doi.org/10.1007/s00484-024-02649-xVan Tubergen A., Van Der Linden S. A brief history of spa therapy. Annals of the Rheumatic Diseases. 2002; 61(3): 273–275. https://doi.org/10.1136/ard.61.3.273Hosseinkhani A., Montaseri H., Hosamo A., Zarshenas M.M. An Evidence-Based Review on Medicinal Value of Clays in Traditional Persian Medicine. Current Drug Discovery Technologies. 2017; 14(1): 2–7. https://doi.org/10.2174/1570163813666161007160036Khalilzadeh S., Shirbeigi L., Naghizadeh A., et al. Use of mineral waters in the treatment of psoriasis: Perspectives of Persian and conventional medicine. Dermatologic Therapy. 2019; 32(4): e12969. https://doi.org/10.1111/dth.12969Verhagen A.P., Cardoso J.R., Bierma-Zeinstra S.M. Aquatic exercise & balneotherapy in musculoskeletal conditions. Best Practice & Research Clinical Rheumatology. 2012; 26(3): 335–343. https://doi.org/10.1016/j.berh.2012.05.008Breger Stanton D.E., Lazaro R., Macdermid J.C. A systematic review of the effectiveness of contrast baths. Journal of Hand Therapy. 2009; 22(1): 57–69; quiz 70. https://doi.org/10.1016/j.jht.2008.08.001Rapolienė L., Razbadauskas A., Mockevičienė D., et al. Balneotherapy for musculoskeletal pain: does the mineral content matter? International Journal of Biometeorology. 2020; 64(6): 965–979. https://doi.org/10.1007/s00484-019-01800-3Fraioli A., Mennuni G., Fontana M., et al. Efficacy of Spa Therapy, Mud-Pack Therapy, Balneotherapy, and Mud-Bath Therapy in the Management of Knee Osteoarthritis. A Systematic Review. BioMed Research International. 2018; 2018: 1042576. https://doi.org/10.1155/2018/1042576Morer C., Roques C.F., Françon A., et al. The role of mineral elements and other chemical compounds used in balneology: data from double-blind randomized clinical trials. International Journal of Biometeorology. 2017; 61(12): 2159–2173. https://doi.org/10.1007/s00484-017-1421-2Sina H.A. Al-Qanun fi al-Tibb [The Canon of Medicine]. Alaalami Library; 2005.Kunutsor S.K., Laukkanen T., Laukkanen J.A. Sauna bathing reduces the risk of respiratory diseases: a long-term prospective cohort study. European Journal of Epidemiology. 2017; 32(12): 1107–1111. https://doi.org/10.1007/s10654-017-0311-6Tungsukruthai P., Nootim P., Worakunphanich W., Tabtong N. Efficacy and safety of herbal steam bath in allergic rhinitis: a randomized controlled trial. Journal of Integrative Medicine. 2018; 16(1): 39–44. https://doi.org/10.1016/j.joim.2017.12.010Mahlouji M., Alizadeh Vaghasloo M., Dadmehr M., et al. Sweating as a Preventive Care and Treatment Strategy in Traditional Persian Medicine. Galen Medical Journal. 2020; 9: e2003. https://doi.org/10.31661/gmj.v9i0.2003Protano C., Fontana M., De Giorgi A., et al. Balneotherapy for osteoarthritis: a systematic review. Rheumatology International. 2023; 43(9): 1597–1610. https://doi.org/10.1007/s00296-023-05358-7Roques C.F., Queneau P. [SPA therapy for pain of patients with chronic low back pain, knee osteo-arthritis and fibromyalgia]. Bulletin de l’Academie Nationale de Medecine. 2016; 200(3): 575–586; discussion 586–587.Santos I., Cantista P., Vasconcelos C. Balneotherapy in rheumatoid arthritis-a systematic review. International Journal of Biometeorology. 2016; 60(8): 1287–1301. https://doi.org/10.1007/s00484-015-1108-5Fernandez-Gonzalez M., Fernandez-Lao C., Martin-Martin L., et al. Therapeutic Benefits of Balneotherapy on Quality of Life of Patients with Rheumatoid Arthritis: A Systematic Review. International Journal of Environmental Research and Public Health. 