What should you know about hot and cold hydrotherapy?

Hydrotherapy takes place in water, often in a purpose-designed [Hydrotherapy Pool](/technology/hydrotherapy-pool/). Warm water can help muscles relax and make joints feel less stiff. Water also reduces the load carried by painful joints, allowing controlled movements that may feel difficult on land.

Cool water may calm soreness after activity. A clinician may combine warm exercise with a brief cool application, or choose one temperature based on your symptoms, circulation, skin sensation and medical history. Hydrotherapy may be used alongside [Exercise Therapy](/treatments/physiotherapy-and-rehabilitation/exercise-therapy/) for conditions such as [Fibromyalgia](/conditions/fibromyalgia/) or [Frozen Shoulder](/conditions/frozen-shoulder/). It is not a cure for the underlying condition.

Start with an assessment by a physiotherapist, particularly if pain, stiffness or balance problems limit your usual activity. Follow the planned water temperature, exercise intensity and session length. Enter and leave the pool with assistance if your balance is uncertain, and drink fluids after activity.

Stop if you feel faint, unusually breathless, confused, numb, or develop burning skin, shivering or worsening pain. Tell the therapist about heart or circulation problems, reduced sensation, open wounds, infection, pregnancy or any condition affecting temperature control. For ongoing symptoms, discuss whether [Hydrotherapy](/treatments/physiotherapy-and-rehabilitation/hydrotherapy/) is suitable.

Seek urgent medical help for new weakness, loss of coordination, chest discomfort, severe breathlessness, fainting, or a sudden inability to use a limb. Arrange an assessment when joint pain or stiffness follows an injury, keeps worsening, repeatedly interrupts sleep, or comes with fever, marked swelling or a hot red joint. [Joint Pain](/symptoms/joint-pain/) and [Joint Stiffness](/symptoms/joint-stiffness/) can have many causes, so hydrotherapy should not delay diagnosis.

Ask which water temperature fits your symptoms, whether buoyant exercise is appropriate for your diagnosis, what signs mean you should stop, and how pool therapy will fit with your home programme. If you have [Ankylosing Spondylitis](/conditions/ankylosing-spondylitis/), ask how spinal mobility and fatigue should guide the session.