Hydrotherapy- (hydropathy or water cure)

This term is inclusive of several uses water for pain relief with water jets, water massage, mineral baths, thalassotherapy, hut tubs, pool therapy, etc.). It is used by naturopathy, physical therapy, and other practitioners to stimulate blood circulation and treat symptoms of diseases.  Hydrotherapy can consist of water used externally to cleanse, reduce infections due to contamination, debridement, use of hot or cool water for thermal effects, or internal water therapy (Indian, Chinese or Japanese water therapy calls for ingestion of 1-1.5 liters of water on awakening in order to “cleanse the bowel”) or water exercise (aquatherapy).   Hydrotherapy may be delivered as a full body immersion tank, arm/leg/whirlpool, or hydromassage in which a person lies in a massage chamber and water in a rubber or plastic jacket massages the patient while the patient remains dry. 

An extension of hydrotherapy is Kneipp therapy, named for Sebastian Kneipp (1821-1897) who believed in a gentle water therapy to “strengthen the constitution and remove poisons and toxins from the body”, but also employed medicinal herbs, massages, balanced nutrition and “regulative therapy to seek inner balance”.  Regulative therapy include acupuncture, purgative procedures (especially the Aschner methods), autohemotherapy, fasting therapy, homeopathy, microbiological and physical therapies.

 

There is alpha level evidence aquatic exercise provides both small clinically and statistically improvement of pain, disability, and quality of life, at least in the short term, for osteoarthritis of the knee and hip (Cochrane Database Syst Rev 2016 Mar 23;3:CD005523).   There is also alpha evidence for the treatment of fibromyalgia with hydrotherapy and aquatic exercise  (Evid Based Complement Alternat Med 2015;2015:610615).  There is alpha evidence (meta-analysis) for use of aquatic exercise for the treatment of stable heart failure (Int J Cardiol 2015;186:22-8).  There is moderate effectiveness of aquatic exercise in the treatment of musculoskeletal conditions (Arch Phys Med Rehabil 2014 Sep;95(9):1776-86).  There is NOT strong evidence that hydrotherapy improves wound healing (J Am Med Dir Assoc 2015 Jun 1;16(6):448-69).  There is much less evidence passive whirlpool or jet therapy is beneficial, however there is beta level evidence that cold whirlpool is better than warm whirlpool for resolving range of motion limitations and pain in joints (J Athl Train. 1998 Jul;33(3):222-8.) and evidence whole body whirlpool are better than warmpacks/cold packs for myofascial pain (Ann Rehabil Med. 2013 Aug;37(4):534-40).