Balneology in Europe has a long tradition. The therapeutic effects of water or steam baths have been used in almost all its territory since early times, first as a purely empiric exercise but in our times with a remarkable progress on its scientific basis. Depending of geographic or cultural circumstances hydrotherapeutic modalities developed in different ways. However the contribution of the Greek Medicine for its roots and of the Roman Empire for the spread of its use must be enhanced.   During the two last centuries we assisted of a growing interest and knowledge of the properties and therapeutic principles of balneology and their action mechanisms, including: physical (hydrostatic, hydrodynamic, thermal), chemical, biologic and psychological factors.   Currently European Balneology progresses remarkably. European Medical professionals aimed several goals to build this progress. Among them we may refer: the establishment of principles and definitions; a manual of good practice; the development of research; the improvement of education on this field; the awareness of public authorities and of the population.   We may say that in the last ten years we really got significant achievements.   We managed to create new cooperation opportunities by the creation of a Balneology Group within the UEMS (European Union of Specialist Doctors) that is also working together with the ISMH. We start several studies trying to know the different realities of Balneology in our European countries. We are also working on the consensus for a common lexicon and taxonomy in Balneology. Some important papers on this were already published and accepted by ISMH leaders. We also assist of the publication of a significant number of scientific studies, namely randomized controlled trials. Many of them with high quality standards.   Nevertheless the difficulties research is in fact improving. We should mention and praise the financial support of institutions specifically created to sponsor scientific studies on the thermal field, like for instance the French “AFreth” or the Italian “FoRST”.   Balneology Education needs to be better standardised in European terms so that we may built a common curriculum and walk towards an European Medical Board that could among other tasks to be able to certify Specialized Doctors on Balneology.   Balneology has a wide scope of interventions which include prevention, treatment and rehabilitation of a large number of health conditions.   We hope that its progress may benefit a greater number of people. Europe should contribute to this important goal.

  Rheumatoid arthritis (RA) is a chronic, systemic, inflammatory disorder of unknown etiology. It is characterized by symmetric, polyarticular pain, swelling, morning stiffness, and fatigue. RA has a variable course, often with periods of exacerbations and, less frequently, true remissions. Outcomes are also variable, ranging from the rarely seen remitting disease to severe disease that brings disability and in some patients premature death. Without treatment, the majority of patients will experience progressive joint damage and, in some patients, this results in significant disability within just a few years. Improvement in health related quality of life is one of the most important goals in the management of rheumatoid arthritis and therefore must be pursued as a crucial aim in clinical practice. This paper draws from 49 qualitative interviews conducted with RA patients, before starting a program of Spa Therapy and aims to get an overview of their main RA related difficulties, worries, and overall understanding of quality of life. Information on the patients’ physical function was also obtained by means of the Stanford Health Assessment Questionnaire Disability Index (HAQ). Patients present a mean HAQ score of 1.42 (SD=0.69). Main findings from the interviews highlight the importance given to being autonomous and feeling independent and healthy. In addition, underlying psychological problems (e.g. depressive signs; coping with progressive dependence) and concerns with social relationships (e.g. perceived support, loneliness) emerged as significant facets of living with the disease. Despite different treatments, RA still has many deleterious consequences which from the patients’ perspective include, among other, persistent pain, functional disability, fatigue, and depression. Along with treating RA signs and associated medical evolution, medical staff should consider and deeply understand the patients’ needs, expectations and main perceived determinants of their quality of life.