09 October 2025
The 10 thermal water treatments recognized by the National Health Service and when to choose them
Spa therapies represent one of the oldest forms of natural medicine, now fully integrated into the Italian healthcare system. The National Health Service (SSN) officially recognizes a series of spa treatments with proven therapeutic efficacy for chronic or recurring conditions, which can be prescribed by a general practitioner or a specialist and carried out in affiliated thermal centers.
The spa approach is based on the rational use of natural mineral waters, muds, and thermal gases for preventive, curative, and rehabilitative purposes. Depending on the chemical composition of the water and the type of disorder, it is possible to identify the most suitable treatment to achieve lasting clinical benefits.
How the SSN Coverage Works
The process is simple: the doctor issues a medical prescription (the so-called “red prescription”) indicating the diagnosis and the type of treatment. Each citizen is entitled to one cycle of spa therapy per year, consisting of 12 consecutive sessions, paying only the co-payment fee unless exempt.
Treatments are carried out in affiliated thermal centers under the supervision of qualified healthcare professionals, who monitor the clinical response and adapt the therapy to individual needs.
SSN-Recognized Spa Treatments
This is one of the best-known and most widely used spa treatments. Thermal mud, enriched with mineral substances, is applied at a controlled temperature (around 47°C) to relieve joint pain and inflammation.
It is indicated for osteoarthritis, rheumatism, tendinitis, and chronic musculoskeletal pain. The combined action of heat and minerals stimulates circulation and promotes the release of natural endorphins, producing analgesic and relaxing effects.
Thermal muds also have a powerful beneficial effect on the abdomen and liver. This treatment can relieve abdominal pain, bloating, and a feeling of heaviness. In fact, hepatic mud applications induce an extended state of relaxation, improving both physical and mental well-being.
Immersion in thermal mineral water, at temperatures between 35°C and 37°C, helps reactivate microcirculation and reduce inflammatory states. It is useful for rheumatic disorders, venous insufficiency, and post-traumatic rehabilitation. Some waters, such as sulfurous or salt-bromine-iodine types, also have beneficial effects on the skin.
Thermal inhalations and aerosols use microscopic particles of mineral water to reach the respiratory mucosa. They are recommended for rhinitis, sinusitis, chronic bronchitis, and pharyngolaryngitis. The combined action of heat and minerals decongests, fluidifies, and regenerates the airways.
This lesser-known but highly effective therapy is used for Eustachian tube dysfunctions and certain forms of chronic otitis. The controlled introduction of thermal gas into the middle ear restores ventilation and reduces inflammation, improving hearing function.
5. Hydropinic Treatments (Drinking Cure)
Drinking thermal water is not just a ritual—it is a true metabolic treatment. Sulphate, bicarbonate, or oligomineral waters act on the digestive, hepatic, and urinary systems. They are prescribed for biliary disorders, dyspepsia, irritable bowel syndrome, and recurrent kidney stones. The doctor determines the quantity and frequency according to the water’s composition and the clinical condition.
Thermal waters with antiseptic or salt-bromine-iodine composition are used for chronic gynecological disorders such as recurrent vaginitis or post-surgical inflammatory states. Local irrigation stimulates microcirculation and promotes mucosal regeneration, restoring balance and comfort.
Psoriasis, atopic dermatitis, chronic eczema, and acne benefit from the soothing and anti-inflammatory action of thermal waters, particularly sulfurous ones. Thermal baths and compresses act on the stratum corneum, improving hydration and modulating the local immune response.
Walking through pools with alternating temperatures stimulates vascular tone and reduces the feeling of heaviness in the legs. This treatment, useful in cases of chronic venous insufficiency or capillary fragility, is a gentle form of vascular exercise with tangible benefits for circulation.
The vascular hydro-path alternates immersion in pools at different temperatures to stimulate blood and lymphatic circulation. This treatment tones the blood vessels, reduces water retention, and improves overall leg wellness.
9. Urinary Treatments
In some spa resorts, the hydropinic therapy is also used preventively for kidney stones, recurrent urinary infections, and mild renal metabolic dysfunctions. Oligomineral waters promote diuresis and prevent the formation of urinary crystals.
10. Integrated ENT Treatments
These combine aerosols, insufflations, and nebulizations for a synergistic effect on the mucous membranes of the nose, throat, and ear. They are indicated for those suffering from chronic sinusitis or otitis who wish to reduce recurrence frequency through a natural yet effective therapy.
How to Choose the Right Treatment
Selecting the most suitable treatment always depends on a careful medical evaluation. Spa medicine is not a generic practice—each water has a specific chemical composition and therefore a distinct therapeutic action. Chronic conditions in a stable (non-acute) phase derive the greatest benefit. It is also important to consider any comorbidities, as certain spa therapies are contraindicated in cases of cardiovascular or acute inflammatory disorders.
The ideal approach combines spa therapy with physiotherapy, rehabilitation, or pharmacological treatment, in a vision of integrated medicine aimed at functional recovery and the patient’s overall well-being.
Conclusions
Modern spa medicine is science, not mere wellness. Each treatment recognized by the SSN has a solid clinical foundation and a clear objective: to prevent, relieve, and rehabilitate.
Choosing the right spa treatment, in agreement with your doctor, means investing in a natural yet scientifically validated therapeutic path—where water, the primordial element, once again becomes medicine.
