Hydrotherapy

Hydrotherapy, formerly called hydropathy and also called water cure, is a branch of alternative medicine (particularly naturopathy), occupational therapy, and physiotherapy, that involves the use of water for pain relief and treatment. The term encompasses a broad range of approaches and therapeutic methods that take advantage of the physical properties of water, such as temperature and pressure, to stimulate blood circulation and treat the symptoms of certain diseases. Various therapies used in the present-day hydrotherapy employ water jets, underwater massage and mineral baths (e.g. balneotherapy, Iodine-Grine therapy, Kneipp treatments, Scotch hose, Swiss shower, thalassotherapy) or whirlpool bath, hot Roman bath, hot tub, Jacuzzi, and cold plunge. Hydrotherapy lacks robust evidence supporting its efficacy beyond placebo effects. Systematic reviews of randomized controlled trials have consistently found no clear evidence of curative effects, citing methodological flaws and insufficient data. Overall, the scientific consensus indicates that hydrotherapy's benefits are not conclusively greater than those of placebo treatments.

Uses

Water therapy may be restricted to use as aquatic therapy, a form of physical therapy, and a cleansing agent. However, it is also used as a medium for delivering heat and cold to the body, which has long been the basis for its application. Hydrotherapy involves a range of methods and techniques, many of which use water as a medium to facilitate thermoregulatory reactions for therapeutic benefit. Shower-based hydrotherapy techniques have been increasingly used in preference to full-immersion methods, partly for the ease of cleaning the equipment and reducing infections due to contamination. When removal of tissue is necessary for the treatment of wounds, hydrotherapy, which performs selective mechanical debridement can be used. Examples of this include directed wound irrigation and therapeutic irrigation with suction.

Technique The following methods are used for their hydrotherapeutic effects:

Packings, general and local; Hot air and steam baths; General baths; Treadmills; Colon Hydrotherapy (Enemas); Sitz (sitting), spinal, head, and foot baths; Bandages or compresses, wet and dry; also; Fomentations and poultices, sinapisms, stupes, rubbings, and water potations. Hydrotherapy, which involves submerging all or part of the body in water, can involve several types of equipment:

Full body immersion tanks (a "Hubbard tank" is a large size) Arm, hip, and leg whirlpool Whirling water movement, provided by mechanical pumps, has been used in water tanks since at least the 1940s. Similar technologies have been marketed for recreational use under the terms "hot tub" or "spa". In some cases, baths with whirlpool water flow are not used to manage wounds, as a whirlpool will not selectively target the tissue to be removed, and can damage all tissue. Whirlpools also create an unwanted risk of bacterial infection, can damage fragile body tissue, and in the case of treating arms and legs, bring risk of complications from edema.

History The therapeutic use of water has been recorded in ancient Egyptian, Greek and Roman civilizations. Egyptian royalty bathed with essential oils and flowers. Romans had communal public baths for their citizens. Hippocrates prescribed bathing in spring water for sickness. Other cultures noted for a long history of hydrotherapy include China and Japan, the latter being centred primarily around Japanese hot springs. Many such histories predate the Roman thermae.

Modern revival

Hydrotherapy became more prominent following the growth and development of modern medical practices in the 18th and 19th centuries. As traditional medical practice became increasingly professional, it was felt that medical treatment became increasingly less personalized. The development of hydrotherapy was believed to be a more personal form of medical treatment that did not necessarily present to patients the alienating scientific language that modern developments of medical treatment entailed.

1700–1810 Two English works on the medical uses of water were published in the 18th century that inaugurated the new fashion for hydrotherapy. One of these was by Sir John Floyer, a physician of Lichfield, who, struck by the remedial use of certain springs by the neighbouring peasantry, investigated the history of cold bathing and published a book on the subject in 1702. The book ran through six editions within a few years, and the translation of this book into German was largely drawn upon by J. S. Hahn of Silesia as the basis for his book called On the Healing Virtues of Cold Water, Inwardly and Outwardly Applied, as Proved by Experience, published in 1738. The other work was a 1797 publication by James Currie of Liverpool on the use of hot and cold water in the treatment of fever and other illnesses, with a fourth edition published in 1805, not long before his death. It was also translated into German by Michaelis (1801) and Hegewisch (1807). It was highly popular and first placed the subject on a scientific basis. Hahn's writings had meanwhile created much enthusiasm among his countrymen, societies having been formed everywhere to promote the medicinal and dietetic use of water; and in 1804 Professor E.F.C. Oertel of Anspach republished them and quickened the popular movement by unqualified commendation of water drinking as a remedy for all diseases. The general idea behind hydropathy during the 1800s was to be able to induce something called a crisis. The thinking was that water invaded any cracks, wounds, or imperfections in the skin, which were filled with impure fluids. Health was considered to be the body's natural state, and filling these spaces with pure water would flush the impurities out, which would rise to the skin's surface, producing pus. The event of this pus emerging was called a crisis, and was achieved through a multitude of methods. These methods included techniques such as sweating, the plunging bath, the half bath, the head bath, the sitting bath, and the douche bath. All of these were ways to gently expose the patient to cold water in different ways.

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