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HydrotherapyIn the world of natural healing, however, hydrotherapy continues to claim devoted proponents. Techniques such as constitutional hydrotherapy and hot fomentation, both of which seek to rid the body of toxins, are advocated for a wide range of diseases. WatsuŽ, a sort of aquatic version of Chinese deep-tissue massage, is said to help pain, stiff joints, spasticity, and tension. Although none of these techniques have been validated through clinical trials, practitioners point to a growing file of case studies as proof of their success. Among hydrotherapy's more conventional uses are treatment of soft-tissue injuries, musculoskeletal injuries, back pain, arthritis, premenstrual syndrome, menstrual cramps, diabetes and other diseases that impair circulation, balance disorders, and muscle weakness. In the alternative medicine realm, claims for procedures such as constitutional hydrotherapy and hot fomentation tend to be much more extravagant. They include treatment of ear infections, high fever, multiple sclerosis, cancer, fractures, migraine, digestive problems, prostatitis, kidney and bladder infections, depression, attention deficit disorder, and anxiety. CONSTITUTIONAL HYDROTHERAPY Typically given in the practitioner's office, this form of therapy combines systematic application of hot and cold wet towels with administration of mild electrical stimulation to various muscle groups. Before starting therapy, the practitioner may conduct a physical examination to diagnose your condition. The sophistication of the exam will depend on the type of practitioner you're seeing. The recommended number of sessions will be based on the therapist's assessment of your condition. Here's how a typical session progresses: First, as you lie face-up on an examination table, the therapist will cover your torso with two hot, wet towels, wrung out so that they are moist but not dripping, and folded in half. The temperature of the towels will be about 120 degrees Fahrenheit. Once the towels are in place, the therapist will pull a wool blanket up to your shoulders, leaving it loose so that air can circulate around the body. The towels are left in place for 5 minutes. Next, the therapist will pull the blanket down and place a new set of hot towels over the original ones, which will have cooled. He will then flip the towels so that new ones are next to your body, and remove the old ones. Next, he will place folded cold towels, described by one practitioner as at "gasping temperature," over the hot towels and flip the towels again. The cold towels remain in place on the chest for 10 minutes. Again, you'll be covered by a blanket. During application of the cold wet towels, the therapist will place "sine wave" (electrical) pads on either side of your spine just below the shoulders. The pads will deliver a mild electrical current to the muscles. This current feels like a buzzing or tickling sensation. It isn't painful, but it should be firm. The sine wave machine will run for 10 minutes. You'll be able to control the strength of the current. (When used to encourage healing after a fracture--once the bones have been set--the sine wave pads are positioned directly over the injured bone.) After 10 minutes, the therapist will remove the cold towels and reposition the pads, with one placed on the center of the lumbar or lower back area and the other located just under your rib cage in the solar plexus region. The sine wave machine will then run for another 10 minutes, without the benefit of new towels. The entire process is then repeated as you lie face-down. At the end of the treatment, the therapist will rub your back down with a dry towel--sort of a "wake-up" call for the skin and body. Treatment Time: Each session takes about 45 minutes to 1 hour. Treatment Frequency: Depending on the condition, as many as 15 sessions may be recommended; children may require fewer treatments. For an acute condition, like the flu, for example, a practitioner may suggest constitutional hydrotherapy every day for 3 or 4 consecutive days. For a chronic condition, therapy is often recommended 2 to 3 times a week. According to practitioners of constitutional hydrotherapy, the treatments are most successful when administered close together. HOT FOMENTATION These treatments are like constitutional hydrotherapy minus the electrical stimulator. They are administered in the practitioners office, where patients with serious, chronic conditions can be monitored if need be. Here's what to expect: As you lie on your back, the therapist will place hot towels over your torso. He will then put hot packs atop the towels, place others under your back, and cover you with a wool blanket. Herbs may be added to the hot water in the towels. This technique can also be used on specific regions of the body to relieve specific symptoms, such as menstrual cramps or