How Is Contrast Bath Therapy Performed?

In physical therapy, many types of energy and methods that we are familiar with from physical science such as electric current, magnetism, heat, cold, light (laser), sound (ultrasound), water are used for therapeutic purposes. These are also called physical modalities. Physical modalities can be used to reduce pain, muscle stiffness, muscle spasm, edema, normalize joint movements and function, and increase muscle strength. Contrast bath therapy is a form of physical therapy in which hot and cold water are used together.

Contrast bathing is a method often described to physical therapy patients for home practice. The method of application is quite simple. It can be made with two containers, one of which is filled with hot water and the other with cold water. This treatment can also be applied with the whirlpool method in physical therapy clinics.

For What Purpose Is Contrast Bath Therapy Used?

Contrast bath can be used to reduce pain and edema, to control the inflammatory response and to increase joint movement. It is a treatment used especially for hands and feet. The sequential application of hot and cold acts like a kind of gymnastics for the connective tissue and blood vessels.

In Which Diseases and Problems Can Contrast Bath Be Used?

It is most commonly preferred in fractures affecting the hand, wrist, foot or ankle, and to relieve the pain, swelling and stiffness observed in the hand or foot after the plaster-splint is removed. In problems involving the shoulder, edema and pain may occur, sometimes secondary to the hand. In such a situation, a contrast bath can be useful. It can help treat complex regional pain syndrome (Sudeck atrophy) that may develop due to nerve injury or fracture. It can also be preferred in problems such as platar fasciitis (pain on the sole of the foot), shin splint, carpal tunnel syndrome, Achilles tendonitis, tennis elbow.

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Contrast bath can also be applied by athletes in the form of immersion of the whole body. A whirlpool device or a regular water bowl can be used in physical therapy centers. For home application, two deep containers are required. Hot water around 40-42 degrees is placed in one of the containers. This is roughly as hot as water for showering or washing dishes. The other container contains cool water. The temperature of the cool water should be around 10-15 degrees. This coldness can be achieved by adding some ice to room temperature water.

After two containers at sufficient temperature are ready, the body part to be treated with a contrast bath is first immersed in hot water. Soak in hot water for 3-4 minutes. At this time, slow joint movements and stretching can also be done. After 3-4 minutes, the treated part (usually hand or foot) is removed from the hot water and immersed in cold water without waiting. Waiting for a shorter time in cold water is generally recommended for 1 minute. This oscillation between hot and cold water is continued for a total of 15-20 minutes. In the meantime, care should be taken to keep the water temperatures at the desired level. For this, hot water or ice can be added as needed. If edema is in the foreground, it can be finished with the last cold application. If the aim of removing joint stiffness and relaxation is more important, it may be more effective to finish with hot. It is applied once or twice a day.

How Does It Affect?

It is thought that the rapid change in hot and cold environments causes the capillaries to expand and contract rapidly, and the contrast bath acts in this way. Veins expand in heat and contract in cold. This action can accelerate the removal of edema in the problem area with the pump effect. With the reduction of edema, the pain usually decreases and it becomes easier to move the joints. Sudden temperature change in the environment can increase tissue metabolism, which can accelerate healing. Contrast bath alone is not an adequate treatment. It is generally recommended to facilitate active exercise movements.

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Things to Consider

Water that is too hot or too cold can cause burns and tissue damage. In newly formed acute injuries, the hot portion of the contrast bath may exacerbate the inflammatory response. Therefore, its use in acute injuries is not recommended.

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