Whether the result of injury, menstrual cramps or an intense game of tennis, pain is an all-too-common cause of discomfort that can debilitate even your most dedicated efforts to maintain a healthy and active lifestyle. That’s why I (and millions worldwide) depend on hydrotherapy—the use of water to restore and maintain health—to ease pain and inflammation.

Hydrotherapy comprises many types of treatments, including ice, steam and soothing baths. I sit on a moist heating pad while writing books to ease pain and stiffness from years of chronic back issues (my so-called writer’s “black lung”). I keep ice packs in the freezer for acute sprains and strains. I also swim daily for physical exercise, as the water supports my weight while I move my body against the water as a means of friction. This allows me to have pain-free movement while boosting muscle strength and flexibility.

The great thing about hydrotherapy is its versatility in managing pain—it doesn’t work on just one specific type. Though each kind of hydrotherapy is different, they all stimulate the body’s own healing capabilities. For instance, a cold compress reduces swelling by constricting blood vessels, helping to control minor internal bleeding. Conversely, a warm, moist compress on a painful area dilates blood vessels, which in turn lowers blood pressure and increases the flow of blood, oxygen and nutrients to speed the elimination of toxins. Moist heat “may give relief for chronic pain like an arthritic hip, low back pain or monthly menstrual cramps,” says Kim Smith, MD, a Florida-based board-certified rheumatologist. “As muscles relax in response to heat therapy, this tends to decrease pain symptoms as well,” she adds.

When choosing whether to go hot or cold, you should consider the physiological effects and the type of pain you’re enduring. For acute injuries (like an ankle sprain), ice can “slow/dampen the inflammation response, including the substances/chemicals that rush to the area,” says Erin Coughenour, DPT, SCS, RYT, a physical therapist, sports certified specialist and registered yoga teacher who reminds us that not all inflammation is bad and is actually a necessary component of healing. “It's fine to use ice to help decrease pain and inflammation a little, but remember that inflammation is a very important step in the healing process and shouldn’t be eliminated completely.”

Ultimately, hydrotherapy is about what brings you the most relief. Choosing ice or heat is a very individual decision, says Coughenour. “This therapy is based not only on tissue physiology, but also comfort and preference of the patient, which is probably most important. Ultimately, the right choice is what the patient responds to best.” 

If you experience an injury that causes sharp pain and inflammation, try ice first. “Ice can reduce the pain of an acute injury such as a sprain or strain if used for at least 10 minutes each waking hour for the first 78 hours after injury,” says Smith. She suggests using an ice pack, an ice towel (a damp towel that has been sealed in plastic and placed in the freezer for about 15 minutes), an ice massage, a cold gel pack or a bag of frozen vegetables. If you choose the warmer route, Smith recommends using a moist heating pad or a warm, damp towel. You can also stand or sit on a stool in the shower and let warm water hit the painful area on your body. Smith reminds her patients to make sure the water isn’t too warm or you can burn your skin.

“Some of my patients find great relief when they do their range-of-motion exercises in a hot tub or sitting on a stool that has rubber tips for safety under a warm shower—comfortable but not too hot,” Smith tells LivingHealthy. “The constant heat flowing on the affected site helps to keep pain minimal and allows for easier movement.” She also recommends using any moist-heat application for at least 15 minutes before exercise, and then again immediately following exercise.

Balneotherapy: Hydrotherapy’s Cousin

According to findings published in the journal Arthritis Research & Therapy, people with the deep-muscle ailment fibromyalgia find long-lasting pain and tension relief with balneotherapy, which is the practice of bathing in heated water. This centuries-old therapy helps to increase muscle relaxation, boost blood supply to the site and decrease rigidity and spasms in the muscles of people with back pain, arthritis, fibromyalgia, menstrual discomfort and most other types of pain. Epsom salts, baking soda, minerals or other natural products can be added to therapeutic warm baths to assist in pain relief and detoxification.

Suffering with abdominal cramps or pelvic pain? Try a sitz bath—fill a bathtub with warm water so it only covers the abdomen, hips and buttocks. Some women add Epsom salts to the warm sitz bath to increase healing. A jacuzzi is another form of balneotherapy. (Caution: Avoid hot tubs or spas if you have diabetes, high blood pressure or cardiovascular disease, or are pregnant.)

Whether ice, moist heat or soothing baths, I personally believe in the power of hydrotherapy for easing aches and pain and increasing healing. As always, talk with your doctor first, and then see if this ancient treatment can give you a healthful benefit. 



  1. University of New Hampshire Health Services: Hydrotherapy
  2. Cochrane: Balneotherapy (or spa therapy) for rheumatoid arthritis
  3. Cochrane: Aquatic exercise for osteoarthritis
  4. Cochrane: Superficial heat or cold for low back pain
  5. Live Science: How Heating Pads Relieve Internal Pain
  6. eMedicineHealth: Relieving Menstrual Pain
  7. ScienceDaily: Minor injuries: How to know whether ice or heat will ease the pain
  8. ScienceDaily: Ricebag to treat soft tissue injuries
  9. Arthritis Research & Therapy: Therapeutic benefit of balneotherapy and hydrotherapy in the management of fibromyalgia syndrome