Indications and contraindications for spa treatment

The Marienbad cure is not a wellness break but a medically supervised course of treatment built on natural healing resources. The overview below sets out which conditions are treated here and the circumstances under which spa treatment cannot be given.

Conditions treated

Oncological diseases

• Oncology cases after the finished complete care, without any signs of relapse

Illnesses of the circulatory system

• Symptomatic ischaemic heart disease
• Condition after myocardial infarction
• Hypertension of II. up to III. level
• Disease of limb arteries based on atherosclerosis II b or inflammation
• Dysfunction of peripheral blood vessels and conditions after thrombosis, at the earliest three months after the acute state subsides
• Chronic lymphatic oedema
• Conditions after reconstructive and bypass surgery of the circulatory system except the heart
• Conditions after percutaneous transluminal angioplasty

Digestive system illnesses

• Chronic and recurring illnesses of the stomach and intestines with maldigestion symptoms persisting during standard pharmacotherapy
• Conditions after heavy intestinal infections, parasitosis and mycotic diseases
• Conditions after stomach, duodenum, oesophagus and intestine surgery with post-resection symptomatology proved by endoscopy
• Crohn’s disease
• Ulcerative colitis
• Chronic diseases of the gall bladder and biliary tract with lithiasis, when surgery is contraindicated
• Sclerosing cholangitis
• Functional disorders of the biliary tract
• Conditions after complicated surgery of the gall bladder and biliary tract, after operations for stenosis and lithiasis of the biliary tract (post-surgical pancreatitis and cholangitis, jaundice, instrumentation of the biliary tract, ERCP)
• Conditions after dissolving stones and extracorporeal lithotripsy
• Conditions after acute hepatitis of any aetiology
• Chronic hepatitis with persisting positive markers
• Associated auto-immune hepatitis
• Primary biliary cirrhosis
• Conditions after resection operations and liver or pancreas transplantation
• Conditions after acute pancreatitis or after exacerbation of chronic pancreatitis
• Proved chronic pancreatitis

Metabolic disorders

• Diabetes mellitus

Non-tuberculous diseases of the respiratory system

• Conditions after surgery of the upper and lower respiratory tract, not concerning conditions after surgery of tonsils, adenoid vegetations and the nasal septum
• Conditions after lung transplantation
• Damage of the larynx and vocal cords due to vocal overload
• Conditions after phonosurgery treatment
• Conditions after complicated pneumonia
• Bronchiectasis
• Recurring inflammations of the lower respiratory tract and chronic inflammations of the respiratory system as an occupational illness according to separate legal enactments
• Asthma bronchiale
• Chronic obstructive pulmonary disease
• Interstitial lung fibrosis of any aetiology under systematic care
• Consequences of toxic gases, smoke, corrosive vapours and irritant dusts to the upper and lower respiratory tract

Nervous system diseases

• Polyneuropathy with paretic symptoms
• Root syndromes with irritation-destructive syndrome
• Conditions after injuries and illnesses of the brain, spinal cord and peripheral nerves with movement disorders showing signs of regeneration
• Neuro-muscular diseases — primary, secondary and degenerative
• Syringomyelia with paretic symptoms
• Parkinson’s disease

