The use of warm water therapy for physical ailments has been around since the establishment of the earliest civilizations. However, hydrotherapy, as it is currently referred to, did not make a lasting impression on the United States until the 1930s when it became public knowledge that President Franklin Delano Roosevelt had been using this method to help alleviate the debilitating symptoms of polio. Roosevelt considered hydrotherapy an imperative part of his rehabilitation therapy for the rest of his life.
Through the years, the introduction of technologically advanced hot tubs and spas further increased interest in warm water therapy. Today, hydrotherapy is a common part of physical therapy for many ailments, especially arthritis.
Sandra Wiggin, a registered nurse, understands pain-but not only because of her profession. Wiggin has osteoarthritis, which has spread throughout her spinal column.
"The disease became apparent over a decade ago when my knees began swelling," she says. "The pain was so bad at times that I was unable to walk. After researching available treatments, I decided to try alternative therapies in conjunction with anti-inflammatory drugs. My program currently includes regular exercise and heat treatments, including soaking in my hot tub."
Wiggin says that regular soaks did more than relieve her pain and help her regain range of motion. "Soaking also helped me to relax and sleep better," she says. "Arthritis often affects sleep patterns, so relaxation techniques are an important part of therapy. When my arthritis flares, I increase the frequency of my soaks, and even when I feel great, I use my hot tub several times a week. Today, my mobility is much better than it was 10 years ago. Now I can walk one mile a few times a week."
Physical therapist, Doreen Stiskal, Ph.D., is a teacher and researcher of orthopedics, arthritis and exercise at Seton Hall University in South Orange, NJ. In addition to her role as assistant chair of the graduate program in health sciences, Dr. Stiskal serves on numerous committees for the Arthritis Foundation. She says that Wiggin's story is a common one.
"People who are just beginning therapy are often in a great deal of pain," Stiskal explains. "One patient felt that she had to hold onto something or someone at all times so that she would not fall. Another woman reported that she had not been able to climb stairs for several years. In these cases, and in many others, people can walk unaided and even climb stairs after only weeks on a therapy program that includes heated and jetted water."
While arthritis is classically defined as "inflammation of joints," there are more than 100 arthritis-related diseases, Stiskal continues, and most react positively to warm water therapy.
"Therapy is customized for patients based on one's symptoms, including his or her severity of pain and heat tolerance level," Stiskal adds. "To help relieve muscle spasms and severe pain, for example, we may increase the water's heat level one or two degrees. People who exercise in the spa to maintain mobility and to prevent pain from increasing (more of a preventative treatment) tend to prefer water that is one or two degrees cooler. The most important factor, regardless of a patient's condition, is that he or she is comfortable with the temperature."
Frequency and duration of hot tub use also depends on the patient. "The body gains the maximum benefit of warm water therapy within 20 minutes of any type of heat treatment," notes Stiskal. "Just like a heating pad, spa therapy can be repeated several times a day if it offers relief."
Dr. Stiskal advises people to confer with their healthcare team before beginning any type of therapy program and to keep doctors, nurses and physical therapists informed of any changes in pain and mobility levels.
Homemaker and mom Donna Fox was diagnosed with rheumatoid arthritis in 1970 at age five. She says that her childhood memories consist of battling pain. Prior to the diagnosis, Fox's parents complained to her pediatrician that Donna cried a lot and demanded an excessive amount of attention.
"They thought I was spoiled," Fox says. "But when I was four, my parents noticed me favoring one leg, and I would slide down the stairs instead of walk."
Soon Fox's joints began swelling. Her parents took her to a specialist who proceeded with a series of diagnostic procedures. By the time she was seven, she was fully aware of her limitations and of the pain that affected every joint in her body.
"My treatment included aspirin, steroid therapy and other treatments," Fox recalls. "I also had physical therapy, whirlpool baths and heat therapy. Over time, I realized that the most beneficial therapies are those that do not have negative side effects. Today, I avoid drugs completely and use alternative treatments."
Learning to listen to her body is what Fox says has helped her the most. "When my joints flare, I back off my routine a little. I increase my heated water therapy, and I include aromatherapy and soft music. It helps me to de-stress and to relax, and that is key to controlling pain."
Fox says that a positive disposition is also imperative. "You may not be able to beat this disease, but you can sure beat the way you deal with it," she adds.
John Klippel, M.D., national medical director of the Arthritis Foundation, has more than 25 years of experience in rheumatology and medical research that is related to arthritis. In his capacity, Dr. Klippel provides direction to the Arthritis Foundation's research programs, and he serves as an authoritative representative for all questions related to arthritis, research and medically-related issues. Dr. Klippel says the most common form of arthritis is osteoarthritis.
Klippel explains: "Osteoarthritis is estimated to account for approximately one-half of the 70-million arthritis cases now affecting Americans. It is associated with aging. Symptoms generally begin when a person is in his or her late 40s to early 50s; more women than men have the disease."
According to Dr. Klippel, many arthritis sufferers find that hot tub use not only provides relief from pain, but that it also maintains or increases joint movement and minimizes physical limitations. "As muscles relax, the blood flow increases throughout the body, facilitating movement and enhancing mobility. The combination of heated water, jet massage and buoyancy results in relief."
People with arthritis do not necessarily have to go to a treatment or rehab center in order to gain relief. "Home spas can be a valuable modality of treatment for many forms of arthritis," Dr. Klippel interjects. "This is especially true in the treatment of arthritis-related diseases that affect the lower back, hips and knees. Reasonable advice for someone who suffers with arthritis is to begin using a hot tub several times a week for about 15 to 20 minutes each session. The level of heat used should always be within the guidelines set by hot tub and spa industry standards. It is important that patients combine spa use with other forms of treatment that are known to be effective for those suffering from arthritis."