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people doing water therapy

Water Therapy for COPD Patients

Have you ever heard of using water therapy for COPD? Sometimes it’s called hydrotherapy or aquatic therapy and it really is a thing. In fact, there have been a number of research studies done about water therapy for COPD. This post will inform you about hydrotherapy and how it may or may not benefit your respiratory status.

What is water therapy?

My first thought when someone mentioned water therapy for COPD was water-based exercise. That wasn’t wrong, but it’s not the only kind of water therapy that might be used. Hydrotherapy has actually taken many forms over the years to treat a variety of health conditions and diseases. It seems that water in its various forms and at different temperatures, both internally and externally, can have different effects on different parts of the body. That might make it a tool in healing, or at least relief from symptoms.1,2

For example:1

  • Water can store heat and energy
  • Minerals and other substances can be dissolved in water
  • Water in the form of ice can cool a body part
  • You can inhale steam, a vaporized form of heated water, or immerse yourself in it
  • Certain forms of water, such as a bath, shower or hot tub, can be soothing and relaxing
  • Exercise in water is easier because there is less resistance to movement

Let’s take a closer look at some of water’s uses in natural medicine.

Superficial cold applications of water therapy

Have you ever seen professional or college athletes sitting in a tub of ice or ice water? That’s a perfect example of superficial cold water therapy. Brr! Thankfully, it doesn’t have to be that extreme. Simply sitting in a tub of cooler than room temperature water can be enough to produce reactions such as:2

  • Slowing metabolism
  • Lowered heart rate and blood pressure
  • Decreasing swelling in the limbs
  • Improved blood flow
  • Calming muscle spasms and nerve hyperactivity
  • Lowering of certain hormone levels, including renin, cortisol and aldosterone
  • Mild numbing of the areas under water

Studies have shown that ice massage and application of ice packs have had similar results on the areas where they were applied.2

Winter swimming (ever heard of the polar bear challenges?) can also be a form of superficial cold hydrotherapy. One study showed that winter swimming:3

  • Decreased tension, fatigue and memory
  • Improved mood during the swim
  • Relieved pain
  • Improved general well-being

Superficial warm/hot application of hydrotherapy

Hydrotherapy may also involve being submerged in warm or hot water up to your neck. Some studies found that this type of water therapy can affect clotting and other blood factors.2 In warm enough temperatures (104 degrees), cardiac output can be improved for the duration of the immersion in the warm water. This, in turn, seemed to improve the use of oxygen in the body.2

Other “medicinal” uses of water for therapy

Some other ways water has been used as therapy include:2

  • Whirlpools, which can help with pain, circulation and anxiety
  • Cold showers, which may help with certain psychoses and depression by “shocking” your sensory cortex in the brain
  • Contrast water therapy, where immersion in hot and cold water is alternated, to help with muscle soreness

Can water therapy do anything for people who have COPD?

Most of the studies that have been done on this subject looked at water-based exercise in regards to COPD, rather than the other forms of water therapy described above. However, one study in Germany did attempt to test the theories of a 19th-century naturopath, Sebastian Kneipp, who believed that applying water could have therapeutic benefits on many body systems, including the respiratory system.4

The researchers in the German study, reported in 2007, applied cold water compresses and washings to the upper body to see what effect it might have on certain respiratory factors, including:

  • Lung function
  • Blood gases
  • Certain immune cells
  • Maximal expiratory flow
  • Quality of life
  • Respiratory infections

Results of the study

The researchers found that this therapy did improve immune system function and lowered the risk of respiratory infections, a common cause of COPD exacerbations. It also had a positive effect on the quality of life. However, this study was a very small sample size (20 patients), so these results may or may not be valid. I couldn’t find any more recent studies validating this one.

