Opportunities for therapy of musculoskeletal diseases through balneotherapy and SPA tourism.

This article aims to review the possibilities and existing recommendations for the application of balneotherapy and SPA therapy in musculoskeletal diseases (MSDs), as well as the possibilities for their integration into the health and tourism sector. The recommendations of the international medical community place balneotherapy alongside physiotherapy as an important element in the treatment of patients with inflammatory and degenerative joint diseases. The article showed clear data that a number of studies prove a significant reduction in pain, improvement in functional capacity and quality of life in osteoarthritis, fibromyalgia and other conditions. Favorable biological effects on cortisol levels and inflammatory markers are also observed. European comparative analyses emphasize the social importance of balneotherapy, related to access, financing and health policy. In Bulgaria, there is a wide network of specialized medical and sanatorium facilities, supported by the Ministry of Health and the National Social Insurance Institute.