Rules of Thermal Hydrotherapy

These are as follows:

• Before starting any form of hydrotherapy, a detailed examination is required to check for the presence of other conditions that may exclude or limit therapeutic bathing. Specifically, the heart function, blood pressure, and the condition of the lungs, stomach, intestines, and gallbladder are examined. Rheumatic diseases, general arthropathies, and post-traumatic injuries are studied to determine the duration, temperature, and type of therapy – whether it will be a bath, shower, hydromassage, steam bath, mud bath, or hydrokinetic therapy—as well as the application area, such as neck, waist, shoulder, arms, hip, knee, etc.
• Medication and ongoing treatments are reviewed to ensure they are not interrupted. It should be noted that hydrotherapy does not replace medication but provides better mental and physical recovery, contributing to pain relief, reduced inflammation, and improved mobility. It offers supplementary treatment, potential modification of disease progression, and stabilization of results achieved through medication.
• Health and psychological benefits are significant without any side effects, unlike medications. Patients who choose therapeutic baths gain a wellness experience that not only provides therapeutic results but also connects them with nature, distancing them from a stressful daily environment.
• Specialist consultation is required to determine the type of therapeutic water, method of application, temperature, duration, location of application, etc. During the treatment, the bather should be monitored and re-examined by the bath doctor midway and at the end of the therapy, who will provide a report for the attending physician.
• Sometimes additional physiotherapy is needed. Treatments usually take place in the morning, with the time spent in the water depending on many factors, ranging from 20 minutes to an hour depending on the condition, circulatory system status, and the patient’s temperament. In very hot waters, staying longer than twenty minutes is tiring, while water temperatures close to body temperature (34-38°C) are more pleasant. Some baths, however, particularly stimulate and eventually tire the body. Each source and each human body have their own rules for hydrotherapy. High-radioactivity sources are usually tiring and not recommended for prolonged stays. In any case, if discomfort occurs, exiting the water is necessary.
• The first bath should be short and as familiarity with the water increases, the bather’s stay in the water can be extended. During the bath, the stomach should be empty, two hours after breakfast and four hours after a meal. After any form of treatment with a therapeutic natural resource, the bather should rest for about half an hour in a warm, draft-free place.
• The ideal duration of a hydrotherapy is 21 days, although some forms extend longer, with the minimum duration being 15 days. During hydrotherapy, no special precautions or activity restrictions are needed. When not bathing, one can travel, drive, participate in social activities, etc.
• Improvement and recovery usually come after twenty baths, though sometimes results are evident from the first baths. The ideal hot bath requires a constant flow of water at 32-38°C to maintain its mineral and gas content (especially CO2 and hydrogen sulfide). Rapid and continuous water renewal stimulates, while slow, steady renewal has soothing effects and enhances the vasodilatory action of CO2. Baths with minimal water should generally be avoided.
• Patients should be informed about the possibility of a bathing reaction. Due to the biological effects of therapeutic waters, there may be a transient clinical deterioration in the general condition of the patient in the first 5 to 10 days, possibly with fever, loss of appetite, headaches, and insomnia. The bathing reaction can also be localized with worsening local symptoms and is not related to the final treatment outcome. This first phase is followed by a positive phase of relative well-being. The second phase is followed by a third called therapeutic fatigue, which can often be premature and should not be confused with the bathing reaction. When baths are done according to all the rules, the bathing reaction is mild. However, in many cases, it manifests intensely, sometimes necessitating the discontinuation of hydrotherapy. If severe exacerbations of skin and arthritic conditions occur by the eighth bath, the baths should be stopped. The bathing reaction usually subsides within one to two days.