 Rheumatic diseases are associated with frailty, which can be managed through the use of spa treatments. Spa treatments have been shown to reduce pain, improve function, and manage comorbidities in rheumatic diseases. They also modulate the MAPK-slash-ERK pathway and the NFKB pathways, leading to reduced levels of pro-inflammatory molecules. Furthermore, spa treatments may provide resources to reduce risk factors, such as drug consumption, inactivity, and disease severity. Research should focus on exploring new approaches, such as exercise training and early diagnosis, to further optimize the management of frailty in rheumatic patients in the spa setting. This article was authored by Maria Chiara Macaron, Anna Scanu, Daniele Carracci, and others.