Using Hydrotherapy in Health & Illness

When I turned 47, my then teenaged daughter made a beautiful card for me — 47 Reasons You’ll Never Grow Old. Among her listings were: you can pull off cool belts, you let your hair go sparkly gray, and you know how to luxuriate in the bath.

The author’s husband luxuriating in the tub some years back

I am not sure about the first two, but the last one is spot on! The bath for me is a much anticipated reward at the end of the day. Lights low, water steamy warm just melts my day away. With some long deep breaths and a body washed clean, I transition from a busy day to my peaceful bed.

For patients in my naturopathic medicine practice, I will prescribe a warm bath for insomnia, for sore muscles and joints, and for patients who are just too keyed up from the hustle bustle of life. Park all your electronics in a different room! Keep the bathroom nice and warm! Bring a cup of tea with you if you like! Some people prefer a quick soak and a brief splash of cold at the end. Others will stay in until the skin gets shriveled up. Whatever works!

My happy relationship to baths started early, as number three of four kids, I was often thrown into the tub with my sisters. I’m not sure if that was to save time or conserve water, but bath time shenanigans, making dippity-dos with shampoo, and learning how to squirt water with my cupped hands was good clean fun. I never really wanted to get out, even when the water turned cold and I was wrinkled up like a raisin.

The author in the middle with her younger & older sister, good clean fun!

Fast forward a few decades, as a young mother, the evolving bath routines with my own children was a delicious part of motherhood. I remember being a bit afraid just how slippery that first tiny baby was, holding her precious body in the white, porcelain, kitchen sink of a bathtub, feeling the weight of responsibility and devotion to keeping her safe and happy! And a few years later, two rambunctious sons, splashing around in the big tub, stacking plastic cups or pretending to snorkel with a straw and a headband, or leaning those sturdy little necks bravely backward so I could wash all that curly hair. My positive posture toward baths and bathing has never wavered.

When I arrived at naturopathic medical school in 1982, I was delighted to learn that there was a whole therapeutic modality called hydrotherapy. Over my 30+ years of seeing patients, I still love using at-home water treatments as a basic healing modality.

The Capellini Defense

Some years ago, a friend came to see me. He said he had a capellini condition. For those who might not remember, capellini is a very thin, rod-shaped spaghetti enjoyed by many a pasta lover. He held out his hand to show me the damage. He had an infection around his thumb nail, an acute paronychia. He had been washing dishes a few days earlier and could not dislodge a piece of capellini adhered to the bottom of a pot. Scrub as he might, it would not come loose, so like a lot of us, he used his thumbnail to get under the pasta to try to remove it. Up it came, but unfortunately, it wedged between his nail and his nail bed and snapped off, a small hard splinter under the nail with no part of the splinter protruding.

There is very little space between the nail and the nail bed, and the pressure and pain were mounting. The throbbing and discomfort were so bad that in the middle of the night, he went to the emergency room. Generally speaking, a splinter under a nail can be removed carefully if a bit is sticking out, by clipping the nail around the splinter and employing a good pair of tweezers. But this was deeper in and an infection had started to brew, with tenderness in the area spreading to the rest of the finger. He came home from the ER without removal of the splinter or resolution to his problem.

As a naturopathic doctor, I thought about the best ways to treat him. I knew he did not want to go back to the emergency department where they would need to cut a deep V in the nail reaching to where the hard pasta was embedded. Due to the infection, he would be prescribed oral antibiotics. I know that infections of the fingertips and nails must be treated carefully to prevent the infection from spreading and that treatments must be individualized to the patient. I suggested the use of botanical and nutritional antibiotic substances alongside some a very basic hydrotherapy treatment.

Photo by Fredrick Suwandi on Unsplash

Some might think of hydrotherapy as a quaint approach used in times gone by, but it is commonly used in both occupational and physical therapy and by naturopathic and other natural and integrative medicine providers. Harkening back to naturopathic medicine roots, hydrotherapy refers to a wide array of treatments that make use of the mechanical and thermal influences of water when applied to particular areas of the body. Depending on the patient’s complaint, the goal is to stimulate, calm or balance the nervous, immune, cardiovascular and digestive systems or to offer pain relief. Scientific research continues to show the impact of hydrotherapy on patients with many different complaints.

Hydrotherapeutic actions rely on the temperature of the water and the length of immersion or application. Cold water makes superficial blood vessels constrict, which pushes blood toward internal organs. In contrast, hot water encourages blood vessels to dilate, which aids in waste removal from tissues. Cold water is stimulating and invigorating; hot water is relaxing and soothing. Alternating hot and cold water decreases inflammation, improves elimination, and stimulates circulation. Moving water impacts touch receptors at the skin, which helps relax tight muscles and supports the circulatory system. Total submersion minimizes pressure on joints and internal organs.

We also now know that hydrotherapy impacts nerve impulses, which play a role in the creation and release of stress hormones, hence why the hot bath or hot tub is so relaxing. Like all medical and healing approaches, hydrotherapy must be applied appropriately for the right conditions. And when done in the clinic, CDC guidelines for Environmental Infection Control in Health Care Facilities-Hydrotherapy Tanks and Pools apply.

In practice, I have patients do treatments at home with plenty of direction. I might suggest treatments directly on an area in question, like soaking for a local infection, described further below. For other patients, I might use a treatment for a more derivative impact, for instance, suggesting a hot foot bath to relieve the pressure of sinus congestion.

For my capellini patient, I recommended alternating hot and cold soaks to the finger. I told him the greater the contrast in temperature, the more effective. The hot water should be as hot as he could tolerate without burning himself, and the cold water should be ice cold. I suggested he immerse his whole thumb and to do three-minute immersions in the hot and 10 seconds in the ice water, back and forth for 10 minutes, repeat every 2–3 hours while awake. I had him put Hydrastis canadensis tincture, a dropperful or so, in the hot water. This herb, commonly known as goldenseal, contains berberine which has been shown to have antibiotic and astringent qualities.

I also recommended extra vitamin C, zinc and a garlic supplementation, each of which helps support healthy immune system function alongside a multi-strain probiotic, to be taken by mouth, to help him better fight the infection. I asked him to refrain from alcohol and refined sugar, to be sure to drink plenty of water and to rest as much as he could.

By the next day, the persnickety piece of pasta had come out and though the area was still pink, the swelling had gone down and it was less tender to touch. I felt comfortable continuing this approach and he carried on with the plan. By the following day, the swelling and inflammation had resolved. His finger was back to normal without the need for the deep V cut to the nail or oral antibiotics.

He was happy he was able fight off the infection and glad to have side-stepped antibiotics, which had historically been difficult on his digestive system. He loved using the hydrotherapy, felt like it supported better circulation to and away from his finger and helped get the infection moving out of his system. He has vowed to let pots with food debris caked on soak overnight from here on out!

For further information about naturopathic medicine see here or here. To read more of Dr. Rothenberg’s writing, see here.

Portions of this article originally appeared in the Huffington Post.



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Amy Rothenberg ND

Amy Rothenberg ND


American Association of Naturopathic Physician’s 2017 Physician of the Year. Teacher, writer and advocate for healthy living.