Hydrotherapy is a broad modality that might encompass anything from water aerobics to a daily shower. In its various forms, hydrotherapy has been effective for healing internal and external injuries or health issues and for improving mental health and overall wellness. Water can be used in conjunction with massage therapy in any of its three forms–steam, liquid, or ice. Bodywork professionals might integrate hydrotherapy by offering a therapeutic bath, a steam shower, or ice water immersion for sore joints and muscles.

History of Hydrotherapy

Today, we might associate hydrotherapy with luxurious spa treatments or the rare experience of a decadent bath. But for thousands of years many cultures used steam and mineral baths to condition warriors, ward off illness, and increase vitality.

The ancient Greek physician Hippocrates famously wrote, “The way to health is to have an aromatic bath and scented massage every day.” He is said to have used hydrotherapy to treat ulcers, fevers, hemorrhages, and other health or surgical conditions. There is also evidence the Babylonians, Chinese, Egyptians, Greeks, and Native Americans also used steams, saunas, mineral soaking, compresses, irrigation, and baths.

Reliable resources on the topic of hydrotherapy come from not only professionals, but also laypeople who have experienced its benefits firsthand. From the Austrian peasant Vincent Priessnitz, who self-medicated with cold water on his own broken ribs to Dr. John Harvey Kellogg, who wrote about treating hundreds of residents at his Battle Creek Sanitorium with hydrotherapy, a wealth of historical evidence exists in support of water therapy.

How Hydrotherapy Works in a Bodywork Practice

Treatments generally fit into two categories: thermotherapeutic (warm/hot) or cryotherapeutic (cool/cold). The application may be short or extended, localized or full-body. Each combination has specific potential benefits.

  • Quick full-body cold: stimulates, energizes
  • Extended full-body cold: lowers body temperature, metabolic activity
  • Quick local cold: reduces circulation and nerve sensitivity
  • Extended local cold: decreases pain, numbs area, counteracts swelling and inflammation
  • Quick full-body heat: increases circulation, metabolic rate
  • Extended full-body heat: raises core temperature and blood cell count
  • Quick local heat: relaxes muscles, decreases tension or spasm
  • Extended local heat: softens tissue, decreases pain, promotes relaxation

Hydrotherapy may be administered in the form of chilled or heated wet washcloths and compresses, gel packs, and wraps. In cryotherapy, ice can be applied directly to the body and used as a massage tool. Ice baths are also applicable for some health issues or localized physical pain.

Steam showers, saunas, and heat packs are all common types of thermal hydrotherapy, but hot immersion baths may be the most popular. Baths pair well with massage therapy and can be easily customized for any health issue with the addition of minerals, salts, essential oils, and more.

Benefits of Hydrotherapy Treatment

An analysis of dozens of studies on the effects of hydrotherapy shows benefits for almost any health application, such as pain reduction, muscle function and strength, joint mobility, balance, and demeanor or affect, among others. Specific studies demonstrate positive results for arthritis, including osteoarthritis, rheumatoid arthritis, and juvenile idiopathic arthritis. Hydrotherapy can also be effective for people with neurological issues, especially as a tool for helping ease physical signs of agitation such as hand-wringing, fidgeting, and pacing.

Any age or demographic can benefit from hydrotherapy. There have been successful applications of its various forms on children, athletes, people who are pregnant or in labor, the severely injured, geriatric individuals, and even infants. One study in particular showed a marked improvement in feeding and quality of sleep for newborns who received a daily bath and gentle massage during the first several days after birth, suggesting hydrotherapy can contribute to physical and mental wellness from the very beginning of life.

Though hydrotherapy is generally not recommended for anyone with open wounds or sores, some types of water therapy can help flush or clean topical injuries. A treatment called pulsed lavage can be beneficial for people with chronic or nonhealing wounds, as well as burn victims.

Precautions and Limitations

Hydrotherapy is generally not recommended for anyone with kidney failure, contagious skin diseases, lung disease, kidney infection, open wounds, cardiac impairment, or extremely high or low blood pressure. Those who have poor circulation or difficulty sensing hot and cold temperatures may be at higher risk for skin burning or freezing and should proceed with caution. Likewise, hydrotherapy may not be for anyone who has difficulty regulating internal body temperatures, such as some elderly individuals and very young children. Localized heat is never used on recent or acute injuries, such as sprains, because heat may lead to inflammation.

Exceptions may be made at the recommendation of a physician who has a complete record of a client’s medical history. If you are considering receiving any type of hydrotherapy and bodywork treatment, consult your primary care provider to help determine which type of therapy that will be most beneficial to you. Find a professional who is both credentialed in massage and trained in hydrotherapy, and always convey your needs and comfort level as treatments progress.


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