Types and Benefits of Hydrotherapy

15 Water-Based Therapies Used in Traditional and Alternative Medicine

Woman taking a bath

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Hydrotherapy is the use of water, both internally and externally and at varying temperatures, for health purposes. Also known as water therapy or "water cures," hydrotherapy includes such therapeutic treatments as saunas, steam baths, foot baths, contrast therapy, sitz baths, and colonic cleansing.

Although some forms of hydrotherapy are commonly used in traditional medical practices, there are some hydrotherapy procedures that are not supported by science and border on pseudoscience.

History of Hydrotherapy

From Roman baths to hot mineral springs, cultures around the world have used water for centuries to treat a variety of health concerns.

Father Sebastian Kneipp, a 19th-century Bavarian monk, is widely regarded as the father of modern hydrotherapy. Kneipp's use of alternating hot and cold water, called contrast hydrotherapy, is still used today.

During the same period, Vincent Preissnitz founded the first hydrotherapy clinic in Gräfenberg, Germany as part of a larger naturalism movement, which involved eating only coarse foods and copious amounts of water.

Soon after, hydrotherapy and the naturalism craze spread to the United States, where John Harvey Kellogg of Kellogg's cereal fame aimed to scientifically prove its benefits at Battle Creek Sanitarium in Michigan. Kellogg had a special fascination with colonic cleansing.

Hydrotherapy is popular in Europe, Asia, and parts of the United States (including Saratoga Springs in New York where Franklin Delana Roosevelt often frequented), where people regularly "take the waters" at hot mineral springs.

Principles

According to proponents of hydrotherapy, hot and cold water induce physiologic changes that are beneficial to human health. Among them:

  • Hot water causes superficial blood vessels to dilate, activating sweat glands, loosening joints, and removing toxic wastes from tissues.
  • Cold water causes superficial blood vessels to constrict, moving blood flow away from an affected area to relieve inflammation.

Immersing the body in water is said to relieve joint pain and muscle injury by counteracting gravity and reducing pressure on a joint or the body as a whole.

There are different appliances used to deliver hydrotherapy, including full-body immersion tanks, body-specific tubs, whirlpool baths, and cold and hot water wraps (compresses).

Types

Hydrotherapy is often performed at health centers, spas, and physical therapy clinics and even at home. Common types of hydrotherapy include:

  • Aquatic exercises: Exercising in a pool of warm or cool water allows you to exercise with less resistance and pressure on joints. It can be helpful for people back pain, arthritis, obesity, advanced age, or physical disability.
  • Balneotherapy: Soaking in mineral-rich waters or natural mineral hot springs are thought to have curative benefits. Known as balneotherapy, the practice is said to treat arthritis, low back pain, immune dysfunction, and fibromyalgia, among others.
  • Colonic hydrotherapy: Also known as colonic cleansing or irrigation, the practice involves rinsing feces from the colon, which proponents claim can help clear toxins and improve health.
  • Compresses: This form of hydrotherapy involves wrapping towels soaked in warm or cool water on a body part to increase circulation or reduce inflammation. Aromatics are often added to the wraps for various therapeutic purposes.
  • Contrast hydrotherapy: Also known as water circuit therapy, it involves alternating immersion in hot and cold water to treat chronic pain or promote lymphatic drainage (thereby removing toxins from the immune system).
  • Floatation tanks: Also known as isolation tanks or immersion tanks, the practice involves floating atop a shallow pool of saltwater in a sealed, darkened tank. Doing so is said to relieve stress and anxiety, improve sleep, and relax muscles.
  • Foot baths: Soaking your feet can reduce swelling and pain after a long day on one's feet. But, it can also be used to soften tissues before a spa foot treatment. Some people even claim that food baths can balance circulation and decrease congestion in the head, lungs, and pelvic organs.
  • Hot fomentation: The application of warm compresses or hot water bottles to the chest is said to relieve acute symptoms of a cold or bronchitis.
  • Ice bath: Popular among athletes, ice baths involve soaking in a tub of water between 45 F and 65 F to speed recovery from an injury or extreme exercise. Also known as cold water immersion, ice baths have increasingly been replaced by cryotherapy, which exposes the body to short bursts of air as cold as -280 F.
  • Sauna: A sauna is a form of hydrotherapy in which dry, warm air induces sweating to release toxins, burn calories, relax muscles, and improve skin quality.
  • Sitz bath: A sitz bath involves sitting a tub of water to treat conditions affecting the anal, rectal, or genital areas. Sitz baths are commonly used for hemorrhoids, premenstrual syndrome (PMS), and anal fissures.
  • Steam baths: Steam baths involve rooms filled with warm, humid aid that proponents claim can amplify the benefits of a sauna. Turkish baths are a form of steam bathing that employs higher humidity and lower temperatures.
  • Therapeutic baths: Therapeutic baths involve soaking in a tub of warm water to treat skin conditions, joint problems, or emotional stress. Additives are commonly used, including Epsom salt, aromatherapy oils, dead sea salts, and herbs. Mud baths are a form of therapeutic bathing.
  • Watsu: This is an alternative massage technique (coined from words "water" and "shiatsu") in which a therapist performs massage while you float comfortably in a pool of warm water.
  • Whirlpool hydrotherapy: Rather than immersing a limb or body in still water, a whirlpool is said to offer additional benefits, including increased circulation and improved tissue repair after a burn, ulcer, or other skin injuries.

