Hydrotherapy, or water therapy, is the use of water (hot, cold, steam, or ice) to relieve discomfort and promote physical well-being.


Hydrotherapy can soothe sore or inflamed muscles and joints, rehabilitate injured limbs, lower fevers, soothe headaches, promote relaxation, treat burns and frostbite, ease labor pains, and clear up skin problems. The temperature of water used affects the therapeutic properties of the treatment. Hot water is chosen for its relaxing properties. It is also thought to stimulate the immune system. Tepid water can also be used for stress reduction, and may be particularly relaxing in hot weather. Cold water is selected to reduce inflammation. Alternating hot and cold water can stimulate the circulatory system and improve the immune system. Adding herbs and essential oils to water can enhance its therapeutic value. Steam is frequently used as a carrier for essential oils that are inhaled to treat respiratory problems.
Since the late 1990s, hydrotherapy has been used in critical care units to treat a variety of serious conditions, including such disorders of the nervous system as Guillain-Barré syndrome.



The therapeutic use of water has a long history. Ruins of an ancient bath were unearthed in Pakistan and date as far back as 4500 B.C. Bathhouses were an essential part of ancient Roman culture. The use of steam, baths, and aromatic massage to promote well being is documented since the first century. Roman physicians Galen and Celsus wrote of treating patients with warm and cold baths in order to prevent disease.
By the seventeenth and eighteenth centuries, bathhouses were extremely popular with the public throughout Europe. Public bathhouses made their first American appearance in the mid 1700s.
In the early nineteenth century, Sebastien Kneipp, a Bavarian priest and proponent of water healing, began treating his parishioners with cold water applications after he himself was cured of tuberculosis through the same methods. Kneipp wrote extensively on the subject, and opened a series of hydrotherapy clinics known as the Kneipp clinics, which are still in operation today. Around the same time in Austria, Vincenz Priessnitz was treating patients with baths, packs, and showers of cold spring water. Priessnitz also opened a spa that treated over 1,500 patients in its first year of operation, and became a model for physicians and other specialists to learn the techniques of hydrotherapy.
Water can be used therapeutically in a number of ways. Common forms of hydrotherapy include:
  • Whirlpools, jacuzzis, and hot tubs. These soaking tubs use jet streams to massage the body. They are frequently used by physical therapists to help injured patients regain muscle strength and to soothe joint and muscle pain. Some midwives and obstetricians also approve of the use of hot tubs to soothe the pain of labor.
  • Pools and Hubbard tanks. Physical therapists and rehabilitation specialists may prescribe underwater pool exercises as a low-impact method of rebuilding muscle strength in injured patients. The buoyancy experienced during pool immersion also helps ease pain in conditions such as arthritis.
  • Baths. Tepid baths are prescribed to reduce a fever. Baths are also one of the oldest forms of relaxation therapy. Aromatherapists often recommend adding essential oils of lavender (Lavandula angustifolia) to a warm to hot bath to promote relaxation and stress reduction. Adding Epsom salts (magnesium sulfate) or Dead Sea salts to a bath can also promote relaxation and soothe rheumatism and arthritis.
  • Showers. Showers are often prescribed to stimulate the circulation. Water jets from a shower head are also used to massage sore muscles. In addition, showering hydrotherapy has been shown to be preferable to immersion hydrotherapy for treating burn patients.
  • Moist compresses. Cold, moist compresses can reduce swelling and inflammation of an injury. They can also be used to cool a fever and treat a headache. Hot or warm compresses are useful for soothing muscle aches and treating abscesses.
  • Steam treatments and saunas. Steam rooms and saunas are recommended to open the skin pores and cleanse the body of toxins. Steam inhalation is prescribed to treat respiratory infections. Adding botanicals to the steam bath can increase its therapeutic value.
  • Internal hydrotherapy. Colonic irrigation is an enema that is designed to cleanse the entire bowel. Proponents of the therapy say it can cure a number of digestive problems. Douching, another form of internal hydrotherapy, directs a stream of water into the vagina for cleansing purposes. The water may or may not contain medications or other substances. Douches can be self-administered with kits available at most drug stores.


Because of the expense of the equipment and the expertise required to administer effective treatment, hydrotherapy with pools, whirlpools, Hubbard tanks, and saunas is best taken in a professional healthcare facility, and/or under the supervision of a healthcare professional. However, baths, steam inhalation treatments, and compresses can be easily administered at home.

Bath preparations

Warm to hot bath water should be used for relaxation purposes, and a tepid bath is recommended for reducing fevers. Herbs can greatly enhance the therapeutic value of the bath for a variety of illnesses and minor discomforts.
Herbs for the bath can be added to the bath in two ways—as essential oils or whole herbs and flowers. Whole herbs and flowers can be placed in a muslin or cheesecloth bag that is tied at the top to make an herbal bath bag. The herbal bath bag is then soaked in the warm tub, and can remain there throughout the bath. When using essential oils, add five to 10 drops of oil to a full tub. Oils can be combined to enhance their therapeutic value. Marjoram (Origanum marjorana)is good for relieving sore muscles; juniper (Juniperus communis) is recommended as a detoxifying agent for the treatment of arthritis; lavender, ylang ylang (Conanga odorata), and chamomile (Chamaemelum nobilis) are recommended for stress relief; cypress (Cupressus sempervirens), yarrow (Achillea millefolium), geranium (Pelargonium graveolens), clary sage (Savlia sclaria), and myrtle (Myrtus communis) can promote healing of hemorrhoids; and spike lavender and juniper (Juniperus communis) are recommended for rheumatism.
To prepare salts for the bath, add one or two handfuls of epsom salts or Dead Sea salts to boiling water until they are dissolved, and then add them to the tub.
A sitz bath, or hip bath, can also be taken at home to treat hemorrhoids and promote healing of an episiotomy. There is special apparatus available for taking a seated sitz bath, but it can also be taken in a regular tub partially filled with warm water.

