Water Therapy
The term water therapy (or hydrotherapy) is a coverall term that includes a wide range of applications from exercising in a pool to swimming in a cold river, to simply taking a bath. On this page, I will focus on three simple applications that can easily be done at home: warm water therapy, cold water therapy, and contrast showers
A brief history of water therapy
One of the first mentions of using cold water for well-being was in the Edwin Smith Surgical Papyrus, which is dated 3500 BC. Ancient Greek thinkers such as Hippocrates and Plato touted the physiological benefits of hydropathy, the Ancient Romans had frigidaria (cool pools) in their public baths. The ancient Chinese physician and surgeon Hua To also used cold water therapy.
The modern evolution of hydrotherapy began with Father Sebastian Kneipp of Germany and Vincent Priessnitz of Austria. Both of them used hydrotherapy to heal themselves from major illnesses: Kneipp from Tuberculosis and Priessnitz from severely broken ribs. Each became internationally famous and attracted thousands of people to seek healing in their respective clinics. Their clinics were made especially famous when they achieved extraordinary rates of healing during the syphilis and smallpox epidemics. Priessnitz treated about 45,000 patients and astonishingly, only 0.1% of them died.
In the US hydrotherapy evolved out of these traditions when O.G. Carroll, ND pioneered a style of in-office hydrotherapy derived from Kneipp combining the use of hot and cold towels with modern physiotherapy devices.
Benefits for Fibromyalgia
Cold water therapy stimulates the body’s natural stress response in a controlled way, triggering a short-term spike in norepinephrine and endorphins. For people with fibromyalgia, this can help reduce sensitivity to pain and lift mood. The sudden exposure to cold also improves blood circulation, particularly in the limbs, which are often cold or achy in fibro patients. Over time, this may reduce systemic inflammation and improve temperature regulation. Cold water immersion and cold showers also support lymphatic drainage, helping the body flush out waste products—a useful benefit when detoxification pathways are sluggish.
Hot water therapy is especially soothing for fibromyalgia symptoms like muscle tightness, joint pain, and poor sleep. Submersion in water at 102°F (38.8°C) encourages vasodilation, which increases blood flow to stiff muscles and delivers oxygen to depleted tissues. The warmth helps reduce the sympathetic nervous system’s grip, creating a window of calm that can ease anxiety and allow the parasympathetic system (rest and repair mode) to activate. As sweating increases, the skin—your largest detox organ—eliminates toxins, supporting gentle cleansing without overwhelming the liver or kidneys. Adding Epsom salts can enhance this process through magnesium absorption, which many people with fibromyalgia are deficient in.
Contrast therapy alternates heat and cold to “pump” the blood and lymphatic systems, improving circulation and clearing stagnation. This rhythmic switching tones blood vessels and may help reduce blood pooling in the legs, common in those with autonomic dysfunction. For fibromyalgia patients with sluggish detoxification, low energy, or brain fog, contrast showers can offer a natural boost by stimulating mitochondrial activity and improving oxygen delivery. This method is also helpful for easing localized pain, such as around the spine or joints, without overexerting the entire body.
Photo by Yaroslav Shuraev at Pexels
Cold water therapy is the practice of intentionally exposing your body to water below 59°F (15°C) for a period of a few minutes in order to achieve therapeutic benefits for the mind and body. There are several different ways to do it from cold showers, ice baths or open water swimming.
The evidence for the benefits of cold water therapy continues to stack up but it’s not for everyone. The truth is that it has some challenges to it that might be too much for someone with a severe chronic illness.
Open water swimming in seas, lakes, or rivers is a wonderful way to connect with nature, but few of us live close to open sources of water. There is also the risk of hypothermia if not done properly.
It’s more convenient is to simply bulk buy ice to dump into your bath at home. That’s providing you have the freezer space. However, the cost of ice will start to stack up if this is a daily practice. Your freezer only has so much space.
In my experience if something takes too much time or preparation people usually give up after a month or two. Here are a few low effort options:
towel method
The towel method requires very little preparation and is very satisfying. You will need a small to medium towel and a bucket of ice water.
Place your towel in the ice bucket and then ring it out so that it’s wet but not drenched.
Start by placing the towel on the area you would like to stimulate blood flow. It can be around an ankle that had a recent strain or it can be on your stomach for pre-menstrual cramping. Keep it there for 3-4 minutes. If it feels uncomfortable remove it immediately.
