General Rules of Hydrotherapy

1. Take a full case history to rule out contraindications.  Check for cardiac problems or other circulatory issues.  Determine the overall state of health (mental, physical, emotional).  People with diabetes should not be treated.
2. Take the client’s temperature before beginning treatment to determine temperature of treatment. Ask them what is their normal temperature. If they are above normal, use less heat.  You may also want to take their pulse and respiratory rate to use as a guideline during the treatment.
3. Always thoroughly explain the treatment before beginning.  Include the procedure, length of session, and any other details.  Be sure they understand everything and are 100% comfortable will all aspects of treatment.
4. Stay with the client at all times or have an emergency signal such as a bell (be sure it can be heard above anything else).  You can also use a baby monitor in the room.
5. Provide a clean room with adequate temperature control to insure the client does not become chilled or too hot (depending on the treatment)
6. Moderation is the key to a positive treatment.  Hydrotherapy can be exhausting and dehydrating to the body.  Too much can cause adverse reactions.
7. Keep fresh drinking water available at all times and encourage them to drink regularly.
8. Watch for adverse reactions and stop immediately.

General Contraindications/Cautions
Please consult the referring physician whenever uncertain about any condition or response.

1. Cancer – Caution is advised when treating clients with cancer.  It is best to work with the consent of a physician.  Some physicians may not be aware of the effects of hydrotherapy.
2. Hemorrhage– Caution is advised when treating a client who has a tendency to hemorrhage.  Applications of heat and cold which cause vasodilation increase the possibility of hemorrhage.
3. Decreased Sensation– Any condition in which the client has a decrease in sensitivity of the skin Hydrotherapy is contraindicated as they may not be able to feel if the skin is too cold or hot.
4. Weakness -Hydrotherapy may be contraindicated in a client that is weak as a treatment may make the weakness worse.
5. Skin lesions– Applications are contraindicated in the case of broken skin or other skin irritation that may be exacerbated by hot or cold.
6. Skin lesions such as pustules, papules, blisters that are infected may rupture due to increased vasodilation and are contraindicated.
7. Pregnancy – Full body hot applications to a pregnant woman are contraindicated as they may be associated with an increased incidence of birth defects.  This contraindicated the use of hot tubs and other steady- temperature hot full body baths as well as local applications of heat to the abdomen.
8. Tuberculosis – Full body hot baths may spread tuberculosis and is contraindicated.
9. Anemia– Full body application of heat increases cellular demands for oxygen that cannot be supplied if the client is anemic.
10. Diabetes Mellitus – Advanced diabetes, especially Type I (juvenile onset) can decrease the client’s ability to sense tissue damage especially in the lower extremities.  The vascular damage caused by this disease also decreases blood flow to tissues.  Heat is contraindicated in these areas.  Consult the physician.
11. Heart disease – Heat and cold applications that increase the heart rate and force of contraction are contraindicated in heart disease as it may overwork an already weakened heart.
12. Hypertension – Heat and cold applications that increase the heart rate are contraindicated due to the stress on the heart.
13. Peripheral vascular disease – Athlerosclerosis and arteriosclerosis clients may have weakened or blocked arteries.  Heat applications increase tissue metabolism and demand for oxygen making heat applications contraindicated.
14. Temperature – Body temperature should not go above 104 degrees.  Temperatures above this may cause tissue damage.  Monitor with oral thermometer.
15. Pulse – Heart rate should not exceed 140 beats per minute as it may overstress the heart.  Monitor with lateral anterior wrist.
16. Post treatment rest period – The body should be allowed to rest for at least a half hour after a full body hot application to allow the body to return to normal.
17. Skin sensitivity – Cold applications are contraindicated for clients who have suffered from frostbite previously or who have hypersensitivity to cold due to Raynaud’s disease or other conditions such as low blood pressure.
18. Hypothyroidism – Cold applications are contraindicated in clients with hypothyroidism which further causes a reduction in basal metabolic rate
19. Kidney problems – Cold is also contraindicated in kidney malfunction or disease.
20. Inflammation – Heat applications are contraindicated in acute conditions of inflammation such as bursitis, arthritis, tendinitis, sprains and strains.

Adverse Reactions:

1. Headaches – may occur as a result of dehydration or reaction to water temperature.  Apply cold compresses to the head or back of neck and drink more water.
2. Shivering – may occur if cold treatment is applied for too long or are not followed by appropriate warming.
3. Vertigo – (dizziness) may occur as a result of dehydration or reaction to changes in blood pressure.  Have client lay down again and get up slowly.
4. Insomnia – may occur after an invigorating treatment.
5. Heart palpation – may accompany dizziness or occur alone as a result of increased temperature of the body.
6. Skin sensitivity – may be ticklish
7. Hyperventilation – may occur if client becomes anxious about treatment or any thing else.
8. Fainting – may occur as a result of changes in blood pressure from treatment.
9. Nausea – May occur as a result of detoxification or reaction to treatment.
10. Sensitivity to water– skin irritation due to prolonged application of water