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No Hot Tub for You! … Contraindications for Hot Tubs and Hydrotherapy

Health Risks

Soaking in a hot tub or spa can be a most wonderful feeling. Hot water can be rejuvenating and soothing to your soul. Still, there are health risks for certain individuals:

People with heart disease, diabetes, high or low blood pressure, any serious illness, or pregnant women should not enter a spa or hot tub.

People with skin, ear, genital, or other body infections should not enter the hot tub or spa because of the possibility of spreading the infection.

Hot tubs should also be avoided by older women and women who already have lowered immune systems. They are more vulnerable to the bacteria that may be in the water. Older people and people with weak immune systems have been known to develop pneumonia and legionnaire’s disease. Bathing longer in the tub and later in the day has been associated with increased risk of disease.

One other serious concern pertains to pregnant women. Elevating a pregnant woman’s core temperature during neural tube formation (during the first 28 days of gestation) carries a risk of poor spinal development for the fetus.

If a woman has a history of bladder infections she should avoid hot tubs. Raising the temperature of the tub will not make a difference; it may only increase the risk of scalding her skin.

People under the influence of alcohol and drugs. Never allow anyone who has been drinking alcohol or using any kinds of drugs (prescribed or illegal) to enter the hot tub or spa. Alcohol in your blood stream and soaking in the tub create a combined effect that can be damaging. The ultimate danger of combined alcohol consumption and hot water soaking is drowning due to loss of consciousness, heart attack or injury due to passing out or falling. As with alcohol, the combined use of certain drugs and medicines and hot water soaking can be dangerous. Never use a spa or hot tub after using narcotics or other drugs that may cause sleepiness, drowsiness, or raise or lower blood pressure. With any drug or medication, consult your doctor about potential harmful effects from combined drug use and hot water soaking.

Cancer – Caution is advised when treating clients with cancer. It is best to work with the consent of a physician. Some physicians may not be aware of the effects of hydrotherapy.

Hemorrhage – Caution is advised when treating a client who has a tendency to hemorrhage. Applications of heat which cause vasodilation increase the possibility of hemorrhage.

Decreased Sensation – Any condition in which the client has a decrease in sensitivity of the skin Hydrotherapy is contraindicated as they may not be able to feel if the skin is too hot.

Weakness – Hydrotherapy may be contraindicated in a client that is weak as a treatment may make the weakness worse.

Skin Lesions – Applications are contraindicated in the case of broken skin or other skin irritation that may be exacerbated by hot.
Skin lesions such as pustules, papules, blisters that are infected may rupture due to increased vasodilation and are contraindicated.

Pregnancy – Full body hot applications to a pregnant woman are contraindicated as they may be associated with an increased incidence of birth defects. This contraindicated the use of hot tubs and other steady- temperature hot full body baths as well as local applications of heat to the abdomen.

Tuberculosis – Full body hot baths may spread tuberculosis and is contraindicated.
Anemia- Full body application of heat increases cellular demands for oxygen that cannot be supplied if the client is anemic.

Diabetes Mellitus – Advanced diabetes, especially Type I (juvenile onset) can decrease the client’s ability to sense tissue damage especially in the lower extremities. The vascular damage caused by this disease also decreases blood flow to tissues. Heat is contraindicated in these areas. Consult the physician.

Heart Disease – Heat applications that increase the heart rate and force of contraction are contraindicated in heart disease as it may overwork an already weakened heart.

Hypertension – Heat applications that increase the heart rate are contraindicated due to the stress on the heart.

Peripheral Vascular Disease – Athlerosclerosis and arteriosclerosis clients may have weakened or blocked arteries. Heat applications increase tissue metabolism and demand for oxygen making heat applications contraindicated.

Temperature – Body temperature should not go above 104 degrees. Temperatures above this may cause tissue damage. Monitor with oral thermometer.

Pulse – Heart rate should not exceed 140 beats per minute as it may overstress the heart. Monitor with lateral anterior wrist.

Post Treatment Rest Period – The body should be allowed to rest for at least a half hour after a full body hot application to allow the body to return to normal.

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