Physical Therapy in Pápa & Thermal Bath Culture

I have suffered from back issues for a while now, and have been seeing various professionals for help (athletic trainer, chiropractor, physical therapist, reflexologist, osteopath, etc) for my entire adulthood. Alignment seems to be my main problem, and when I’m off, it affects my lower back, neck area, and can even cause pain in my hips and knees. As a former athlete and very active person, it is frustrating to be slowed down by these problems, so I was very relieved when I was able to get connected with the local “physiotherapist” here in Pápa for treatment. I had heard about the unique water therapies available and was excited to check it out! Before this I had gone on my own to random professionals in the area (massage, reflexology, osteopath, chiropractor) but it was getting expensive. Luckily, physical therapy through the thermal baths is covered by our insurance! I thought my friends in the PT field would appreciate hearing these interesting new perspectives.

Thermal Bath Culture

Széchyeni Thermal Bath in Budapest is the largest in Europe!

The Várkertfürdő is the thermal bath, spa, and wellness center in Pápa. There is nothing quite like it in America, but I would compare it to a large pool complex or water park combined with a physical therapy center and spa. These facilities are very popular in this part of Europe, as soaking in thermal waters has been a part of Eastern European wellness culture for centuries, dating back to ancient Roman times. Hungary in particular is famous for their “furdos,” or baths, and they boast some of the oldest and largest in Europe. They are so popular that there are eleven furdos in Budapest alone! Most thermals are made into pool complexes, but Hungary also has the largest thermal lake in the world that is available for swimming, Lake Heviz.

Heviz Thermal Lake, Hungary

The thermal baths and thermal lake are open year-around. The common factor, of course, is varying degrees of warm mineral water for soaking. Components of the thermal water include sulfate, calcium, magnesium, bicarbonate and a significant amount of metaboric acid and fluoride. The combination hot and cold treatments are renowned for relieving muscular aches and pains, detoxing skin, improving body metabolism and increasing circulation. When my parents visited and we went to a thermal, they were struck by two things – the amount of elderly people there and the amount of people just sitting. “It is so different in America! Everyone would be splashing around at a pool,” they commented. It is true, we are used to very different experiences at pools. In the states, pools are a place of learning to swim, cooling off, and splashing around. People are rarely just sitting, and it is also more commonly a place for children and families. In contrast, thermal pools are mostly welcoming to children and families (although some have rules) but unless they have waterslides and wave pools in the outside section, they’re more likely frequented by adults and the elderly as part of social and physical health routines.

This wellness culture helps elderly people stay in strong physical condition. It is common to see very old men and women riding bicycles from place to place, and sometimes balancing an umbrella on their bike in the rain! They also walk everywhere, which keeps them healthy too. It is worth noting that it is very reasonable to visit these thermal baths, and unless you’re going to the famous or fancy ones, you can expect to spend between $5-$10 for a visit.

The Wellness Centers

Just soaking wasn’t going to be enough for what ailed me. So, I headed over to the “Medicine” side of the furdo for a consultation with the physiotherapist (doctor) at the wellness center. He looked at my MRIs, asked me a bunch of questions and set me up with a series of treatments. Some of them looked familiar (stim, massage) and others sounded unique and brand new to me! I was assigned to three areas: water therapy, massage, and electrical.

Hydrotherapy

Water therapy consists of a variety of treatments, many of which (including hot or cold soaks, jet massages) are also available in the states. There are many different ailments these water therapies can support or treat, including sore muscles and joints, poor circulation, and post operative recovery. They also have carbonated water treatments for heart health and steam or “inhalation” therapies to help with lung issues!

In a traction bath, weights are attached to the waist or ankles and gently stretch out the spine as you are suspended in water.

Traction Bath. The unique treatment I was assigned to is called an “underwater traction bath.” In this unique treatment developed here in Hungary, the patient is suspended in water by their armpits or head with special pads, while weighted down either on their waist or ankles. For me the therapist wrapped ankle weights on and I waded into water up to my shoulders, allowing my feet to dangle into deep water as I held myself up by my armpits (not by my neck like the photo, but this is possible too). It was an interesting feeling as the weights pulled down on my legs and stretched out my spine – almost like an inversion but without the rush of blood to the head! For 20 minutes I was still, allowing the therapy to work, and although my arms began to tingle, the stretching felt quite nice!

Massage

From there I was sent to a 30 minute massage. This was a targeted deep muscle massage that focused mostly on either side of my spine, scapula and neck/shoulder area. It was fantastic! For all the massages I have had since moving here (sorry not sorry – they’re a quarter of the price!) this was the most therapeutic and actually helped me with my issues. I was very impressed! In fact, I would probably go even if it was just for the massage.

Electric

From there I went to the “Electrical” section of the Medical/Wellness center and realized I was scheduled for four treatments: “phototherapy,” electrical stim, ultrasound, and vacuum stim. The phototherapy was first, applied with a small wand (similar to ultrasound but without gel and no rubbing – just holding it there) around my knee, and I felt nothing. I heard a buzzing sound but I’m not exactly sure what it was meant to do. When I asked, my therapist said “helps with pain.” Ok, we will see! This lasted around 3 or 4 minutes.

Ultrasound machine.

Next up was ultrasound. I have had ultrasound treatments long ago with college basketball injuries and remember it being quite helpful. They used this mostly on my neck, and it was as great as I remembered – a perfect combo treatment for the massage. I was sitting upright the whole time, and it lasted about 10 minutes.

After the ultrasound we moved to electrical stim for my lower back. Again, this is a familiar treatment for me as I had stim throughout my basketball career and with various injuries after. Little sticky pads were secured to my back as they turned up the current and it pulsed for about 12 minutes. It was turned up enough to feel prickly but not painful. This was also relaxing as I could be lying down on a table.

Vacuum stim machine

Finally came another new therapy for me, a suction/vacuum cup and electrical stim combo. This “vacuum stim” felt very nice, and I think I preferred it to regular stim. Four cups were placed on my back in strategic places and the stim current was turned up (again, so you feel it but it shouldn’t be painful). It pulsed for another 12 minutes as I was able to relax on the table. It reminded me a little bit of “cupping,” and now I want to try that, too!

movement

This combination of therapies is extensive and takes me around 2 hours to get through. So far it’s hard to tell how much they will help me, especially as there is no adjustment/chiropractic component, but I appreciate the attention to my back and neck muscles for sure. In comparison to my experience with PT in the states, services here focus a lot more on body treatments than training. Back home, half of my PT sessions involved learning and performing exercises for movement, flexibility and strengthening. I notice there are water exercise and movement classes in the facility here as well, but I don’t think I was assigned this due to the language barrier. I will have to rely on the exercises I learned back home to help supplement my treatment here. I’m very curious what my Physical Therapist friends would think of these unique therapies!

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