Hydrotherapy is the use of water for the treatment of trauma and disease. A contrast bath involves immersing the joint alternating between hot and cold water. Because heat dilates the blood vessels and cold causes them to get smaller (vasoconstriction), this hydrotherapy treatment helps to increase blood flow in the immersed area, thereby accelerating recovery in the muscles from strenuous exercise, and is beneficial for treating swelling, and reducing inflammation in a person's joints or muscles. It is useful for treating joint injuries, such as mild sprains (after 48 hours of injury). Contrast baths may also increase the elasticity of the ligaments, which may help those with arthritis improve their range of motion. It is important to end a contrast bath with a soak in cold water to help close the pores and reduce swelling.

Contrast baths prove helpful in the treatments of infections because they increase white blood cell activity. They also help fractures to heal better. If the right wrist is broken and is in a cast, for example, alternating hot and cold to the left wrist also increases blood flow and consequently improves healing to the right wrist via consensual reflex. A consensual reflex is a reflex action in which stimulation of one body part results in a response in another part.

Contrast baths also reduce the risk of undesirable clotting by significantly reducing platelet stickiness and aggregation in individuals with known risk factors such as ischemic heart disease.

CAUTIONS AND CONTRAINDICATIONS:

Contrast Baths should not be done to an acute injury. Treatment should not be initiated until 48 hours have passed”) than 48 hours after the injury or after all bleeding (if present) has stopped. Contraindications for contrast baths include local malignancies, peripheral vascular disease, impaired sensation, bleeding and acute inflammation. Individuals with diabetes and neuropathy can often be benefited by alternating warm and cool water bath temperatures if they have good pulses in the extremities. Only a well-trained hydrotherapist or a physical therapist should perform this treatment in individuals with diabetes, especially if neuropathy is present. As is the case for any hydrotherapy treatment, the room being done should be warm and free of drafts. It has been documented that cool room temperatures make the contrast baths less effective.

EQUIPMENT:

Before you start, you will need:

1. Two containers large enough and of proper shape to allow the body part to be treated
2. Water-bath thermometer
3. Drape sheet
4. Towels (for drying and to put under the basins)
5. Cold compress to the head (cold washcloths)
6. Pitcher to remove and add hot water
8. Means for heating water if not near a tub or sink
9. Ice for cold compress and cold bath.

PROCEDURE:

1. Place the body part(s) to be treated in hot water 104 degrees F. (40 degrees C.) for 3-4 minutes. Apply a cold compress to the head.
2. Then place the body part in ice water or tap water—45 to 70 degrees F. (7-21C) for 30 seconds to 1 minute).  While they are in the cold, increase the temperature of the hot water each time, but do not exceed 110 degrees F (43 degrees C).  In other words, after each change, increase the contrast between the hot and cold. 
3. Make 6 to 8 changes and always end with cold (except in cases of rheumatoid arthritis, in which case/in which you would end in hot) and dry thoroughly. 
4. As previously mentioned, warm and cool contrast baths are performed for diabetic individuals, but should not be attempted by a lay person.  Warm water is defined as 92 degrees F to 100 degrees F. Cool water is between 70 and 80 degrees F.  If the person is a diabetic, do not exceed 102 degrees F (even if the foot pulses are palpable).

OTHER CONSIDERATIONS

The ratio of heating time to cooling time is adjusted according to the likelihood of creating tissue swelling. Hydrotherapy is more effective best when one follows a well-balanced plant-based, low sugar diet and engages in mild exercise.

REFERENCES:

Godwin, Eddie, Diabetic Neuropathy, Wildwood Medical Seminar, 2010.

Sorokina El, Ali O.,The effect of contrast baths on the hemostatic function of patients with ischemic heart disease] Vopr Kurortol Fizioter Lech Fiz Kult. 1998 May-Jun;(3):26-8.

Thomas, Charles, PhD., Hydrotherapy: Simple Treatments for Common Ailments, Teach Publishers, 51-53.

Vaile JM, Gill ND, Blazevich AJ., The effect of contrast water therapy on symptoms of delayed onset muscle soreness. J Strength Cond Res. 2007 Aug;21(3):697-702

www.answers.com, Contrast Baths