Spa treatment by condition
Spa treatment for respiratory conditions
Chronic respiratory conditions such as asthma, COPD or recurrent bronchitis form their own indication group in Marienbad. The cure draws on inhalations from the carbon-dioxide-rich Forest Spring, breathing therapy and a climate officially recognised as therapeutic since 2023, at around 630 metres of altitude.
What is treated here
- Bronchial asthma and chronic obstructive pulmonary disease (COPD) (position V/5 of the indication list)
- Bronchiectasis and recurrent inflammation of the lower respiratory tract, including as a recognised occupational disease (V/4)
- Interstitial lung fibrosis of any cause under ongoing treatment (V/6)
- Allergic rhinitis and chronic inflammation of the upper respiratory tract
- Conditions after pneumonia, including the after-effects of COVID-19
How the cure works
Initial examination on arrival day
The spa physician reviews lung function findings and medication and puts together the treatment plan. Bring recent findings from your pulmonologist or family doctor, plus a list of your medication.
Two to three treatments daily
Mornings bring inhalation from the Forest Spring and breathing therapy, supplemented by carbon dioxide baths or gas injections as prescribed. Rest lying down follows every treatment.
Climate therapy and terrain cure
Guided walks on the historical network of promenades in the submontane climate, with pace and gradient matched to your fitness. Walking in fresh air is part of the treatment, not a leisure activity.
Weekly check-up and final report
The physician checks your respiratory findings and function weekly and adjusts inhalations and exercises. At the end you receive a report for your own doctor and a home breathing exercise programme.
Treatments used
- Mineral-water inhalation from the Forest Spring
- Finely misted water moistens the mucous membranes and is traditionally used to loosen phlegm; usually two treatments daily.
- Breathing therapy
- Individually and in groups with physiotherapists: prolonged exhalation, diaphragmatic breathing, coughing technique — the part of the cure you carry on using for good.
- Carbon dioxide bath
- CO₂ absorbed through the skin widens the small vessels and increases skin blood flow; a supplementary treatment for respiratory diagnoses.
- Dry gas bath and gas injections
- CO₂ from the local Maria’s gas with no circulatory strain from water, for when a full bath would be too demanding.
- Climate therapy and terrain cure
- Guided walking in the officially recognised therapeutic valley basin; guided walking has been studied in COPD as training that improves quality of life and walking endurance.
- Drinking cure
- A supplement depending on diagnosis; which spring, amount and timing apply is set individually by the doctor.
- Supplementary treatments
- Massage, a salt cave or relaxation techniques depending on findings, for breathlessness and tension.
How long, and when
For asthma and COPD (position V/5), stays covered by Czech public health insurance run to 28 days of comprehensive or 21 days of contributory spa care; for bronchiectasis and recurrent inflammation of the lower respiratory tract (V/4) it is 21 days with the option to repeat, and for interstitial lung fibrosis (V/6) 28 days of comprehensive or 21 days of contributory spa care. Self-paying guests usually choose two to three weeks in consultation with the spa physician. There is no medical rule for the season, though autumn is considered especially suitable because of falling pollen levels and as preparation for the heating season.
What the studies show
A systematic review of 27 studies on inhaling mineral waters describes better nasal patency and mucociliary transport, but points to the low quality and heterogeneity of the studies (Fontana et al., 2025, Int J Biometeorol). A further systematic review on asthma and COPD finds improved lung function in asthma (Calzetta et al., 2024, J Clin Med; the number of high-quality randomised trials is limited). For exercise in water in COPD, a narrative review describes the evidence as strong, and for sulphur inhalations it describes better mucociliary clearance (Khaltaev et al., 2020, J Thorac Dis). A Hungarian before-after study without a control group in 678 patients with asthma or COPD recorded, after a three-week programme with daily outdoor breathing therapy, a rise in mean FEV1 from 71.0% to 77.7% of predicted; the influence of the climate cannot be separated from training and supervision in it (Müller et al., 2018, Eur J Integr Med). Guided walking itself is documented in COPD by a multicentre randomised trial of 143 patients: it improved quality of life and walking endurance after 8 to 10 weeks compared with usual care — but in an outpatient programme, not a spa stay (Wootton et al., 2014, Eur Respir J). None of the studies shows a change in the course of asthma or COPD itself.
