SaveYourself.ca • Sensible advice for aches, pains & injuries
updated 5/04/11
A hot bath is probably the original hydrotherapy treatment, and still the best. But as much as you may already enjoy a hot bath, there’s a good chance that you’re not tapping its full potential. At its best, a hot bath can be a surprisingly powerful tool for healing. But it’s easy to fall short of the maximum benefit. To get the most out of it, a little extra know-how is helpful. This article offers several tips for better, more therapeutic bathing. Most readers will be surprised by at least half of them.
A hot bath is psychologically relaxing. It was the original psychotherapy, and I suspect it is still the best.
Technically speaking, however, hot baths are a stimulant — that is, they get your nervous system revved up. The sensation of relaxation is an illusion in a number of ways. The ritual is safe and soothing. Strong heat tends to dominate your awareness, forcing out other thoughts. It also tends to make you stay still afterwards, while body temperature and other physiological conditions are restored to normal. A super-heated bath can also be exhausting, almost like a work out — see more about this below.
But your nervous system is actually stimulated. While a few people do get drowsy after a hot bath, many remain alert for at least an hour, and some will even have considerable difficulty sleeping for hours afterwards. A too-hot bath in the evening is a particularly bad idea for insomniacs.
So the most relaxing baths are in not-quite-hot water. Most people I know still prefer a good hot soak for its other benefits — but if you are bathing for sedation or specifically to help you sleep, keep the temperature quite easy.
Note that pregnant women should keep their baths to a maximum of about 37˚C (100˚F) — just barely above body tempature!
Of course, “some like it hot” …
They don’t call it “heat exhaustion” for nothing: enduring intense heat can be tiring. Your circulatory system has to do a lot of work to cope with high temperatures. You sweat a lot, and you can burn quite a few calories.
This is a “thermal workout,” and it can be a nice way of wearing yourself out — but it’s better to do it earlier enough in the day that your nervous system has time to calm down before bed time. And make sure that it’s not actually dehydration that’s making you feel whipped afterwards.
If you alternate between a hot bath and a cool shower or pool, things get even more exhausting — even dangerous, so please be careful and don’t overdo it, especially if you’re not fit. For more information, see:
Many people avoid hot baths because they feel wilted and cruddy and headachey afterwards. This can be avoided by keeping a cool head. Or feet. Or hands. Or all three.
As beneficial as it can be, your body doesn’t really love being heated up entirely, with no opportunity at all for heat shedding. This creates an artificial fever. An artificial fever has its uses (more below), but it can also have some unpleasant side effects, such as headaches.
So dump glasses of cool water over yourself! Or drape a cool washcloth over your neck. Or spray your feet with a shower hose.
Give your body some opportunity to shed some heat. Your core body temperature will still go up (and you’ll get the benefits of that), but it will cause less physiological stress. You may be quite surprised at how much this improves the quality of the experience.
An artificial fever has its uses, but it can also have some unpleasant side effects.A bath is a perfect place to do a little self-massage to release muscular trigger points. And the perfect method is to bring a ball into the bath with you, and trap it under your body to apply pressure to stiff and aching muscles. I call this “the bath trick,” because it’s such an amazing combination of therapeutic factors. The bath trick works particularly well because the pressure you apply to your muscles is easy to control.
Run a hot bath, and trap a ball between your body and the bottom or back of the tub to rub your back muscles — your buoyancy allows for excellent control over moderate pressures.
Run a hot bath, and trap a ball between your body and the bottom or back of the tub to rub your back muscles — your buoyancy allows for excellent control over moderate pressures.
In standard “tennis ball massage,” often people find that the full weight of their body trapping a tennis ball against the floor is simply too much — the pressure is too intense, and they’re unable to achieve a relieving sensation. But in the bath, you are much lighter! You have much better control and a moderate intensity of pressure.
While the heat relaxes you, your bouyancy in the water allows finely tuned control over moderate pressure on your trigger points. Applying a little more or less pressure is as simple as rising up in the water a little, or submerging more of yourself.
For more detail, see:
Stretching is not generally as useful as most people imagine, but it’s certainly not useless. One of the things stretching may be fairly effective for is relieving muscular aches and pains caused by knots. Even that’s not exactly guaranteed to work miracles — lots of people fail to get rid of muscle knots just by stretching — but doing it in a bath almost certainly improves the odds of success.
Heat aids stretch in almost every way you can imagine. It reduces baseline muscle tone, it significantly softens connective tissue, it eases the neurological vicious cycle that powers muscle knots, and so on. If you’re going to stretch, then stretch in the bath.
Curious about the limitations of stretching I referred to above? See Quite a Stretch. Or for a detailed exploration of how muscle knots in particular are affected by stretching, see Stretching for Trigger Points.
You sweat under water. In a very hot bath, oddly enough, you can lose a lot of fluid.