Hot Water Therapy
Hot water therapy involves taking a bath in hot water every other day for a period of at least a month. Unlike a conventional bath you lay back in the water so that your head is submerged with only your face out of the water. If the tub is too short, you can bend your knees, but it’s vital to keep your head in the water.
A 2013 clinical study led by Eric Hollander MD, a professor at Albert Einstein College of Medicine, done with 40 autistic children, found just one 30-minute bath at 102° F (38.8°C) helped soothe the symptoms of autism and made the children more sociable.
What is most significant in this study is that these changes did not occur when the bath was only a few degrees cooler at 98° F (36.7°). A hot bath worked while a warm bath did not.
method
The standard method is to spend an hour in the bath starting at a temperature of 98° F (36.7°) and slowly increasing it to 102° F (38.8°C).
The difficulty with this method is that most people don’t have baths that are temperature controlled. Of course you could buy a special bathtub heater that warms your bath but they are expensive and I’m sure you are not too keen on being immersed in water with an electronic device that may burn or shock you.
easy alternative
On the first day run a hot bath. Sit in the tub until your body has acclimated to the water and then slowly lower your upper body until your ears and most of your head are immersed. If you feel any discomfort sit up immediately and wait for the temperature to drop before trying again. Aim for a total of 20 minutes of immersion.
On the following days raise the temperature slightly each time until you reach 102° F (38.8°C). Do not try to go above this temperature: there are no added benefits to higher temperatures and you could burn yourself.
safety
If you feel any signs of physical or emotional discomfort such as a headache or fear of drowning, stop immediately and try again another day.
During the session you will sweat a lot, so to avoid becoming dehydrated drink a decent amount of water before you start. You’ll probably feel thirsty while in the tub so have a glass of cold water within reach. You’ll probably feel thirsty after the session too.
Once you are done and it’s time to get out the tub make sure to stand up slowly. There is a chance you could feel light headed.
If possible let someone know what you are doing and have them check up on you now and then.
tips
Spending time in a tub for 20 minutes or more may be boring to some people and I’ve heard recommendations of listening to music or to a podcast, however I found this counterproductive. The reason for this is that hot water therapy is very much an emotional experience. Once your ears are submerged you enter a whole new universe. The outside world fades and it’s as if you are back in the womb.
I suggest turning off the lights before you get into the tub. Close your eyes and turn your attention inward to your body. Listen to your heartbeat and other physiological activities taking place.
Dr. John Gray, who has been using this therapy with his ADHD and autism patients for 15 years, recommends adding 6 pounds (2.7kg) of Epsom salts to the water. You could also try normal table salt or baking soda.
Contrast Showers
Contrast showers are gentler than cold water plunges and require very little preparation. Begin with your usual warm shower.
Once your body is sufficiently warm switch to a tolerable cool temperature. The more abrupt the change the better. Aim for 30 seconds of cool water.
Repeat this cycle of switching from hot to cold, making the cold water a little colder each time. The experts recommend always ending on cold as this is more beneficial. However, this is up to you. Ending on cold is more invigorating but if you feel tired or it's cold outside then end on hot. It’s recommend to rest for 20 minutes afterwards. Hot water dries the skin so you might want to apply a little moisturizer.
The great thing about a contrast shower is that you don’t need to spay your entire body with water, you can focus the spray on a specific area of your body.
The Towel Method
The towel method requires a bit more preparation but it’s much more satisfying. You will need two small to medium towels, one bucket of cold iced water, and one bucket of hot water.
Place one towel in the ice bucket and then ring it out so that it’s wet but not drenched. Dip the other towel in the bucket of hot water and ring it out. Make sure that it’s hot but not so hot that you risk burning your skin.
Start by placing the warm towel on the area you would like to stimulate blood flow. It can be around an ankle that had a recent strain or it can be on your stomach for pre-menstrual cramping. Keep it there for 3-4 minutes. If it feels uncomfortable remove it immediately.
Then quickly switch the hot towel with the cold towel. It will feel cold but energizing. Keep the cold towel on for 30-60 seconds.
Repeat this cycle 4 to 8 times, always remembering to end on cold.
You may do hydrotherapy daily if you’d like but once every 2-3 days is sufficient.
contraindications
This treatment is not recommended if you are pregnant, have diabetes, Raynaud’s disease, Multiple Sclerosis, asthma, acute bladder infections, difficulty sensing hot or cold, or low body temperatures
disclaimer
The information in this article is for educational purposes only and it’s not the author’s intent to substitute the article for diagnosis, counseling, or treatment by a qualified health professional.