Locomotive system disorders

• Rheumatoid arthritis I. to IV. stage including juvenile arthritis, systematically treated within ambulant care
• Ankylosing spondylitis (Bekhterev’s disease) systematically treated within ambulant care
• Other seronegative spondarthritis systematically treated within ambulant care (psoriatic arthritis, Reiter’s syndrome)
• Secondary arthritis systematically treated within ambulant care
• Abarticular rheumatism, systematically treated within ambulant care
• Diffuse disease of connective tissue treated within ambulant care (systemic lupus erythematosus, scleroderma, polymyositis, dermatomyositis, Sjögren’s syndrome and other overlap syndromes)
• Osteoporosis with complications, when systematic ambulant rehabilitation longer than 3 months is ineffective
• Bone changes which are the consequence of working in pressurised air as an occupational illness according to separate legal enactments
• Painful syndromes of tendons, tendinous sheaths, bursae, muscle sinews, skeletal muscles or joints (including illnesses caused by vibrations and long-term, excessive, one-sided overloading as an occupational illness according to separate legal enactments)
• Coxarthrosis, gonarthrosis in systematic ambulant care of an orthopaedist and rehabilitation doctor
• Arthrosis in other locations, arthropathy
• Chronic vertebrogenic algic syndrome of functional origin in systematic ambulant rehabilitation care
• Conditions after orthopaedic surgery with the use of joint replacement
• Conditions after injuries to the locomotive system and after orthopaedic surgery, including conditions after intervertebral disc surgery and stenosis of the spinal channel, when systematic ambulant or in-patient rehabilitation care is ineffective
• Conditions after amputation of a lower limb, degree of activity 1 to 4, where the patient has a prosthetic limb

Kidney and urinary tract diseases

• Recurring and chronic non-tubercular inflammations of the kidney and urinary tract resistant to antibiotic and other pharmacological treatment, in systematic care of a urologist for at least 12 months
• Cystic kidney disease
• Nephrolithiasis without congestion in the urinary tract
• Nephrocalcinosis
• Conditions after kidney and urinary tract surgery including endovesical surgery and conditions after complicated prostatectomy and nephrolithotripsy, after-treatment following extracorporeal shock wave lithotripsy
• Chronic prostatitis or chronic prostatovesiculitis resistant to pharmacological and antibiotic treatment, in systematic care of a urologist for at least 12 months
• Conditions after kidney transplantation with stabilised function of the graft
• Donor of the graft (kidney)

Skin diseases

• Atopic eczema
• Generalised and arthropathic psoriasis vulgaris

General contraindications for spa treatment

Even with an indicated diagnosis, spa treatment cannot be given if any of the following applies. A doctor always makes the final assessment.

1. Infectious diseases transmitted from one person to another and the carrying of bacillus, especially typhoid and paratyphoid. When a disease indicated for spa treatment is associated with tuberculosis of the respiratory system or another form of tuberculosis, spa treatment may be allowed only after the anti-tuberculosis treatment has been completed.
2. All diseases in the acute stage.
3. Clinical signs of circulatory failure, malignant arrhythmias.
4. Conditions after deep thrombosis within 3 months of remission of the disease; superficial thrombophlebitis within 6 weeks of remission.
5. Labile diabetes mellitus (except children and adolescents) and decompensated diabetes mellitus.
6. Recurrent or profuse bleeding of all kinds.
7. Cachexia of any kind.
8. Malignant tumours during and after treatment with clinically detectable signs of continued illness.
9. Epilepsy, except in cases where there have been no attacks in the last 3 years and the EEG does not record epileptic graphoelements. If pathological changes in the EEG recording persist, spa treatment can be offered only with the consent of the neurologist providing the patient’s care.
10. Active attacks or phases of psychosis and mental disorders with antisocial symptoms or reduced communication capability, or transient states of confusion.
11. Alcohol dependence or dependence on addictive substances.
12. Patients dependent on the help of another person for self-care (except for the blind). Admission (usually with a companion) is possible only after prior arrangement with the head physician of the spa.
13. Incontinence of urine and stool, enuresis nocturna.
14. Smoking by adolescents and patients.
15. Pregnancy.
16. Non-healing skin defects of any origin.
17. Hypertension above 16 kPa of diastolic pressure (120 mm Hg).

Before you decide

This overview is for information only and does not replace medical advice. A doctor always decides whether spa treatment is suitable, and in what form and length. If you are paying for the stay yourself, the spa hotel doctors will advise you at the initial examination.

Source: list of indications for Mariánské Lázně, Léčebné lázně Mariánské Lázně a.s., 2025 edition.