Sweating is an important form of excretion, and some waste metabolites are removed from the body this way. Exercise is one way to do this, of course, but a hot bath is a lot easier — and, in fact, people usually sweat much more in a bath than they ever do when exercising.
Some people will call this “detoxification,” a word that gets thrown around waaaaay too casually (usually to make something sound more therapeutic than it really is). A good sweat is a good thing, but it isn’t “detoxifying” any more (or any less) than having a bowel movement! It is more sensible to simply say that sweating stimulates elimination of waste products.
But sweating a lot in a bath also means that you must drink water — before, during and after! This is a vital key that most people miss. If you don’t hydrate, a hot bath may actually be stressful to your system. I think this is actually a major reason why some people do not like baths — they get far more dehydrated than they realize, and it’s unpleasant. A headache is the most common consequence. You must replace lost fluids to feel good after a hot bath.
Drinking a lot of water is definitely not as important as most people seem to think (see Water Fever and the Fear of Chronic Dehydration), and there actually even a genuine danger in the modern craze for constantly sucking on a bottle of water.1 However, when it comes to hot baths, you definitely do need to replace lost fluids — and it’s easy to lose more than you suspect.
Hot baths are modestly effective as a treatment for certain kinds of muscle soreness. This is surprisingly hard to prove, or even understand — it’s not exactly a hot target for research funding — but it’s pretty obvious to all of us that it works, at least a little, sometimes. Here are some possible reasons why …
Covering yourself in hot water — “systemic” heating — can do something for muscles that no hot pack can ever do. As good as a nice hot pack can feel, the effect is a minor, local, neurological effect — warm skin relaxes the muscles underneath it. That’s a nice effect, but it’s limited. A hot bath also has this effect, but additionally it’s able to actually increase the temperature of the muscle itself deep heating.
Hot packs simply cannot increase the heat inside your muscles. The human body is incredibly good at temperature control, at getting rid of heat. When you try to heat a muscle with a hot pack, you end up heating just the superficial blood, which quickly gets pumped away and immediately cooled.2 So what to do? How to get the benefits of heating? The hot bath may work.
In a hot bath, excess heat has nowhere to go. The body cannot get rid of it, anywhere. The entire system heats up slightly — a mild fever! It’s not a major effect, but it’s certainly much more than you can manage with a hot pack. And this is may be good for sore muscles in a few ways.
Although heat alone is rarely effective, “rarely” is not “never.” I had a recent dramatic success ….
Another common idea for bathing is that Epsom salts assist with detoxification and recovery from minor injuries, aches and pain. Do they?
No, probably not. Recent scientific evidence has shown that Epsom salts do indeed soak through the skin when you bathe in them3 — which is actually a bit biologically surprising, and had never been proven before. But, unfortunately, there is literally no scientific evidence whatsoever about what happens after Epsom salts soak through the skin, and it’s not really plausible. There’s no chemistry involved that seems to have anything to do with common pain problems.
People certainly think there’s a therapeutic effect, but unfortunately that’s no way to judge the matter — people think all kinds of things, and in this case it would be very easy to mistake the benefits of the heat for an effect of the salt. For a surprisingly detailed discussion, see:
A hot bath is not only a much better choice for the great majority of low back pain than icing — which is usually harmful — but soaking in the tub may simply be the single best therapy there is for low back pain, or at least the best bang for your buck! And yet many people actually avoid a hot bath when they have low back pain — tragically — because they think they are “inflamed” and the heat will make it worse. This is very rarely the case.
The great majority of low back pain is essentially muscular in nature, contrary to the popular and mistaken medical view that it’s usually caused by something “mechanical” like a intervertebral disc herniation.
Specifically, the cause of most back pain is myofascial trigger points (“knots” in your muscles), which can cause far more grief than most people realize — and yet they are relatively treatable. A little reassurance, rubbing, and a hot bath go a surprisingly long way, even with the most horrendous case of low back pain. hot bath is amazingly good therapy for back pain, and the price sure is right.
Once again, trigger points are eased by heat, and usually irritated by cold. For more information about why you shouldn’t ice low back pain, see (Almost) Never Use Ice on Low Back Pain!. For (much) more information about the nature of low back pain, see:
To me, bathing is practically a religion. After years of “therapeutic bathing,” I am still experimenting. One thing I’ve learned about bathing that I can’t really explain — something about temperature-induced changes in blood chemistry, perhaps — is that the experience is improved by strong, deep breathing. Not the slow, meditative breaths you probably expect me to recommend, but deep, intense breathing to “blow of steam.” Huff and puff a bit.
I’m fascinated by the way this breathing method seems to extend my tolerance for the heat and enhances relaxation.
Conscious, deeper breathing is always relaxing and embodying, but it seems to be even more effective in a hot bath. For more about this kind of breathing, see:
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