Hydrotherapy and Arthritis
An Information Sheet
What is hydrotherapy, and how does it differ from swimming?
Swimming itself has many health benefits. It is enjoyable and it particularly helps people with arthritis and other musculoskeletal disorders because the water supports their joints while they are exercising. Some swimming pools reserve special entry times for people with joint problems.
Hydrotherapy is the use of water in the treatment of a range of conditions, including arthritis and other musculoskeletal disorders. Hydrotherapy differs from swimming because it involves special exercises which take place in a warm-water pool, usually within a hospital physiotherapy department. The water temperature is usually 33–37ºC, which is warmer than normal swimming pools.
People who might benefit from hydrotherapy are referred by their doctor or rheumatology nurse specialist to a physiotherapist, who then decides if hydrotherapy is a suitable treatment. Not all physiotherapy departments have a hydrotherapy pool, so you may have to travel to another hospital for treatment.
What are the benefits of hydrotherapy?
The warm temperature of the water allows your muscles to relax and eases the pain in your joints. This makes it easier to exercise.
The water supports your weight. This helps to relieve pain in your joints and can also increase the range of movement of your joints. By pushing your arms and legs against the water you can also improve your muscle strength.
Who benefits most from hydrotherapy?
Usually people who have arthritis in several joints find most benefit from hydrotherapy. This is because all the joints can be exercised easily in the warm supportive water. Hydrotherapy also helps people who feel pain when walking, since the water provides extra support.
Hydrotherapy is sometimes used after joint replacement surgery and for people with back pain or ankylosing spondylitis.
What happens on my first appointment?
You will be seen by a physiotherapist, either in the physiotherapy department or on the hospital ward.
The physiotherapist will ask you about your general health and about your arthritis and the problems resulting from it. Using this information and the information provided by the doctor, the physiotherapist will then decide whether hydrotherapy is appropriate for you. The initial meeting will take approximately 30–45 minutes. If a course of hydrotherapy is agreed, you will probably have five or six sessions of about 30 minutes each. You might not go in the water on your first appointment.
What will I need?
You will usually need to take your own swimming costume and towel.
What if I can't swim?
You do not have to be able to swim to have hydrotherapy. The pool is quite shallow, so you can exercise well within your depth. Buoyancy aids are also available, and there will always be a physiotherapist in the pool and an assistant on the side of the pool. Even if you are worried about water, you should try hydrotherapy if it has been recommended by your physiotherapist. Most people find the warm water very soothing and enjoyable.
How do I get into the pool?
To get into the pool you need to climb down a few steps. For people who cannot manage steps there will be a mechanical hoist to lower you into the water. Most pools have different depths, varying from waist height to chest height. There is also a rail around the edge of the pool for extra support.
What happens at the end of a course of hydrotherapy?
Exercise helps almost all forms of arthritis, so after your course of hydrotherapy you will probably be advised to continue your exercises in your local swimming pool. It is worth investigating your local facilities, as some swimming pools have special sessions when the water temperature may be increased. Some sports centres may organise classes for exercise in water. You should speak to your physiotherapist or doctor before joining these. In some areas local arthritis support groups (such as Arthritis Care and the National Ankylosing Spondylitis Society) may hire a hospital pool or health-club pool for regular hydrotherapy sessions.
Gentle swimming might also help, but again speak to a health professional first.
What are the side-effects of hydrotherapy?
Hydrotherapy is one of the safest treatments for arthritis and back pain. The warmth of the water and the exercise may make you feel tired after treatment. This is normal.
When is hydrotherapy not appropriate?
With certain medical conditions hydrotherapy may not be suitable. These include:
- wound or skin infections
- viruses/stomach upset
- a raised temperature
- high or low blood pressure
- severe breathing difficulties
- people on renal dialysis programmes
- angina/heart problems
- incontinence
- chest infections
You must tell the physiotherapist if you have any of the above conditions. If you have any questions or doubts you should also discuss these with your physiotherapist. If you feel unwell on the day of your hydrotherapy appointment you should contact the physiotherapy or hydrotherapy department.
What is spa therapy?
A spa is a place where the local spring water is said to have special health-giving properties. Some people believe that the mineral content of the spa water gives it advantages over tap water for bathing and (in some cases) for drinking. Hydrotherapy in spa water, or spa therapy, is commonly used in mainland Europe. One reason it is so popular there is the many naturally-occurring hot springs found in Germany, Poland, Hungary, Switzerland and Italy.
Some recent research from Israel supports the suggestion that the mineral content of spa water does make a difference. However, research from Bath in the UK suggests that hydrotherapy using just ordinary tap water will have significant benefits.
Where can I get further information?
For more information on hydrotherapy contact:
The Chartered Society of Physiotherapy
14 Bedford Row, London WC1R 4ED.
Phone: 020 7306 6666. www.csp.org.uk.
For self-help support and an information/counselling service contact:
Arthritis Care
18 Stephenson Way, London NW1 2HD. Phone: 020 7380 6500.
Helpline (freephone): 0808 800 4050. www.arthritiscare.org.uk.
National Ankylosing Spondylitis Society (NASS)
Unit 0.2, One Victoria Villas, Richmond, Surrey TW9 2GW.
Phone: 020 8948 9117. www.nass.co.uk.
