In France, balneotherapy is a medical treatment prescribed and supervised by doctors and reimbursed by the Social Security. In 2013, 540,000 patients were treated in the 105 french balneotherapy care facilities. Some patients were treated for two conditions. The cares are delivered for 18 successive days to patients with rheumatisms (83%), respiratory and ENT conditions (17%), venous conditions (17%), metabolic conditions (8%), other conditions (dermatological problems, stress related disorders, neurological disorders) (10%). The average cost of a balneotherapy treatment (cares, doctor’s fees, accomodation, transport) is 1600 €; of which 500€ are reimbursed by the Social Security. Balneotherapy represents 0.13% of the total health expenses of France. 110,000 persons have an employ directly or indirectly related to balneotherapy. The teaching of balneotherapy is organized in the second cycle of the medical studies with a specific item of the national programme dedicated to the prescription of a balneotherapy treatment and 27 items of particular clinical situations offering the oportunity to prescribe balneotherapy. A two years post-graduate training for balneotherapy specialists (Capacité d’Hydrologie) is delivered by 4 universities (Toulouse, Montpellier, Grenoble, Nancy). Scientific research in balneotherapy is related with several academic (Paris, Bordeaux, Toulouse, Grenoble, Nancy) or private (Aix les Bains, Saujon) bodies. The creation of the AFRETH (french association for thermal research) by the balneotherapy contractors’ union and the mayors of the thermal resorts, in 2004, with a yearly funding of 1 million €, gave an impulse to clinical investigation. 11 Millions € have been engaged in 38 programmes validated by the scientific committee out of the 108 projects submitted after the 10 calls. 16 papers have been published in english speaking journals with impact factor. Several large randomized clinical trials have been implemented demonstrating the actual medical benefit of balneotherapy ; they concern knee-osteoarthritis, overweight and obesity, anxiety generalised disorder, women treated for breast cancer, chronic venous insufficiency..
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