Now Reading
Hydrotherapy: Different Types, Benefits, and Precautions

Hydrotherapy: Different Types, Benefits, and Precautions

woman in hydrotherapy tub with geometric overlay

Hydrotherapy is the practice of using water with the intent of benefiting health. There are several types of hydrotherapy that each have an advantage based on your needs. Treatments can be as simple as taking a cold shower or as involved as colonics.

Hydrotherapy is a popular pillar of naturopathic treatment but also sees mainstream use in fields such as sports medicine. One popular modern method of hydrotherapy is the Wim Hof method which combines intermittent hypoxic training with cold water immersion. Hydrotherapy has a lot to offer when done right. Knowing different approaches and techniques of hydrotherapy can help ensure you apply it with maximized success.


  • Hydrotherapy uses water in a way to benefit local and/or holistic health
  • Cold, Hot, and Combined Hydrotherapy all support different health benefits
  • Hydrotherapy relies, largely, on stimulating vasodilation and vasoconstriction
  • Hydrotherapy has been used throughout human history as a therapeutic practice
  • Our body’s abilities to adapt to temperature change decrease with age
  • May help treat arthritis, injury, osteoporosis, and cardiovascular disease
  • Regarded as safe with few side effects when done conservatively

What is Hydrotherapy

Hydrotherapy uses water as a means of therapeutic treatment for a range of health conditions. It’s been used for thousands of years in Ayurveda and naturopathic practice as a means of stimulating blood circulation (R). Hydrotherapy uses water as a medium of heat transfer to stimulate thermally-regulated processes.

There are many different types of hydrotherapy that are used in naturopathic, occupational, and physiotherapy practices. Hydrotherapy can be done locally to specific areas of the body or more holistically through full-submersion. Some common examples of hydrotherapy include the following:

  • Whirlpool baths
  • Hot Tubs
  • Cold Plunges
  • Mineral Baths
  • Swiss Shower
  • Thalassotherapy (Sea Water Therapy)
  • Water Aerobics
  • Splashing Water on Your Face (SWYF)

SWYF is something I added to illustrate how casually hydrotherapy can be. The defining characteristic of any hydrotherapy practice (aside from water) is the therapy aspect. Splashing a little water on your face to clean off the dust after blowing leaves in the yard isn’t hydrotherapy. Splashing cold water on your face every 6 hours to help stimulate better facial blood circulation is. As with many things—many of hydrotherapy’s defining characteristics boil down to intention.

Vasodilation vs. Vasoconstriction

Hydrotherapy can be broken into several sub-classes. One such distinction is the use of hot water hydrotherapy vs. cold water hydrotherapy. These are often referred to as “modalities” of hydrotherapy.

Hydrotherapy largely relies on processes underlined by both vasodilation and vasoconstriction. These opposing processes control the diameter of blood vessels such that blood flow can be either increased, decreased, or remain the same.

Vasodilation and vasoconstriction are two primary mechanisms by which the human body helps regulate temperature. When our environment is cold, vasoconstriction helps reduce the amount of heat loss.

By contrast, vasodilation is seen in response to warmer environments as a means to help the body avoid over-heating.

These two fundamental processes underpin the human body’s heat exchange system. The dynamics of their effect on the body is the premise on which hydrotherapy works.

Hot vs. Cold Hydrotherapy

Hydrotherapy can be applied using either hot, cold, or ambient temperature water. Contrast Hydrotherapy uses both hot and cold, though there is some research that suggests little benefit of this approach. It’s important to understand when hot water might be your best option and when you should be considering colder temperature therapies instead.

Benefits of Cold Water Hydrotherapy

First, it’s important to recognize that ice is considered a form of cold-water hydrotherapy. That qualifies ice baths and ice packs applied to local areas. Cold modality hydrotherapy is used to limit local swelling following physical trauma. One example of this modality is icing a sprained ankle (R). Anyone having grown up playing sports is likely familiar with this concept.

