Hydrotherapy is the use of water in the treatment of different conditions, including axial spondyloarthritis (axSpA). Hydrotherapy differs from swimming because it involves special exercises that you do in a warm-water pool. The water temperature is usually 34ºC, which is warmer than a typical swimming pool.
You’ll normally have hydrotherapy treatment within a hospital’s physiotherapy department or with a private physiotherapist. Usually a physiotherapist or a physiotherapist’s assistant with specialist training will show you how to do the exercises. The focus of the exercises can be adjusted to help your range of movement or strength, depending on your symptoms.
Hydrotherapy is different to aqua aerobics as it’s generally more focused on slow, controlled movements.
Spa therapy is based on the theory that the mineral content of spa water has special health-giving properties. Although there’s some research that suggests the mineral content of the water may make a difference, other studies show that hydrotherapy has significant benefits regardless of the water used.
Hydrotherapy can help you in a number of different ways:
Scientific studies have shown that hydrotherapy can improve strength and general fitness in people with axSpA. The exercises can be tailored to your individual needs, so you can start to slowly and gradually build up your strength and flexibility.
The extra support that the water provides may make you feel like you can do more exercise than normal, so be careful not to overdo it. The exercise and the warmth of the water may make you feel tired after treatment, but this is quite normal. In general, hydrotherapy is one of the safest treatments for axSpA.
Hydrotherapy pools are usually located in hospitals, community centres, aquatic centres, private clinics and special schools.
Your rheumatologist or any member of your rheumatology healthcare team or your GP should be able to refer you to an aquatic physiotherapist in your area if they think you might benefit from hydrotherapy.
You can also choose to see an aquatic physiotherapist privately, at your own cost. Contact the Australian Physiotherapy Association below to find an aquatic physiotherapist in your area.
You should take:
You don’t have to be able to swim to benefit from hydrotherapy. The pool usually has a shallow end (about waist to chest height) where most exercises will be done standing up. In your first few sessions, the aquatic physiotherapist or assistant will be close by to give you the help you need. Even if you’re nervous about being in the water it’s worth trying hydrotherapy – most people find the warm water soothing and pleasant, and become more confident in the water with time.
Most hydrotherapy pools will have a ramp down into the pool, as well as a mechanical hoist if you can't manage the ramp.
Most pools have different depths, varying from waist height to chest height, and there will be a rail around the edge of the pool for extra support.
There are certain situations where you may not be able to have hydrotherapy. You must tell your physiotherapist if you have any of the following:
You and your aquatic physiotherapist will decide whether hydrotherapy is suitable. The decision will be based on the severity of your condition, whether it affects more than one part of your body and your medication. Hydrotherapy isn’t advised if you have certain conditions in the list, but with others it’s just to inform the physiotherapist so they can take precautions if they need to.
One of the main aims of hydrotherapy treatment is to give you confidence to continue and manage a programme of exercises on your own once the course has finished. Your physiotherapist will probably suggest that you carry on with your exercises in your local swimming pool.
Some swimming pools have special sessions when the water temperature may be increased and some sports centres offer water-based exercise classes. Ask your doctor or physiotherapist for advice before you join a class to make sure it’s suitable. You should also speak to the instructor about your arthritis and its effects so they can adapt some of the exercises for you if necessary.
It may also be possible to pay for further sessions without the physiotherapist in the hospital pool.
If you can’t swim, it might be worth learning – swimming is an excellent form of exercise for improving your fitness and mobility without putting a lot of strain on your joints. Ask a healthcare professional for advice if you’re not sure whether it would be suitable for you.
Contact your local Arthritis Office on T: 1800 011 041 for more information about hydrotherapy availability and services.
This resource has been developed based on the best available evidence. A full list of references is available upon request.