Thermal Bath houses or Spas in Germany promote wellness, healing and entertainment
Thermal bathing facilities have natural, mostly mineralized groundwater with a source temperature of over 20°C or 68°F is used. These thermal waters can come from a natural source (Aachen), or have been developed through a deep well, about 1000 meters as in Bad Füssing.
The Johannesbad in Bad Füssing is the largest of all three Thermal Springs in town. I walked by, there were Tourist busses outside, and seemed already crowded. I retrieved a brochure, it says it has 4500 square meters of water and 13 pools with temperatures of 27 to 39 °C (80°F to 102°F).
The brochure says that the Johannesbad practice the holistic approach for wellbeing and a therapeutic approach with massage and/or therapeutic thermal baths. They have five saunas and lots of place to sit and lay down, inside and out.
The thermal water has a relaxing effect on the muscles, stimulates the circulation and relieves with its mineral components chronic diseases of the joints, also rheumatism or allergies.
Thermal baths are used for therapeutic purposes and are often associated with spa facilities. Swimming pools with different temperature levels, brine baths, sauna areas with several saunas and steam baths and massage treatments can be part of a thermal bath.
The groundwaters with at least temperature of over 20°C or 68°F are referred to as thermal water according to the definitions of the German Spa Association. The vast majority of thermal waters contain numerous dissolved salts, often carbonic acid and in some cases radioactive constituents. Carbonated thermal waters contain at least 1000 mg of free dissolved carbon dioxide.
Depending on the chemical composition of the thermal waters, the mineralized waters are referred as mineral thermal waters, with the differentiation into major and minor constituents. For example, the Aachen thermal water is defined as fluoride- and sulfur-containing sodium chloride bicarbonate thermal water.
In accordance with the legal regulations for pool water designed for swimming, the natural thermal water must normally be treated before it can be discharged into the public bathing areas.
The therapeutic effect (head-above water immersion) of the thermal water is mainly due to the hydrostasis, that is on the all-round hydrostatic pressure in the water and the temperature of the water. The physiological effects of hydrostatic pressure include improvement of venous function, like tissue drainage and activation of metabolism and the kidney.
The positive effect of warm water causes, for example muscle relaxation, joint relief, edema reduction, suppression of stress hormones and blood flow increase. Thus, a number of indications, such as arthritis, edema, diseases of the rheumatic type, hypertension and psychosomatic disorders can be positively influenced.
The German public health insurance provides a “Kur” under two conditions: either for recovery from illness (rehabilitation), short Rehab or prevention. A common case is the so-called “follow-up rehabilitation”. It is designed to help the patient to recover quickly after treatment in the hospital and to continue living independently.
For this reason, cures are often prescribed after heart attacks or similarly serious illnesses and are paid for in their entirety, including accommodation and supplements. However, a cure can be approved even if there was no prior hospitalization. Because cures should help to control disease and to avoid aggravation. It was just thought of older people, because they should not come too early in adult care facilities, but live as long as possible in their own four walls.
If the doctor proves that a Kur/cure serves these purposes, the health insurance will probably approve the application. However, they have the right to examine the individual case and to see what kind of service is actually medically necessary. Especially with the assumption of costs of accommodation and food, most funds will be approved rather strictly.
Above: Kurhaus in Wiesbaden, the oldest Kurort or Spa town in Germany. Photo by Von Pedelecs by Wikivoyage and Wikipedia
First and foremost, rehabilitation should be carried out on an outpatient basis – for example in a rehabilitation center near the place of residence. In some cases the health insurance will probably decide that a cure is helpful, but it does not necessarily and needs to be done “stationary”.
There are preventive cures, distinguished from rehab cures. These are aimed at people who have a disease risk that can be reduced by the treatment. However, the health insurance company also decides if it is medically justified – the costs for accommodation and meals.
It looks better for parents. Since April 2007, the health insurance pays them a stationary mother-child or father-child Kur or cure. Again, the cure must be medically necessary.
In Germany, the Rottaler Bäderdreieck, with its three spas Bad Füssing, Bad Griesbach and Bad Birnbach, is the largest provider of cures and overnight stays. In Southern Bavaria too, numerous new spas have sprung up in recent decades. The best known are in Berchtesgaden, Bad Reichenhall, Bad Endorf, Bad Aibling and Erding.
In Europe, the most famous spas are found in Italy, the Pannonian Basin, the Egergraben and the Rheingraben. In Japan and Taiwan, thermal baths have a long tradition. In recent decades, many new spas have sprung up in the so-called Thermenregion Oststeiermark, Burgenland and West Hungary as well as in the Podhale region at the foot of the High Tatras. The largest spa resort in the world is the Hungarian capital of Budapest with more than 21 public, some up to 450 years old Thermal baths.