Water has been used for healing and relaxation for thousands of years. Modern research and public health guidelines provide a clearer picture of how hydrotherapy and aquatic environments support wellness.

World Health Organization guidelines on water environments

The World Health Organization published Guidelines for Safe Recreational Water Environments, Volume 2: Swimming Pools and Similar Environments on January 2, 2006 (ISBN: 92 4 154680 8). While focused on public health and safety, the guidelines explicitly acknowledge health benefits of recreational water use.

Key points from the WHO guidelines:

• Recreational water activities provide health benefits including exercise and relaxation
• Social interaction, relaxation, and physical activity in water environments are associated with benefits to health and well-being
• Effective management of water facilities helps maximize these benefits while minimizing health risks
• The guidelines apply to swimming pools, spas, and similar environments using fresh or thermal water, whether indoors or outdoors

Clinical benefits of aquatic therapy

A narrative review titled "Health benefits of immersion and therapeutic aquatic exercise in swimming pools and spas in health care" examined evidence for patients with rheumatologic, orthopaedic, and neurological conditions. The review searched major medical databases and focused on Level 1-3 evidence.

Findings across musculoskeletal disorders (including low back pain, osteoarthritis, fibromyalgia, and rheumatoid arthritis):

• Both active and passive aquatic interventions showed low to high clinical effects on pain, function, and quality of life
• No adverse effects were reported in the reviewed literature
• For neurological conditions (stroke, Parkinson's disease, multiple sclerosis), moderate to high clinical effects were found for balance, gait, and functional independence

The WHO has been updating these guidelines to include a dedicated chapter on the health benefits of immersion and therapeutic aquatic exercise, reflecting growing recognition of water-based therapies in healthcare.

How this relates to spa visits

Spa hydrotherapy elements such as warm baths, steam, and contrast temperatures can promote relaxation and temporary relief from muscle stiffness. Warm water immersion increases circulation and reduces joint load, which is why many guests feel lighter and more relaxed after hydrotherapy sessions.

Hydrotherapy at a spa is a wellness practice, not a medical treatment. Guests with cardiovascular conditions, open wounds, infections, or pregnancy should consult a doctor before using hot tubs, saunas, or steam rooms. Read our spa etiquette guide for health and safety information before your visit.

Sources

• World Health Organization. Guidelines for Safe Recreational Water Environments, Volume 2: Swimming Pools and Similar Environments. Published January 2, 2006. who.int/publications
• Health benefits of immersion and therapeutic aquatic exercise in swimming pools and spas in health care. Journal of the Japanese Society of Balneology, Climatology and Physical Medicine. 2013;77(5):417-430.

Explore our spa packages or browse more Articles.