From the Guidelines
Hydrotherapy is conditionally recommended as a complementary approach for managing chronic disease symptoms, but land-based physical therapy interventions are preferred over aquatic therapy interventions due to greater accessibility and moderate-quality evidence supporting their efficacy 1.
Key Points
- Hydrotherapy shows promising results for conditions like osteoarthritis, fibromyalgia, chronic low back pain, and some cardiovascular conditions.
- Typical hydrotherapy regimens involve 2-3 sessions per week for 6-12 weeks, with each session lasting 30-60 minutes in water temperatures between 32-36°C (90-97°F).
- The therapeutic effects of hydrotherapy stem from water's physical properties: buoyancy reduces joint stress, hydrostatic pressure improves circulation, and warmth relaxes muscles and reduces pain.
- Patients should consult healthcare providers before starting hydrotherapy, especially those with open wounds, acute infections, severe heart conditions, or uncontrolled high blood pressure.
Evidence Summary
The American College of Rheumatology recommends land-based physical therapy interventions over aquatic therapy interventions for patients with active ankylosing spondylitis, citing moderate-quality evidence and greater accessibility 1. While hydrotherapy may be beneficial for certain chronic conditions, the evidence is not strong enough to support its use as a primary treatment. Nonpharmacologic and nonopioid pharmacologic treatments, such as exercise therapy, cognitive-behavioral therapy, and selected anticonvulsants and antidepressants, have been shown to be effective in managing chronic pain 1.
Recommendations
- Patients with chronic diseases should consult with their healthcare providers to determine the best course of treatment, which may include hydrotherapy as a complementary approach.
- Land-based physical therapy interventions should be preferred over aquatic therapy interventions due to greater accessibility and moderate-quality evidence supporting their efficacy.
- Patients should be aware of the potential benefits and risks of hydrotherapy and discuss any concerns with their healthcare providers before starting treatment.
From the Research
Hydrotherapy for Chronic Disease Management
The use of hydrotherapy, or water-based therapy, has been studied as a treatment for various chronic diseases, including osteoarthritis and fibromyalgia.
- Hydrotherapy has been shown to improve pain and function in older women with knee osteoarthritis, with studies demonstrating significant reductions in pain intensity and improvements in functional status 2, 3, 4.
- A systematic review of randomized controlled trials found strong evidence for the use of hydrotherapy in the management of fibromyalgia syndrome, with positive outcomes reported for pain, health-status, and tender point count 5.
- Hydrotherapy has also been compared to conventional physiotherapy in the treatment of osteoarthritis, with one pilot study finding beneficial effects of hydrotherapy on pain intensity and joint mobility 6.
Benefits of Hydrotherapy
The benefits of hydrotherapy for chronic disease management include:
- Reduced pain intensity 2, 5, 3, 4
- Improved functional status 2, 3, 4
- Increased joint mobility 6
- Improved health-related quality of life 6
- Reduced tender point count in patients with fibromyalgia syndrome 5
Study Findings
Studies have consistently shown that hydrotherapy can be an effective treatment for chronic diseases such as osteoarthritis and fibromyalgia.
- A randomized controlled trial found that hydrotherapy improved pain and function in older women with knee osteoarthritis, with significant reductions in pain intensity and improvements in functional status 2.
- A systematic review of randomized controlled trials found strong evidence for the use of hydrotherapy in the management of fibromyalgia syndrome 5.
- A pilot study found that hydrotherapy had beneficial effects on pain intensity and joint mobility in patients with osteoarthritis, compared to conventional physiotherapy 6.
- Another randomized clinical trial found that hydrotherapy was superior to land-based exercise in relieving pain before and after walking in patients with osteoarthritis of the knee 3.
- A study published in 2019 found that a 4-week hydrotherapy program resulted in significant decreases in pain and improvements in self-perceived functional status in individuals living with knee osteoarthritis 4.