Hydrotherapy can refer to any treatment that uses water. Several types of hydrotherapy are used in pain management. 

Hydrotherapy performed in pools or tanks allows patients to exercise with less stress on their joints. In other situations, warm or pulsating water may relieve pain by massaging the body, relaxing tight muscles and increasing circulation. This can help relieve conditions including back pain, other joint pain, arthritis, fibromyalgia or spasticity following spinal cord injuries. Hydrotherapy is also used for wound care.

Hydrotherapy can be performed with swimming pools, whirlpools, showers, saunas, compresses, foot baths, body wraps, immersion tanks and other techniques. It often employs heat (thermotherapy), cold (cryotherapy) or both.

Though hydrotherapy is beneficial for treating many disorders, there are conditions and situations where it is not recommended. Patients should consult their physician before beginning hydrotherapy.

Hydrotherapy is treatment using water to relieve pain or help wounds heal. Swimming pools, whirlpools and Hubbard tanks (tanks that allow patients to immerse their entire body in water) are all used to perform hydrotherapy. Benefits of hydrotherapy may include:

• Decreased pain and stiffness
• Increased muscle relaxation
• Greater ease when performing exercises and daily activities
• Increased healing

Hydrotherapy is often used in arthritis patients to help them exercise joints. The buoyancy of the water counteracts the effects of gravity, allowing patients to exercise with less stress on their joints. Exercise is important for patients with arthritis, because it helps them to retain their maximal range of motion and strength in joints, tendons, ligaments and muscles.

Hydrotherapy is also used to reduce the pain that some patients feel. The water may be heated or cooled to relieve painful acute or chronic conditions such as back pain, neck pain, other joint pain, arthritis, fibromyalgia or spasticity following spinal cord injuries. It can help maintain joint mobility in diseases that restrict range of motion, such as muscular dystrophy.

Physical therapists and other health professionals use hydrotherapy to help wounds heal. Whirlpool treatments assist in debridement (removal of dead tissue and foreign matter).

Though hydrotherapy is beneficial to treating many conditions, there are conditions and situations where it is not advised. For example, people with open wounds may be referred to whirlpool therapy for wound care, but instructed not to use swimming pools. Patients should always consult with their physician before beginning any hydrotherapy treatment plan.

Holistic and alternative health facilities and spas promote many forms of hydrotherapy, such as damp body wraps and facial douches. Such techniques are sometimes advertised as complementary and alternative treatments for everything from varicose veins to migraines, often without scientific backing. Colon hydrotherapy (also known as a high colonic, high enema or colonic irrigation) has been marketed as a treatment for many conditions. However, organizations such as the American Cancer Society caution that colon hydrotherapy is not supported by scientific evidence and can pose dangers such as spreading infections. 

There are many types of hydrotherapy. They include:

• Pool. Swimming pools can be used to perform pain–relieving therapy. Therapy in a pool – which may or may not involve swimming – is beneficial to many patients because the buoyancy of water supports the body’s weight and removes the effects of gravity. This allows patients suffering from pain to perform low–impact exercises that are less stressful to the joints of the spine, legs and feet.

The support of the water also allows patients to move through their full range of motion more easily. At the same time, the water provides resistance that can help build strength and endurance.

A physician may recommend aquatic exercise therapy for patients who cannot tolerate high-impact activities. Research has shown that water aerobics can also relieve back pain and pelvic pain in pregnant women.

• Hubbard tank. These allow patients to immerse their entire body in water. Convection heating may be used to increase water temperature, facilitating range-of-motion exercises and easing conditions such as arm pain, shoulder pain, leg pain or back pain. Heating can cause blood vessels to dilate, increasing circulation. Therapy in a Hubbard tank can be particularly useful for burn patients, because temperature can be regulated and electrolytes can be added to the water.
  
  
• Whirlpool. This form of therapy involves heated, churning water that can help ease muscle sprains, chronic spinal conditions and wound debridement (excision of dead, devitalized or contaminated tissue). Jet nozzles in whirlpools release a mixture of warm water and air that massages the body and helps relax tight muscles.
  
  
• Sitz bath. The individual sits in a small tub with water covering the hips. Sitz baths may be advised for conditions such as lumbar pain, pelvic pain, prostatitis or testicular/scrotal pain.
  
  
• Saunas and steam baths. A physician may recommend these to ease conditions such as back strain or to relieve stress.
  
  
• Damp hot packs or cold packs. These types of thermotherapy and cryotherapy may be part of a physical therapy treatment plan. Moist compresses can be applied at home to ease conditions including migraines, facial pain and herniated discs. 

Some patients can obtain the benefits of water therapy at home by installing a pool or spa or using less expensive techniques, such as foot baths and damp compresses. However, home treatments must be performed correctly to be safe and effective. Patients must be sure that home pools can be entered and exited safely, and that thermometers are available to accurately measure water temperature. Patients should consult with their physician about details such as proper water temperature, suggested exercise routines and length of treatment sessions.

Hydrotherapy is generally safe when conducted under the supervision or guidance of a physician, but it does carry some risks: 

• Pool. In some cases, an inappropriate water temperature may produce unwanted effects in the body. Patients who are unable to swim need to wear a life vest or other flotation device (or receive supervision) to avoid the potential for drowning. Pool therapy should not be undertaken by patients who have bowel or bladder incontinence, open wounds or sensitivity to certain chemicals.

In addition, exercise performed in a pool is not weight-bearing. This means that patients who exercise in pools are not building bone mass, which is critical to helping protect against conditions such as osteoporosis, a bone-thinning disorder that is most common in women after menopause.

• Hubbard tank, whirlpool and sitz bath. Inappropriate water temperature can cause unwanted side effects in the body. For example, too much time spent in hot water can increase blood pressure. In addition, researchers have found that many recreational whirlpools have bacteria that can cause conditions such as urinary tract infections, skin infections and pneumonia.
  
  
• Sauna and steam bath. Use can be dangerous or inappropriate for many individuals, such as those with heart conditions, impaired circulation or sensation (e.g., from diabetes), acute rheumatoid arthritis, acute infections or sexually transmitted diseases.
  
  
• Damp hot packs. Improper use can cause burns.

Preparing questions in advance can help patients have more meaningful discussions with their physicians regarding their conditions. Patients may wish to ask their doctor the following questions about hydrotherapy:

1. How can hydrotherapy help relieve my pain?
   
   
2. Do you recommend hydrotherapy for me?
   
   
3. Which types of hydrotherapy can help me?
   
   
4. Are there any types of hydrotherapy that can harm me?
   
   
5. Where will my treatments take place?
   
   
6. I’m concerned about infections. What sort of tank disinfecting and water testing is performed at this facility to ensure cleanliness?
   
   
7. What will my treatment involve? Will it include exercises?
   
   
8. How often will I be treated and for how long?
   
   
9. Do any of my conditions rule out any forms of hydrotherapy?
   
   
10. Can I safely perform hydrotherapy at home? What types of home hydrotherapy do you recommend?
    
    
11. Does hydrotherapy pose any risks for me?