PMS. Other variations include placing your feet in hot water while the hot towels are being applied to your chest, or putting a cold compress on your forehead while you're wrapped in the blankets. A rub down over the chest with a cold towel sometimes follows the hot towel application. Treatment Time: Each session lasts about 1 hour. Treatment Frequency: Sessions may be repeated once a week or more frequently, depending on the illness under treatment. OTHER HOT/COLD TREATMENTS Some naturopathic practitioners recommend a procedure called a "wet T-shirt treatment" for use at home. To relieve symptoms of a cough, for example, the patient is told to stand in a hot shower long enough for steam to build up. He then dries off, wrings out a T-shirt that's been soaking in ice water, puts it on, covers it with a wool or flannel shirt or sweater, and goes to bed under several layers of blankets. A comparable treatment for children or infants who can't stand in a shower involves cold, moist socks covered by dry, warm socks. Many primary care physicians recommend a variation of this procedure for colds, coughs, and congestion, especially in young children and infants. Parents are instructed to sit with the child in the bathroom while the running shower creates steam. After about 15 minutes in the steam, the parent then holds the child's face in front of the opened freezer compartment of the refrigerator, while encouraging the child to inhale the cold air. If the weather is cold enough, a brief trip outside, holding the child in a blanket, may achieve the same effect. This process should be repeated several times. AQUATIC PHYSICAL THERAPY This form of water-supported exercise is recognized by many insurance providers. Still known as hydrotherapy in Europe, it is recommended for patients whose medical condition causes pain during physical therapy outside of water, or whose rehabilitation will be aided by a water environment. Procedures range from immersion in a whirlpool bath to movement therapy in a swimming pool. WATSU This unique form of therapy has been described as water ballet, though it is wholly passive on the patient's part. The therapist holds, floats, tosses, or stretches patients through the water in a specific sequence of movements. The effect is somewhat like aquatic yoga combined with maneuvers from shiatsu, or Chinese massage. CONSTITUTIONAL HYDROTHERAPY The practice of constitutional hydrotherapy originated with Otis G. Carroll in 1908. To earlier forms of water treatment, Carroll added electrical stimulation, shortening the application times for the hot and cold packs. He believed that this regimen could change the constitution of the cells in the body. Today, advocates claim that the treatments detoxify the system and bring it back into balance. They believe that alternate applications of heat and cold can increase the body's white cell count, and hence boost its ability to fight infection and disease. They claim that, since the nerves in the skin are connected to the central nervous system, the hot/cold treatments can also help reestablish normal neurological functions. They add that the therapy can be expected to improve circulation and metabolism in the digestive organs and increase the amount of oxygen in the blood stream. The mild electrical current administered during the treatments is believed to promote the production of digestive enzymes by stimulating the smooth muscle in the lining of the stomach and the ducts of the pancreas, gallbladder, and liver. Despite all these purported benefits, many patients feel worse, rather than better, after a course of these treatments. Advocates of constitutional hydrotherapy (and hot fomentation) explain this reaction as a "healing crisis" said to occur when the body becomes strong enough to throw off harmful toxins. For example, if constitutional hydrotherapy is used to cure a sinus infection, the body is said to eliminate its toxins through the mucus in the sinuses, thus causing what appears to be a relapse. Patients also tend to experience a mild, flu-like feeling for a couple of days as the body restores itself. On the plus side, advocates promise that once the body has experienced a healing crisis it won't succumb to the same illness as severely in the future. Critics of these treatments suggest that almost any activity, from taking a cold shower to getting too much sleep, can boost the body's infection-fighting T cells. They add that although many of the treatment's actions may sound plausible, there's no evidence that they actually occur. HOT FOMENTATION Some practitioners believe that hot fomentation aids the body in destroying cancer cells, viruses, and bacteria, all of which have a narrow tolerance to high temperatures. (The goal when treating cancer, for instance, is to raise the body temperature to 102 to 105 degrees for 30 to 45 minutes.) Other practitioners recommend these heat treatments to