Water works for joint pain

The benefits of hydrotherapy to sore muscles and stiff joints is immeasurable

HYDROTHERAPY MEANS different things to different people.

In the so-called wellness industry, luxuriating in swimming pools with hot and cold water jet sprays and jacuzzis is sometimes referred to as hydrotherapy. However, in more clinical settings, hydrotherapy is defined as an active form of therapy, carried out in warm water swimming pools to help people manage or recover from specific conditions.

"Hydrotherapy is not passive. In fact, it can be quite vigorous and while it is commonly used for rheumatology patients, it is also used for sports rehabilitation and for people who have had spinal and head injuries," explains Fiona Pegum, senior chartered physiotherapist in hydrotherapy at Our Lady's Hospice in Harold's Cross, Dublin.

Rheumatology patients with inflammatory arthritis, osteoarthritis, chronic pain and musculoskeletal problems are referred from St Vincent's Hospital to Our Lady's Hospice in Harold's Cross for rehabilitation.

"We also offer hydrotherapy to patients in the community reablement unit who have had minor falls and have been referred to us from St James's Hospital and then we have children with arthritis who come here from Our Lady's Hospital in Crumlin," explains Pegum.

The range of patients who use the hydrotherapy pool at Our Lady's Hospice in Harold's Cross paints a picture of how valuable it is.

"Patients are difficult to discharge from hydrotherapy because they like it so much," says Pegum. "Moving in water helps them build up their confidence again and they often don't realise how much they are moving," she explains.

"In Ireland, older people can be terrified to get into the pool but often it's those who were most afraid who make the biggest journeys and become real converts. Some of them go on to learn how to swim afterwards," explains Pegum.

She stresses that patients don't have to be able to swim to participate in hydrotherapy. "Swimming can, in fact, aggravate certain knee or hip or back injuries but hydrotherapy will help almost every condition," she says.

Hydrotherapy is also used to help children and adults with congenital physical disabilities access a wider range of movement than would be possible on dry land.

"A lot of the children with physical disabilities can achieve independent movements in the water that they can't have on dry land," explains Michele Marvefley, physiotherapist who works with Enable Ireland in Galway city.

The benefits of hydrotherapy occur due to the combined effects of warm water and the buoyancy of water in general. "The buoyancy allows people to feel weightless in water and the warm water [the temperature must be between 32 and 35 degrees Celsius] helps relax the muscles," explains Marvefley.

Hydrotherapy has also been found to relieve general aches and pains, improve circulation, relieve tension and stress and help people sleep better.

Mark Halliday (4) has been attending hydrotherapy sessions, organised by Enable Ireland in Galway city for the past three years or so. His mother, Aisling, explains that it offers him both opportunities for physical and social learning.

"Mark has spina bifida and uses a wheelchair but his disability disappears in the water. When he's in the pool, he can swim around with the other children," she says.

The group hydrotherapy sessions which are led by a physiotherapist focus on movement through fun and games. "He loves the freedom of it and being at one with everyone else," says Aisling Halliday.

Eoin Kiely (4) has also been attending hydrotherapy organised by Enable Ireland in Galway city. "Eoin has congenital muscular dystrophy and his limbs are quite weak but being in the water gives him a range of movement he doesn't have when he has to contend with gravity," explains his mother, Hilary Kiely.

Both Eoin and Mark will be among the first children to enjoy the new Enable Ireland hydrotherapy pool which opened in Galway yesterday.

Gaining access to hydrotherapy can be difficult for many people who already know the benefits of the therapy. Organisations such as Enable Ireland offer public hours to specific groups such as Arthritis Ireland in their pools.

Their swimming pools are specifically designed for hydrotherapy so will have water at the correct temperature and will have fitted hoists which are needed by some people to get in and out of the pools.

Some hotels and community swimming pools throughout the State are also good at accommodating groups by increasing the water temperature on specific mornings or evenings.

However, Arthritis Ireland believes a lot more could be done to help people avail of this therapy.

"If you consider that 700,000 people in Ireland have arthritis and a huge part of the management of their condition depends on the individuals themselves, more access to hydrotherapy would benefit the individuals and the health system," says Grainne O'Leary from Arthritis Ireland.

O'Leary also points out that hydrotherapy pools in acute hospitals in Ireland tend not to be available to non-patients.

"In the UK, many hydrotherapy pools in hospitals offer hours to various groups outside the hospital but that doesn't seem to be happening here. With a bit of lateral thinking, this could help reduce costs of managing the pools and see them used more," says O'Leary.

The benefits

• The warm water relaxes sore muscles, eases stiff joints and improves blood circulation.

• The water's buoyancy reduces the pressure on the joints and makes it easier to perform a range of movements.

• It promotes relaxation, relieves pain, stress and tension and encourages better sleep.

• It provides a social outlet to people who might be less able to interact with others.