Introduction to Hydrotherapy
Having completed this lesson, you will be able to:
- Define the term hydrotherapy.
- List two characteristics of water that make it useful as a therapeutic modality (e.g., stores and transmits heat, good conductor, changes states over a narrow temperature range, effective cooling agent, etc.).
The term hydrotherapy originates in two Greek words, hydro, meaning water, and therapeia, meaning therapy. Stedman’s Medical Dictionary for Health Professions and Nursing defines hydrotherapy as the “external application of water as a liquid, solid, or vapor for therapeutic purposes.”1
The use of water for healing dates back before recorded history, and many cultures around the globe have traditions that include hydrotherapy. North American Indian tribes, for example, used a special hut or a covered sweat lodge built partly into the ground. Large stones were heated in a fire and taken inside the hut where they were sprinkled with water to warm the air, causing the body to perspire as a means of purification. There is evidence that every major U.S. hot spring was used at some point by an Indian tribe.2 Native Americans considered hot springs to be sacred, neutral ground. Warriors could rest by hot springs to heal battle wounds without worry of attack from another tribe.
Early civilizations often had a version of the spa bath, which combined some form of social interaction with cleanliness. The hamam (bath) became popular in Islamic countries around 600 AD after Muhammad recommended sweat baths for spiritual cleanliness. Later, hamams became central to the community both as a place of spiritual retreat and for socializing with friends. Bathers would stop first at the camekan, a small court of changing cubicles surrounding a fountain, before entering the hararat (hot marble baths). Bathers would receive a vigorous massage or kese (exfoliation with a rough cloth) on a raised marble platform above the wood or coal furnaces used to heat the hararat.3
As mentioned briefly in Chapter 15 (Spa Therapies and Other Approaches), the baths of the Roman Empire are probably the most famous in history. The central role of public baths in Roman culture led to a well-developed understanding of hydrotherapy, and garrisons were often built around hot springs so that the soldiers could heal their battle wounds. By 43 AD the Roman public viewed the baths as a way to relax and maintain health, and by the early fifth century A.D. Rome alone had 900 baths.
The medical benefits of hydrotherapy were advanced in Europe by two natural healers who developed their methods in the early 1800s. Many of these methods are still used today as part of hydrotherapy. The first was the Austrian Vincent Priessnitz (1699-1852), who promoted “the cold water cure.” This “cure” consisted of drinking large amounts of cold water, bathing in cold water, a simple diet, and physical activity in the open air. Priessnitz used the cold water cure to care for a personal injury that doctors of the time thought untreatable. In 1826 Priessnitz opened a water cure establishment at Grafenberg in the mountains of Silesia, where his ideas were adopted by many prominent physicians.4
The second natural healer was Father Sebastian Kneipp (1824-1897), a Bavarian priest who cured himself of pulmonary tuberculosis by bathing in the icy Danube and “shocking” his body into health. In one of his many books, My Water-Cure (1894), Kneipp writes, “Being a priest, the salvation of immortal souls is the first object for which I wish to live and die. During the last 30 or 40 years, however, the care for mortal bodies has absorbed a considerable portion of my time and strength.” Instead of administering last rites to the gravely ill, he used water and herbs to cure them. Kneipp’s healing system, which combined physical exercise, simple food, hydrotherapy, and herbs, forms the basis of modern naturopathy. He is well known for the “wet-nightshirt” treatment that involved wearing a shirt that had been dipped into water with salt or hay flower. He also introduced classic methods of friction like salt glows and body wraps, which are widely used today in spas.5
Today, hydrotherapy applications are used successfully to treat a broad range of conditions and are particularly useful for musculoskeletal problems. Modern research proves what people throughout the ages have always known: water has healing characteristics that change the way we feel mentally, emotionally, and spiritually.
