Spa treatment by condition
Spa treatment for polyneuropathy
When the nerves in the feet and hands no longer send accurate signals and strength declines, every step becomes a task requiring concentration. The Czech indication list places polyneuropathy with paretic symptoms among the nervous system diseases. In Marienbad, the focus is on what can be trained: gait, standing stability and strength.
What is treated here
- Polyneuropathy with paretic symptoms, that is, with a demonstrable loss of strength
- Diabetic polyneuropathy where diabetes is well controlled
- Polyneuropathy after chemotherapy, once oncological treatment has been completed
- Unsteady gait and standing instability caused by a lack of feedback from the feet
- Muscle wasting and declining stamina from protective inactivity
How the cure works
Initial examination on arrival day
The spa physician takes the neurological findings, checks strength, sensation and reflexes, and examines the feet — open areas or pressure damage also determine which treatments are possible. Bring your neurologist's findings and, if you have diabetes, your current lab results.
First week: standing safely
The focus is on standing stability and gait. Practice takes place with visual control and on different surfaces, because the feedback from the feet is missing and has to be replaced through the eyes and hips.
Second week: strength and endurance
Targeted strengthening of the weakened muscles, walking distances outdoors, and exercises in water, where buoyancy allows movements that would feel unsteady on dry land. Massage is added for any accompanying tension.
Final examination and a plan for home
Strength, gait and standing stability are assessed again and recorded. You receive an exercise programme along with guidance on daily foot checks, since a lack of sensation can hide small injuries.
Treatments used
- Individual physiotherapy
- Daily, building up the weakened muscles and practising a safe rolling motion of the foot when walking.
- Gait and balance training
- Standing stability on varying surfaces and walking with visual control, to compensate for the missing feedback from the feet.
- Exercise therapy in the pool
- In warm water, strength and gait can be practised without fear of falling, because buoyancy supports the body's weight.
- Carbon dioxide bath in mineral water
- A bath at around 34°C; the carbon dioxide absorbed from the mineral water promotes skin blood flow.
- Dry gas bath in Mariengas
- The natural carbon dioxide of the Marien Spring is applied without water and without the strain of heat — suitable when warm baths are not an option.
- Classic massage
- For the accompanying tension that develops from protective posture and unsteady gait.
- Climate therapy and guided walks
- Walking distances outdoors under guidance, with length increasing cautiously according to stamina.
How long, and when
Polyneuropathy with paretic symptoms is position VI/2 on the Czech indication list. For stays covered by Czech public health insurance, the initial stay provides for 28 days of comprehensive spa care or 21 days of contributory care; a repeat stay runs to 28 days of comprehensive or 21 days of contributory care, 14 in certain cases. Self-paying guests agree the length with the spa physician; the professional minimum is at least 10 treatments over at least 10 days. There is no medical requirement for the season, though where sensation in the feet is impaired, paths free of snow and ice are safer.
Experience and research under way
With polyneuropathy the cure aims at what can be trained: gait, standing stability and strength. These building blocks have long been prescribed in Marienbad, put together according to the neurological findings and from clinical experience. How the individual guest fares is not left unchecked: every treatment stay begins with an initial and ends with a final medical examination and a written final report, so the course is documented and the spa physician can adjust the plan along the way. Systematic evidence for spa medicine as a field is being built for the first time in a long while. The Institute of Spa Medicine and Balneology (Institut lázeňství a balneologie, v.v.i.), founded by the Karlovy Vary Region in 2019, has been running the first clinical study of this format in thirty years since 2026, together with Léčebné lázně Mariánské Lázně. It covers urological and nephrological diagnoses rather than the one described on this page: more than a hundred patients are examined before and after the spa stay for health status and quality of life, with prim. MUDr. Ladislav Špišák, CSc. as professional guarantor, and results are not yet available. The study runs within the Spa Research Centre project (2024 to 2027), funded by the Just Transition Operational Programme and working with the Czech Technical University, the University of West Bohemia and the Czech Academy of Sciences. What such work can produce is shown by the same institute’s earlier collaboration with the Marienbad spa houses: their joint study of spa rehabilitation after COVID-19 received the European Spas Association Innovation Award in 2021 in the Medical Spa Scientific Research category.
When a spa cure is not an option
- Polyneuropathy without paretic symptoms — the position on the indication list requires paretic symptoms
- Unassessed nerve disorder without a neurological work-up
- Unhealed wounds or ulcers on the feet, for example in diabetic foot syndrome
- Ongoing oncological treatment; a spa cure is possible once it is completed
- Acute illness, pregnancy, epilepsy, and an inability to manage personal care independently
Whether a spa cure is appropriate for your polyneuropathy is decided by the spa physician at the initial examination, based on the neurological findings and the condition of your feet. The stay supplements treatment of the underlying condition — such as diabetes management — and does not replace it. This page provides information and does not replace medical advice.
Frequently asked questions
Is a spa cure for polyneuropathy covered?
The Czech indication list lists polyneuropathy with paretic symptoms as position VI/2: for people insured with a Czech health fund, the initial stay provides for 28 days of comprehensive spa care or 21 days of contributory care. The key qualifier is 'with paretic symptoms' — a loss of strength must be documented. Guests insured outside the Czech Republic should clarify cost coverage with their own insurer in advance.
What does spa treatment for polyneuropathy involve?
The focus is on what can be trained: gait, standing stability and strength in the affected muscles. In addition there is exercise therapy in warm water, carbon dioxide baths or dry gas baths from the local natural remedies, massage against the accompanying tension, and guided walking outdoors. The spa physician puts the plan together after the initial examination.
Does the cure help with polyneuropathy after chemotherapy?
A spa cure is possible once oncological treatment is complete and you are in remission; it is excluded during ongoing cancer treatment. The same things are then treated as in other forms: gait, standing stability and strength. For aftercare following cancer treatment as a whole, Marienbad has a dedicated programme.
What do I need to know if I have diabetes?
Bring your current lab results and your medication; the spa physician bases the plan on them. Daily foot checks matter: where sensation is missing, pressure spots and small injuries can go unnoticed. Open areas on the foot rule out a number of treatments, which is why the feet are examined at the initial examination.
Does the cure heal the nerves?
No. There is no robust evidence for such an effect in polyneuropathy, so this page makes no such claim. What the cure can change is how you cope with the consequences: gait stability, strength in the affected muscles and stamina in everyday life. Treatment of the underlying condition continues unchanged.
Sources
Studies and official documents this article relies on. Our content does not replace medical advice.
- Clinical study of the objective effects of comprehensive spa care in kidney and urological conditions (NCT07435844) — Ongoing study by the Institute of Spa Medicine and Balneology with Léčebné lázně Mariánské Lázně, more than a hundred patients, started 2026. It covers urological and nephrological diagnoses; results are not yet available.
- Czech indication list for spa treatment (Decree No. 2/2015 Coll.), Group VI — position VI/2 — Polyneuropathy with paretic symptoms: initial stay 28 days of comprehensive or 21 days of contributory care; repeat stay 28 days of comprehensive or 21 days of contributory care (14 in certain cases).
- Decree No. 2/2015 Coll. on the professional criteria for spa medical rehabilitation care — Group VI — Full text of the indication list for nervous system diseases, including contraindications and required initial examinations. Czech-language text.
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