Steam inhalation

Steam inhalation treatments can be easily administered with a bowl of steaming water and a large towel. For colds and other conditions with nasal congestion, aromatherapists recommend adding five drops of an essential oil that has decongestant properties, such as peppermint (Mentha piperita) and eucalyptus blue gum (Eucalyptus globulus). Oils that act as expectorants, such as myrtle (Myrtus communis) or rosemary (Rosmarinus officinalis), can also be used. After the oil is added, the individual should lean over the bowl of water and place the towel over head to trap the steam. After approximately three minutes of inhaling the steam, with eyes closed, the towel can be removed.
Other herbs and essential oils that can be beneficial in steam inhalation include:
  • tea tree oil (Melaleuca alternaifolia) for bronchitis and sinus infections
  • sandalwood (Santalum album), virginian cedarwood (Juniperus virginiana), and frankincense (Boswellia carteri) for sore throat
  • lavender (Lavandula angustifolia) and thyme (Thymus vulgaris) for cough


A cold compress is prepared by soaking a cloth or cotton pad in cold water and then applying it to the area of injury or distress. When the cloth reaches room temperature, it should be resoaked and reapplied. Applying gentle pressure to the compress with the hand may be useful. Cold compresses are generally used to reduce swelling, minimize bruising, and to treat headaches and sprains.
Warm or hot compresses are used to treat abscesses and muscle aches. A warm compress is prepared in the same manner as a cold compress, except steaming water is used to wet the cloth instead of cold water. Warm compresses should be refreshed and reapplied after they cool to room temperature.
Essential oils may be added to moist compresses to increase the therapeutic value of the treatment. Peppermint, a cooling oil, is especially effective when added to cold compresses. To add oils to compresses, place five drops of the oil into the bowl of water the compress is to be soaked in. Never apply essential oils directly to a cloth, as they may irritate the skin in undiluted form.


Individuals with paralysis, frostbite, or other conditions that impair the nerve endings and cause reduced sensation should only take hydrotherapy treatments under the guidance of a trained hydrotherapist, physical therapist, or other appropriate healthcare professional. Because these individuals cannot accurately sense temperature changes in the water, they run the risk of being seriously burned without proper supervision. Diabetics and people with hypertension should also consult their healthcare professional before using hot tubs or other heat hydrotherapies.
Hot tubs, jacuzzis, and pools can become breeding grounds for bacteria and other infectious organisms if they are not cleaned regularly, maintained properly, kept at the appropriate temperatures, and treated with the proper chemicals. Individuals should check with their healthcare provider to ensure that the hydrotherapy equipment they are using is sanitary. Those who are using hot tubs and other hydrotherapy equipment in their homes should follow the directions for use and maintenance provided by the original equipment manufacturer.
Certain essential oils should not be used by pregnant or nursing women or by people with specific illnesses or physical conditions. Individuals suffering from any chronic or acute health condition should inform their healthcare provider before starting treatment with any essential oil.
Essential oils such as cinnamon leaf, juniper, lemon, eucalyptus blue gum, peppermint, and thyme can be extremely irritating to the skin if applied in full concentration. Oils used in hydrotherapy should always be diluted in water before they are applied to the skin. Individuals should never apply essential oils directly to the skin unless directed to do so by a trained healthcare professional and/or aromatherapist.
Colonic irrigation should only be performed by a healthcare professional. Pregnant women should never douche, as the practice can introduce bacteria into the vagina and uterus. They should also avoid using hot tubs without the consent of their healthcare provider.
The vagina is self-cleansing, and douches have been known to upset the balance of vaginal pH and flora, promoting vaginitis and other infections. Some studies have linked excessive vaginal douching to increased incidence of pelvic inflammatory disease (PID).

Side effects

Most forms of hydrotherapy are well tolerated. There is a risk of allergic reaction (also known as contact dermatitis) for some patients using essential oils and herbs in their bath water. These individuals may want to test for allergic sensitization to herbs by performing a skin patch test (i.e., rubbing a small amount of diluted herb on the inside of their elbow and observing the spot for redness and irritation). People who experience an allergic reaction to an essential oil should discontinue its use and contact their healthcare professional for further guidance.
The most serious possible side effect of hydrotherapy is overheating, which may occur when an individual spends too much time in a hot tub or jacuzzi. However, when properly supervised, this is a minimal risk.

Research and general acceptance

Hydrotherapy treatments are used by both allopathic and complementary medicine to treat a wide variety of discomforts and disorders. Not as well accepted are invasive hydrotherapy techniques, such as colonic irrigation, enemas, and douching. These internal cleansing techniques can actually harm an individual by upsetting the natural balance of the digestive tract and the vagina. Most conventional medical professionals agree that vaginal douches are not necessary to promote hygiene in most women, and can actually do more harm than good.



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