<cb16-1> Concept Brief 16-1: Hydrotherapy History
Therapeutic Characteristics of Water
Water is a unique substance that covers more than 70% of the earth’s surface and provides the natural beauty of oceans, rivers, rain, waterfalls, and snow. The human body is 55-60% water, and tissues like lean muscle (75%), blood (95%) and bone (22%) contain significant amounts of water. Water also has a number of characteristics that make it useful as a therapeutic application. Water is versatile and changes forms, dissolves other therapeutic substances, exerts hydrostatic pressure, causes buoyancy, and absorbs and transfers hot and cold temperatures.
Water Is Versatile and Changes Forms
Water is a liquid that can easily be changed into ice or vapor. It is therapeutically useful in all of these forms. As a liquid, water is applied in baths and showers or used to heat special packs, called hydrocollator packs, that bring moist heat directly to a specific body area. Ice packs and ice massage cool heated tissue and reduce inflammation, while saunas and steam-rooms utilize water in a vaporized form to promote perspiration and detoxification.
Water Dissolves Other Therapeutic Substances
Water is known as the “universal solvent” because it dissolves so many other substances. Many of the known elements found on earth are dissolved in seas and lakes. For example, people all over the world have noticed that they feel revitalized from a day at the beach and swimming in the ocean, where seaweeds and minerals dissolve in the water making it a rich, therapeutic soup. Many different substances can be dissolved from a solid to a liquid form for absorption through the skin. Substances like clay, minerals, powdered seaweed, ground oatmeal, and a variety of herbs are routinely dissolved in water and applied to the body in baths and body wraps as part of hydrotherapy.
Water Exerts Hydrostatic Pressure
Hydrostatic pressure is a term that refers to the amount of pressure exerted by a liquid, in this case water, when the liquid is at rest. In other words, water has weight. If you have swum underwater, you have probably noticed that the deeper you go, the more pressure you feel in your ears from the accumulated weight of the water above you. If you stand neck deep in water, there is greater hydrostatic pressure on the lower part of your body (deeper) than on your upper body. Hydrostatic pressure pushes blood and fluid from the lower body into the thorax. This characteristic of water has been used effectively to treat edema in the extremities caused by many different conditions. Pregnant women who exercise in water find that hydrostatic pressure reduces lower leg edema, decreases the occurrence of varicose veins, improves general blood circulation, and stabilizes blood pressure.6
Water Causes Buoyancy
Buoyancy refers to floating in water. When you enter a swimming pool, you displace water and there is an upward thrust of water that lifts you. This is why you feel weightless when you swim. The water you displaced supports the weight of your body. Exercising in water reduces the stress on joints, tendons, and bone that would occur with the impact of the body moving on a hard surface. People who have arthritis, are elderly, or have recently undergone surgery for a musculoskeletal condition benefit from movement in a buoyant environment.
Water Absorbs Hot and Cold Temperatures
Water can be heated or cooled to specific temperatures for therapeutic application to the body. Topic 16-2 will describe the effects of hot and cold temperatures on the structures and function of the body. As you can probably imagine, hot applications increase local blood circulation, warm soft-tissue structures, relax tense muscles, and soften muscle tissue. Cold applications decrease local blood flow to an area and increase muscle tone.
Water Transfers Hot and Cold Temperatures
Water effectively transfers hot and cold temperatures to the body in two different ways. When heated or cooled water makes contact with your body, it transfers the warmth or coolness to your body through conduction (the transfer of hot or cold temperatures through direct contact). Water is more effective at transferring hot or cold temperatures than is air, which is why moist heat feels hotter than dry heat.
Convection is the process by which hot or cold temperatures are transferred via air or gas. For example, it feels colder when the wind is blowing (wind chill) than if the air is still. Saunas are an example of the transfer of temperatures via air; water poured over hot rocks turns quickly into a vapor, which evaporates into the air and warms it.
These general characteristics of water help lay the foundation for better understanding the mechanisms by which hydrotherapy is effective in the following topics.
<cb16-2> Concept Brief 16-2: Therapeutic Characteristics of Water