Aquatic water therapy for chronic pain: Myth or reality?

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AQUATIC THERAPY FOR PAIN: Fact or fiction Author: Anil Minocha of Shreveport, LA

Aquatic therapy also known as Water aerobic therapy or pool therapy refers to the physical therapy and rehabilitation performed in water without the need for weights.

• Scientific data and expert opinions indicate that it provides therapeutic benefit in fibromyalgia. 
• Aquatic therapy has potential for benefit in patients with other types of chronic pain disorders and cancer and neuro-rehabilitation.
• Human trials suggest that aquatic therapy also provides short-term benefit in patients with osteoarthritis.

A variety of hydrofitness devices are available and can be individualized.

Principles of aquatic or water therapy

Water provides resistance and is believed to be healthier than the use of weights. The hydrostatic pressure produces forces perpendicular to the bodys surface Water buoyancy helps support the weight of the patient.

The combination of water resistance and  buoyancy reduces weight bearing and stress placed on the joints allowing low impact exercises with reduced joint stress as compared to exercises on land.

A decrease in stress on joints makes it easier for patients to get benefits of exercise with lesser pain/stress.

Types of aquatic therapy

Water enthusiasts have many options regarding not only depth of water, i.e.shallow versus deep water therapy but also the format of exercises that they may enjoy and find easy to perform consistent with their health. Various types of aquatic therapy are available:

Ai Chi: Developed by Jun Konno of Japan, it combined deep breathing associated with slow movements of limbs and torso. 

Ai Chi Ne: This is a partner requiring 2-person exercise program involving breathing and stretch exercises.

BackHab: This may be undertaken as an individual or a group. It is specially tailored for patients with physical impairments including back problems. It includes walking in water and a variety of limb movements tailored to the patient’s health problems.

Bad Ragaz: Initially developed in Germany, it is described as  the Bad Ragaz Ring Method targeting  muscle re-education via utilizing particular ways of resistance, endurance, and  range of motion.

The Burdenko Method: The Burdenko Method combines land and water exercise therapy for athletic training as well as physically challenged subjects.

Feldenkrais: Created by nuclear physicist Moshe Feldenkrais, it is based on principle that our movements etc depend upon the way we think and feel. Thus exercises of combining breathing and flexibility of movement are undertaken in context of awareness of old patterns and concerted effort to modify them to improve the overall other aspects of life. Touch and tissue manipulation by the therapist may be involved.

Halliwick: It is a 10-point program of motor learning and mental adjutments that specializes in teaching patients with a variety of physical or mental disabilities to get involved with water activities exercises with the goal of getting them to move about and swim in water independently in water, and to swim.

Wassertanzen: Wassertanzen means water dance. This type of aquatic therapy is a dynamic movement therapy that involves exercises below the water surface utilizing nose clips. This form of therapy is unique in the sense that it involves the patient surrendering control of his/her breath to go under water.

Water Yoga: Yoga exercises are performed with subject in waist- to chest-depth water. 

Watsu: Created by Harold Dull, watsu as the name suggests is a combination of water and shiatsu wherein the subject is held in warm water by the therapist and moved around using water resistance as the source of massage. Watsu aims to integrate massage, muscle stretching and dance. It has been described as especially suited for elderly and pregnant.

Yogalates: It uses a combination of yoga, Pilates, and Ai Chi. 

Miscellaneous aquatic therapies: Other modifications/styles include Lyu Ki Dou and Water Pilates

Contraindications to aquatic/water therapy

• Significant cardiac or respiratory disease
• Fever and active  infections
• Urinary or stool incontinence
• Consult your physician prior to any exercise program 

Significance in of aquatic therapy in health and sickness

• While there is lack of data on the role of aquatic therapy in digestive health, data on its beneficial effect in chronic pain disorders like fibromyalgia indicates that it may have potential for therapeutic benefit in chronic functional bowel disorders. 
• Randomized controlled trials indicate that an exercise program thrice a week in a warm pool improves symptoms of fibromyalgia.
• Thomas and Blotman conclude that aerobic-only exercise provides improves physical function and may be therapeutic for tender points and pain in fibromyalgia.

Bottomline: Aquatic therapy is well suited for healing as well as health maintenance for diverse patient populations. Besides wide margin of therapeutic safety, the therapist can easily develop a specifically targeted therapeutic program for diverse clinical conditions.

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Comments

[Amin]

I have heard about aquatic water therapy but i did not confirm when i read your article then i understand the worth of aquatic water therapy really it is very informative for me i will share your site with my friend.

[Torque Wrench]

I have this doubt for a long time about water therapy, until I bumped into your blog for some reasons that I benefited the most, Now I am completely sure that water therapy helps a lot not just for health maintenance but for healing reasons, ...many thanks for sharing this...I'll be sharing this on FaceBook too

[Diet for fatty liver]

I wonder if aquatic water therapy has any known benefits for internal organs...such as the liver, kidneys, etc. Perhaps by reducing the effect of gravity?

DJ