Cold hydrotherapy leverages vasoconstriction to influence local or systemic changes in the body. In such cases as a sprained ankle, the reduced blood flow can help lower swelling (edema.) On a holistic scale, cold compresses can help reduce temperature drops in deep tissue and, in the case of wide-ranging injury, organs (R). Some of the results of cold hydrotherapy include the following:

  • Lower Heart Rate
  • Lowered Blood Pressure
  • Lower Cortisol Levels
  • Increased Urinary Elimination
  • Increased Metabolic Rate
  • Increased Noredreneline & Dopamine

These are some of the many responses noted with cold immersion hydrotherapy. It’s important to note that different temperatures will often elicit varying responses in the body. For example, researchers have noted much larger increases in total metabolic rate when lower temperature water is used (R).

Benefits of Warm Water Hydrotherapy

Warm temperature hydrotherapy offers the benefits associated with vasodilation. For casual discussion this can likewise be considered the benefits of increased blood flow. In other words, vasodilation leads to increased blood flow.

Warm baths have been noted as helping to improve cardiac function in patients with congestive heart failure. No one’s hopping out of the tub to run a marathon, but increased heart rates and lowered blood pressure can be expected. Research suggests that warm-water hydrotherapy is likely to produce the following effects (R)(R)(R) :

  • Lowered Blood Pressure
  • Increased Heart Rate
  • Improve Peripheral Circulation
  • Increased Total Cardiac Output
  • Improved Skin Blood Flow
  • Decreased Muscle Soreness
  • Increased Creatine Levels

Alternating Contrast Hydrotherapy

Another modality of hydrotherapy—called contrast hydrotherapy—is described by alternating hot and cold exposure. An example would be hopping from an ice bath into a hot tub.

Research suggests that the immune system benefits given by certain cold immersion therapies can be increased when combined with heat therapies (R). This was measured in total circulating immune cells, natural killer cells, and levels of inflammatory biomarkers. This particular study used hydrotherapy as a pre-treatment and cold-air exposure as the treatment. Not a complete comparison for hydrotherapy but designed on a similar principle.

Other studies designed with alternating temperatures have produced conflicting results. One study found this modality did not provide any dose-dependent benefit on recovery following exercise (R). Another study found contrast hydrotherapy didn’t provide any significant benefit for post-surgical recovery in carpal tunnel syndrome patients (R). That’s a pretty specific and pretty acute case.

Other investigations into alternating therapies have seen a notable benefit in the perception of decreased post-workout fatigue—but not necessarily in levels of testable biomarkers (R).

Health Benefits

Considering the benefits of hydrotherapy can help better understand if it’s right for you. The benefits above are specific in the processes they may stimulate in the body but still a bit ambiguous as to their applied benefits. In other words—what good are they!?

Controlling blood flow—increasing or decreasing—has many applications in health therapies. One such application is addressing conditions where inflammation is a major underlying factor. Another is where burden of blood flow is of concern, such as with stroke or cardiovascular health. Below are some of the many health conditions hydrotherapy may benefit

  • Arthritis
  • Osteoporosis
  • Athletic Injury
  • Heart Health
  • General Inflammation

Age-Related Vascular Impacts

Vasodilation and Vasoconstriction are thermoregulatory processes that become less efficient with age. Research suggests that the elderly are more likely to have decreased vascular responses to changes in temperatures.

Oddly enough, this isn’t a holistic phenomenon and is more pronounced in certain areas such as the forearm (R).

That’s why grandma’s house is always so hot—her body’s vasoconstrictive efficiency is reduced and she’s losing body heat faster! In my opinion alone, hydrotherapy is likely to help counterbalance these types of age-related issues—at least as another tool to be used.


Insights gained by modern science into the benefits of hydrotherapy help recognize its favor throughout human history. From the bathhouses of ancient Roman culture to modern-day spas—hydrotherapy has something to offer to anyone willing to dip their toes in it.

My personal experiences with hydrotherapy have been nightly soaking in scalding-hot Epsom salts baths, deep breathing exercises in belligerently cold showers, and splashing my face with cold water during transitional periods of the day.

I’ve definitely noticed a reduction in inflammation and pain I attribute to that inflammation. Additionally, I’ve noticed an increase in alertness, creativity, and improvements in mood. I haven’t seen anything that makes me believe it to be a miracle therapy but it’s certainly worth checking out.