Experience and research under way
Inhalations from the Forest Spring, breathing therapy and climate therapy have been part of the programme for respiratory conditions in Marienbad for generations; since 2023 the town has been recognised as a climatic spa by decision of the Ministry of Health. 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
- Acute infectious respiratory disease and an acute worsening (exacerbation) in an active stage
- Active cancer with clinically detectable signs of persisting or progressing disease
- Uncompensated heart failure or marked circulatory weakness
- Pregnancy, or an inability to manage personal care without a companion
Whether and to what extent a spa cure is right for you is decided by the spa physician at the initial examination, based on your lung function findings. This page provides information and does not replace medical advice.
Frequently asked questions
Where should I go for spa treatment for respiratory conditions?
Marienbad is listed as a spa town for the official indication group V — non-tuberculous diseases of the respiratory organs. The basis is the carbon-dioxide- and bicarbonate-rich Forest Spring for inhalation, natural carbon dioxide for gas baths, and a climate officially recognised as therapeutic since 2023, at around 630 metres of altitude.
Does a spa cure help with asthma or COPD?
Asthma and COPD (position V/5) is a covered indication. A systematic review describes improved lung function in asthma and mixed results in COPD, with overall few high-quality studies; guided walking is documented as training in COPD by a randomised trial. The cure does not replace prescribed medication.
What does inhaling mineral water achieve?
Finely misted water from the Forest Spring moistens the mucous membranes and is traditionally used to loosen phlegm. A systematic review of 27 studies describes better nasal patency and mucociliary transport afterwards, but points to the low quality of the underlying studies.
Why is autumn especially suitable for this cure?
Pollen levels fall markedly in autumn, while the heating season begins, which further dries out the upper respiratory tract. Two to three weeks in moist, cool forest air with daily inhalation are therefore considered good preparation for winter.
How long does a spa cure for respiratory conditions last?
For asthma and COPD, stays covered by Czech public health insurance run to 28 days of comprehensive or 21 days of contributory spa care, and 21 days for bronchiectasis. Self-paying guests usually choose two to three weeks; the first noticeable relief typically comes during the first week.
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 V — non-tuberculous diseases of the respiratory organs — Positions V/4–V/6 with type of care and length (e.g. V/5 asthma/COPD: K 28 or P 21; V/4 bronchiectasis: K 21).
- Official tourism portal of the town of Mariánské Lázně — Forest Spring (Lesní pramen) — Water analysis (free CO₂ 2,960 mg/l, bicarbonate 1,352 mg/l, sodium 549 mg/l); traditional use for inhalation and the drinking cure.
- Fontana M et al. 2025, Int J Biometeorol — systematic review of 27 studies on inhaling mineral waters — Better nasal patency, mucociliary transport and some lung parameters. Low quality and heterogeneity of the studies.
- Calzetta L et al. 2024, J Clin Med — systematic review on balneotherapy in asthma and COPD — Improved lung function in asthma, mixed results in COPD; few high-quality randomised trials.
- Khaltaev N et al. 2020, J Thorac Dis — narrative review on balneotherapy in chronic respiratory disease — Exercise in water in COPD has strong evidence; sulphur inhalations improve mucociliary clearance. Narrative review.
- Müller A et al. 2018, Eur J Integr Med — before-after study, 678 patients with asthma and COPD, three-week climate programme — FEV1 rose from 71.0% to 77.7% of predicted. No control group; influence of climate not separable from training and supervision.
- Wootton SL et al. 2014, Eur Respir J — multicentre randomised trial, 143 patients with COPD — Guided walking 2–3 times weekly over 8–10 weeks improved quality of life and walking endurance. Outpatient programme, not a spa stay.
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