Clinical Evidence

Although many of the health claims of hydrotherapy are unsupported (and several are far-fetched), other forms of are supported by a larger body of research. This is particularly true with respect to conditions like arthritis and the use of hydrotherapy among sports therapists.

Osteoarthritis

In a study published in Clinical Rehabilitation in 2018, researchers compared the effectiveness of twice-weekly aquatic exercise sessions to once-weekly group education in people with knee osteoarthritis. After eight weeks, people who engaged in aquatic exercises had reduced pain and improve joint function compared to those who managed their condition but didn't engage in hydrotherapy.

According to a 2016 review published in the Cochrane Database of Systematic Reviews, aquatic exercise may improve pain, disability, and quality of life in people with knee or hip osteoarthritis, but the benefits are usually short-lived.

Rheumatoid Arthritis

In people with rheumatoid arthritis, hydrotherapy may improve outcomes when used in combination with prescribed medications, according to a 2017 study in the International Journal of Rheumatic Diseases.

For this study, half of the participants received hydrotherapy with rheumatoid arthritis medications, while the other half were treated with medications alone. After 12 weeks, the group receiving hydrotherapy had increases antioxidant levels and decreased oxidative stress, suggesting that the progression of the disease had been slowed.

Sports Recovery

Cold water immersion and contrast water therapy may improve recovery following sports and extreme physical activity, suggests a 2017 review of studies in the Journal of Strength and Conditioning Research.

According to the research, cold water immersion improves recovery in athletes after 24 hours as measured by sprint times and jump performance. Similarly, athletes who underwent contrast water therapy experienced better recovery after 48 hours compared to those who didn't.

However, neither form of hydrotherapy improved the perception of recovery among athletes, meaning that the symptoms reported were more or less the same.

Precautions

Hydrotherapy may not be appropriate for everyone. Exposure to sudden cold or prolonged heat can have adverse effects on the cardiovascular system. Prolonged soaking can lead to skin maceration and infection.

Similarly, colonic cleansing can disrupt the normal bacterial flora in the lower intestine as well as the balance of electrolytes in the body if overused.

Hydrotherapy may need to be avoided or used with caution in people with the following health conditions:

  • Cardiovascular disease
  • High blood pressure
  • Colds, flu, or other respiratory infections
  • High fever
  • Incontinence
  • Kidney disease
  • Thrombosis
  • Skin infections
  • Cancer
  • Pregnancy

Always check with your health care provider before using any form of hydrotherapy.

A Word From Verywell

Hydrotherapy is a broad category of therapeutic techniques, some of which are a part of the modern medical lexicon and others that are not. Do not be swayed by anyone who claims that hydrotherapy can "cure" a disease or condition.

Hydrotherapy can sometimes be therapeutic, but it has never be considered a cure for any medical condition and should not be used as a substitute for standard medical care.

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