Rheumatoid arthritis (RA) is a chronic autoimmune disease causing joint pain, stiffness, and swelling. While medication remains the primary treatment, many explore complementary therapies to manage symptoms and improve quality of life. One such approach is hydrotherapy – the therapeutic use of water in various forms and temperatures.
Hydrotherapy isn’t a cure for RA, but it can provide short-term relief and a safe way to exercise, particularly during flares when movement is limited. However, it should always be integrated into a treatment plan under a rheumatologist’s guidance.
What is Hydrotherapy?
Hydrotherapy encompasses everything from warm baths and hot tubs to cold plunges. Physical therapists use it to help patients move more easily while reducing joint pain. It’s not just about relaxation; the principle is that water can reduce stress on joints, improve circulation, and ease inflammation.
Current guidelines from the American College of Rheumatology categorize hydrotherapy as a “conditional recommendation,” meaning it can be helpful if patients prefer it as part of their treatment. Many people with RA report significant benefits, making it a valuable tool for daily symptom management.
Aquatic Exercise: A Gentle Approach
Exercising in water is one of the most studied and recommended hydrotherapy methods for RA. The buoyancy reduces stress on joints, allowing for strength training, aerobic exercise, and flexibility work with less impact than land-based routines.
Warm pools (around 80°F) are ideal. The combination of warmth and buoyancy allows patients to perform movements more safely while water resistance strengthens muscles. Physical therapists often supervise initial sessions, but once patients learn proper techniques, they can continue independently.
Research shows that 12-week aquatic exercise programs (twice weekly for 45 minutes) can improve physical fitness, reduce pain, and even alleviate depression in women with RA. A review of nine studies confirms that warm water exercise improves pain, disease severity, and daily function compared to land-based or no exercise.
Heat Therapy: Saunas, Steam Rooms, and Hot Tubs
Saunas, steam rooms, and hot tubs may also offer benefits by improving joint mobility, relaxing muscles, and reducing stress. Saunas are particularly effective: regular heat exposure can reduce pain and stiffness while increasing circulation.
However, caution is needed. Steam rooms may carry a risk of respiratory infections if not properly maintained. Saunas and hot tubs can lead to dehydration or worsen heart conditions if used without proper breaks and fluid intake. Always consult a healthcare provider before use.
Cold Water Immersion: Caution Advised
Cold plunges or ice baths can alleviate pain, accelerate recovery, and boost mood. However, cold therapy isn’t widely recommended for RA patients. One small study found that combining aerobic exercise with cold immersion improved heart rate and blood vessel flexibility without worsening joint pain, but the evidence is preliminary.
People with circulation issues, cardiovascular conditions, or sensory sensitivities should avoid cold water immersion unless cleared by a physician. Some may experience increased bone pain or stiffness.
Hydrotherapy at Home
Access to pools or therapy facilities isn’t always possible. Fortunately, at-home hydrotherapy is simple: a warm bath or shower can provide similar benefits. A warm shower in the morning can ease pain and stiffness, helping you move more comfortably.
Prioritize safety: install grab bars, use shower benches, and avoid unsupervised entries and exits from tubs to prevent falls.
The bottom line: Hydrotherapy can be a valuable addition to RA treatment alongside medication. It offers relaxation, gentle exercise, and symptom relief. Always consult your healthcare team to ensure it’s safe and appropriate for your individual needs.
