What if hydrotherapy does not relieve joint stiffness?

Pool exercise reduces the load on joints and warm water can make movement more comfortable, but it may not address every reason a joint feels stiff. The programme may need a different intensity, range of movement, frequency or progression. Stiffness can also be influenced by inflammation, an old injury, muscle weakness, reduced activity or a problem in another nearby joint. Lack of improvement does not by itself show that hydrotherapy was harmful or that surgery is needed.

Record which joints are stiff, when symptoms are worst, how long stiffness lasts after waking, and which pool exercises help or aggravate it. Tell your physiotherapist whether you can complete the movements and whether symptoms return after sessions. They may check your movement, strength and walking pattern, adjust the programme, or suggest land-based exercise and pacing. Continue only within the limits you were given; do not force a painful range or make sudden increases. A clinician can decide whether further assessment or another treatment is appropriate.

Seek prompt medical advice if stiffness comes with a hot, markedly swollen or red joint, fever, severe pain after an injury, new weakness, numbness, or inability to use the limb. Urgent care is appropriate for sudden loss of movement or severe symptoms that are rapidly worsening. Otherwise, book a routine review when the planned course has ended or symptoms are interfering with sleep, work or daily tasks.

Could another joint or condition be contributing to the stiffness? Is the pool programme at the right level for my movement and strength? Which home exercises should I continue between sessions? What changes should make me stop an exercise? When should we review progress and consider another approach?