Hydrotherapy primarily consists of applying water to the body for the treatment of specific conditions and also for pain relief. The therapeutic form has existed for thousands of years and has been utilized by several civilizations throughout history. The ancient Hawaiians, Egyptians, Romans and Greeks all relied on the cleansing and curative effects of water. Several methods of hydrotherapy exist today, many of which are prominently featured in spa treatments. Although the practice is no longer used extensively in conventional medicine, it is still recognized as an effective form of therapy for a number of conditions, in particular, those that affect the circulatory system.

History of Water Therapy
The first known use of hydrotherapy dates back to the Ancient Egyptians. Baths were created for royalty using pure mineral water, essential oils and flowers. The Romans popularized hydrotherapy, a concept they adopted from Greek society. Public bath houses were created with highly sophisticated aqueducts and elaborately designed buildings. They were considered an offering that all citizens could use and they were impeccably maintained and managed. Civilizations in China, Japan and the Pacific islands also utilized hot springs as a curative therapy around this time. By the middle ages, a serious decline in hydrotherapy was observed. Bathing became synonymous with disease development and as a result it was outlawed by the Catholic church.

However, it once again emerged during the 18 th and 19th century after extensive research into the area was carried out by J.H Rausse, J.S. Hahn, Vincent Priessnitz and Professor Oertel. Hydrotherapy soon became a medically prescribed treatment that was primarily administered by doctors for a variety of ailments and conditions.

Spa Tourism
Hydrotherapy caught on in the UK and Europe which led to the development of spa tourism. Large establishments were created to facilitate bathers from several different regions across the globe including the Americas. Many English visitors to German spas preferred the winter period when the water was particularly cold. Though doctors recommended the use of spas during the spring and summer, this was not followed in practice. Although these spas received the largest numbers of visitors between the July - August period, many tourists especially the Americans, visited year round. The popularity of hydrotherapy and spa tourism continued well beyond the early part of the 20 th century. However, hydrotherapy as a form of medical treatment soon began to wane with the advent of drugs that were better able to control diseases with more consistent results. Yet, its effectiveness as a therapeutic option is still viable even today.

Mechanism and Modern Applications of Hydrotherapy
The efficacy of hydrotherapy is based largely on the thermal conductivity of water. Different therapies rely on the body's ability to react to cold or hot stimuli. The heat in conjunction with the pressure created by the water helps to create a nerve response which has the potential to improve the immune system, lower the production of cortisol (a stress hormone), influence the circulation of blood throughout the body, aid digestion and decrease the sensory response to pain.

The disparate temperatures produced during this form of therapy are attributed with different effects. Heat is said to calm the body, reduce the exertion of internal organs and relieve muscular pain. Cold therapy is said to relax tense areas of the body and control high stress levels. It is not uncommon for both forms of the therapy to be used simultaneously to create a contrastingly pleasing effect. A simple warm shower undertaken at home has the potential to release tension and stimulate the body, especially when followed directly by a few minutes of cold water immersion.

Hydrotherapy can also be affected by the method of submersion utilized. When the body is placed in a pool, spring or other body of water a weightless sensation is produced which allows the natural action of gravity to stimulate relief. Additionally, as the water flows over the body it gently massages and promotes better circulation while releasing tense muscles.

Types of Hydrotherapy
There are several forms of hydrotherapy that can be used with far reaching benefits. Some of the more popular forms include showers, sitz baths, foot baths, ice baths, cold mitten friction scrub, steam inhalation, neutral bath, hot compresses, body wrap, wet sheet pack, cold compress, salt glow and mineral baths. Typically the body is immersed in water that is either hot or cold. The type chosen will depend on the condition and the results desired. Hot water will automatically relieve muscle tension and induce sweating which helps to detoxify the body. It is also indicated in the treatment of arthritic pain, poor circulation, rheumatism and muscular pain. Heat therapy is considerably more effective in conjunction with aromatherapy which has a relaxing effect on the body. Cold water therapy is able to increase blood flow within the dermal area and muscles.

These thermal forms of hydrotherapy are particularly effective when they target the specific areas that are affected. Heated water packs can be directly placed on the chest to relieve the congestion associated with colds or flu and may also be applied to areas that are prone to arthritic pain including the feet and hands. A cold compress is best applied to areas that need quick pain relief. They are often placed on sprains, on the jaw area after dental surgery and on the head to relieve headaches. An entire body pack may be used to detoxify the body and is also indicated in the treatment of anxiety disorders.

Benefits of Hydrotherapy
Hydrotherapy can be used as an effective treatment for a number of ailments and medical conditions including arthritis, colds, depression, joint and muscle issues, anxiety disorders, stress, headaches, digestive tract problems, stress, chronic pain and circulation issues. The non-invasive therapy helps to detoxify, relax and loosen muscles, improve metabolism, hydrate the cells, increase the body's immune response, and stimulate blood flow.

Although hydrotherapy is no longer utilized as a primary mode of treatment it is still considered a worthwhile option that can be undertaken at home or a spa. The benefits derived have consistently been observed throughout the ages. It is an ideal therapy for stress management and pain and can easily be used to promote relaxation in healthy individuals.

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