relieve fever. The theory here is that fever-reducing medications disrupt the body's normal regulatory mechanisms, ultimately destroying its ability to bring the fever to an end. By raising body temperature to between 101 and 103 degrees, hot fomentation is said to reestablish the natural fever cycle, allowing the body to break the fever itself. AQUATIC PHYSICAL THERAPY The uplifting effect of immersion in water can relieve the pain of a compression injury in a joint or the spine. Hydrotherapy can also improve circulation and reduce swelling or fluid build-up in the legs. And exercising in water can help patients achieve a more efficient heart rate. WATSU Watsu, created by Harold Dull, at the School of Shiatsu and Massage in Harbin Springs, CA, has sparked controversy among physical therapists. Although some consider its methods helpful for some patients, others find its intimate, though nonsexual, nature uncomfortable. It is typically recommended to relieve stiffness and tension. Hot/cold treatments, including constitutional hydrotherapy and hot fomentation, are ill advised for anyone suffering from loss of sensation in a part of the body to be exposed to the treatments. You should also avoid this type of therapy if you have asthma, kidney disease, a weak heart, a bleeding disorder, or an organ transplant. Likewise, frail people such as the elderly may not tolerate the treatments well. Constitutional hydrotherapy, in particular, is inadvisable for people with metal implants or pacemakers, due to the electrical stimulation used during treatment. Aquatic physical therapy and techniques such as Watsu are best avoided if you have inner ear problems, a disorder of the spine, multiple sclerosis (in warm water), an acute orthopedic injury or unstable joint, or a condition that makes breathing in water difficult. Avoid Watsu, in particular, if you have a head injury or a dislike of intimate contact. The "healing crisis" often encountered in constitutional hydrotherapy and hot fomentation is an unpleasant, but short-lived, side effect. Procedures that leave one tightly wrapped in towels and blankets sometimes trigger feelings of claustrophobia in those prone to the problem. The heat used in many of the treatments can also prove overwhelming to some patients. For the majority, however, these treatments are usually harmless. The "detoxifying" forms of hydrotherapy are especially popular among naturopathic physicians--practitioners who focus on helping the body heal itself. The noninvasive, nontoxic nature of these therapies fits in well with naturopathy's emphasis on the "healing power of nature." Indeed, naturopaths are the only alternative medicine practitioners who receive formal training in hydrotherapy techniques. When choosing a naturopathic practitioner, check with the American Association of Naturopathic Physicians (AANP) to make sure he is licensed or accredited. (Only 11 states currently require a license.) Physicians recommended by the AANP must complete four years of graduate-level naturopathic medical school, receiving training in the same basic sciences covered in conventional medical schools. There are currently two such schools in the United States. Avoid graduates of correspondence courses. If you need to consider water-based physical therapy, look for a certified professional experienced in this special type of treatment. Many physical therapists, occupational therapists, physical or athletic trainers, and massage therapists offer aquatic therapy. It was recognized as a special interest area by the American Physical Therapy Association in 1992. If you're not sure whether aquatic therapy is right for you, consult a licensed physical therapist. He or she can provide an assessment and treatment plan for your condition, and recommend a specialist. "Detoxification" with hydrotherapy is usually discontinued as soon as a "healing crisis" occurs. Ordinarily, several sessions are required to trigger the crisis. An additional session or two may be recommended to help you through the symptoms. Other forms of hydrotherapy can be stopped when symptoms subside--or when the treatments no longer help. Although some practitioners advocate hydrotherapy as a treatment for cancer, there is absolutely no scientific evidence that it works. Using hydrotherapy as a substitute for conventional treatment will therefore put your life at risk. Continue to see an MD or DO if you have cancer or any other serious illness. Likewise, if you have chest pains, a rapid pulse, and difficulty with exertion--or even suspect you have a heart condition--get mainstream medical care. Most natural healing programs don't even attempt to remedy acute cardiac problems (though many seek to prevent them). Recurrent fevers, infections, or pain may be signs of a serious chronic illness. If such symptoms return or are made worse by hydrotherapy, turn to a conventional doctor for further evaluation. |