2021; 18(24): 13216. https://doi.org/10.3390/ijerph182413216Bothe G., Coh A., Auinger A. Efficacy and safety of a natural mineral water rich in magnesium and sulphate for bowel function: a double-blind, randomized, placebo-controlled study. European Journal of Nutrition. 2017; 56(2): 491–499. https://doi.org/10.1007/s00394-015-1094-8Dupont C., Constant F., Imbert A., et al. Time to treatment response of a magnesium- and sulphate-rich natural mineral water in functional constipation. Nutrition. 2019; 65: 167–172. https://doi.org/10.1016/j.nut.2019.02.018Anti M., Lippi M.E., Santarelli L., et al. Effects of mineral-water supplementation on gastric emptying of solids in patients with functional dyspepsia assessed with the 13C-octanoic-acid breath test. Hepato-Gastroenterology. 2004; 51(60): 1856–1859.García-López H., García-Giménez M.T., Obrero-Gaitán E., et al. Effectiveness of balneotherapy in reducing pain, disability, and depression in patients with Fibromyalgia syndrome: a systematic review with meta-analysis. International Journal of Biometeorology. 2024; 68(10): 1935–1951. https://doi.org/10.1007/s00484-024-02732-3Tefner I.K., Kovács C., Gaál R., et al. The effect of balneotherapy on chronic shoulder pain. A randomized, controlled, single-blind follow-up trial. A pilot study. Clinical Rheumatology. 2015; 34(6): 1097–1108. https://doi.org/10.1007/s10067-013-2456-3Antonelli M., Donelli D., Fioravanti A. Effects of balneotherapy and spa therapy on quality of life of patients with knee osteoarthritis: a systematic review and meta-analysis. Rheumatology International. 2018; 38(10): 1807–1824. https://doi.org/10.1007/s00296-018-4081-6Montvydaitė-Kreivaitienė O., Kubilius R., Burbulytė A., et al. Comparative efficacy of mineral water and mud therapy vs standard rehabilitative interventions: a systematic review of osteoarthritis studies from 2000. International Journal of Biometeorology. 2025; 69(6): 1181–1206. https://doi.org/10.1007/s00484-025-02889-5Cozzi F., Ciprian L., Carrara M., et al. Balneotherapy in chronic inflammatory rheumatic diseases—a narrative review. International Journal of Biometeorology. 2018; 62(12): 2065–2071. https://doi.org/10.1007/s00484-018-1618-zTafazoli V., Tavakoli A., Mosaffa-Jahromi M., et al. Approach of Persian medicine to health and disease. Note. Advances in Integrative Medicine. 2022; 9(1): 3–8. https://doi.org/10.1016/j.aimed.2021.07.007Razi M.Z. Al-Havi Fi Al-Tibb (Arabic). Dar Al Kotob Al-islmiyah; 2000.Srámek P., Simecková M., Janský L., et al. Human physiological responses to immersion into water of different temperatures. European Journal of Applied Physiology. 2000; 81(5): 436–442. https://doi.org/10.1007/s004210050065Ojima S., Ohishi M. Effects of hot spring bathing on cardiac and vascular function. Hypertension Research. 2023; 46(7): 1705–1706. https://doi.org/10.1038/s41440-023-01290-2Gálvez I., Torres-Piles S., Ortega-Rincón E. Balneotherapy, Immune System, and Stress Response: A Hormetic Strategy? International Journal of Molecular Sciences. 2018; 19(6): 1687. https://doi.org/10.3390/ijms19061687Carter H.H., Spence A.L., Pugh C.J., et al. Cardiovascular responses to water immersion in humans: impact on cerebral perfusion. American Journal of Physiology-Regulatory, Integrative and Comparative Physiology. 2014; 306(9): R636–R640. https://doi.org/10.1152/ajpregu.00516.2013