In my opinion, it's worth it! Remember that an active fermentation produces heat itself, and the warmer the fermentation, the faster it goes. The faster it goes, the warmer it gets. I've seen some active fermentations go 10 degrees above ambient- which means a "steady 70 degree room" may have an 80 degree fermentation! That's beyond too hot.
A "cooler" fermentation is slower and steadier usually, and less explosive. Yeast love those hot temperatures, but it doesn't produce the best beer. The best temperatures for fermentation tend to be on the lower end of the yeast strain's optimum fermentation temperature (found on the yeast manufacturer's website). For nottingham dry yeast, it's great at 60 degrees but pretty foul at 72. For Wyeast 1056, 64-68 is perfect. Generally speaking, an ale at under 68 degrees provides the best flavor.
A water bath really doesn't cause temperature spikes. Remember that it takes a long time for 5 gallons of beer to change temperature and that water is a great insulator. I use maybe 5 gallons of water in my water bath, so there is a total of about 10 gallons of liquid. Dropping a frozen water bottle or two in there every day, and floating a thermometer in there, shows me that it's a very slow change to warm up or cool down.
I have pictures in my gallery of my igloo cooler waterbath set up, if you'd like to look.