Water-based exercise has more promising benefits

On the other hand, a few more studies have been done that looked at whether COPD patients could benefit from water-based exercise. These studies seem based mainly on the premise that, as COPD is most common in older adults, they would likely have other health challenges as well, including:5

  • Bone, joint and muscle deformities or weaknesses
  • Cerebrovascular disease, resulting in decreased blood flow to the brain
  • Obesity

Land-based exercise is often recommended for people with COPD and is part of every traditional pulmonary rehab program. It is known to improve exercise capacity and quality of life.6 But when the person with COPD also has one or more of the issues mentioned above, land-based exercise might be difficult or not even possible.

So researchers have studied whether moving exercise to the water, such as in a pool, might be easier to tolerate and have greater benefits. One study, done in Australia and reported in the European Respiratory Journal, looked at the effect of water-based exercise on:5

  • Exercise capacity
  • Health-related quality of life
  • Respiratory muscle strength

They found that water exercise was effective in all aspects. However, this study size was again quite small (53 participants). So the researchers expanded their research by doing a review of similar studies.6 They found 5 studies overall with 176 participants; only 71 of those participated in water-based exercise programs.

The result of their review was that there do appear to be at least short-term benefits in exercise capacity and some quality of life factors. However, there is not enough quality evidence proving long-term benefits. Certainly, we need more extensive research to be sure.

Most water therapy is safe

So, if you have COPD, should you be considering some sort of water-based therapy? The bottom line is that most water therapy, when used correctly and with your health care team’s OK, is safe. So, chances are, there’s no harm in trying. And water-based exercise seems to have the most promise and is in line with the general goals of pulmonary rehabilitation.

If you’d like to try it, there are a number of types of water-based exercise you might try. You could join your local health club and start swimming or walking laps in their pool. Some health clubs offer specific aqua exercise programs, such as water aerobics or Aqua Zumba. There are even water-based Pilates, yoga and tai chi programs available in some areas.

You should never begin an exercise program without your health care team’s blessing. But once you have that, give it a try. You just might like it, and you might feel better for it as well!

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.

  1. Hydrotherapy. (2018, September 20). Retrieved from
  2. Mooventhan, A., & Nivethitha, L. (2014). Scientific evidence-based effects of hydrotherapy on various systems of the body. North American Journal of Medical Sciences, 6(5), 199. doi: 10.4103/1947-2714.132935
  3. Huttunen, P., Kokko, L., & Ylijukuri, V. (2004). Winter swimming improves general well-being. International Journal of Circumpolar Health, 63(2), 140–144. doi: 10.3402/ijch.v63i2.17700
  4. Goedsche, K., Förster, M., Kroegel, C., & Uhlemann, C. (2007). Repeated cold water stimulations (hydrotherapy according to Kneipp) in patients with COPD. Complementary Medicine Research, 14(3), 158–166. doi: 10.1159/000101948
  5. Mcnamara, R. J., Mckeough, Z. J., Mckenzie, D. K., & Alison, J. A. (2012). Water-based exercise in COPD with physical comorbidities: a randomised controlled trial. European Respiratory Journal, 41(6), 1284–1291. doi: 10.1183/09031936.00034312
  6. Mcnamara, R. J., Mckeough, Z. J., Mckenzie, D. K., & Alison, J. A. (2010). Water-based exercise training for chronic obstructive pulmonary disease. Cochrane Database of Systematic Reviews. doi: 10.1002/14651858.cd008290


  • kbair55
    2 months ago

    How can you encourage water therapy in a pool when it’s very common that the steam from a shower can negatively affect breathing? Just like a day with high humidity or dew points. It is recommended to shower with tepid water, exhaust fan on & door open. It took me years to comfortably shower using oxygen, without getting panicky 1st due to the steam and close quarters. How could one navigate a pool area without getting expensive oxygen therapy equipment (ie; the Inogen, as tow along tanks would not provide much 02 time) wet? I was a tadpole growing up. LOVED to swim. But I’ve got to say suggesting that we who suffer from COPD go to a steamy public pool environs and start an exercise program is ridiculous! Especially for those of us who are oxygen dependent. It is just yet another activity I have to accept I can no longer do unless one was fortunate enough to have their own private backyard pool…& even then… my opinion, only those in the very early stages could consider this therapy.

  • wheezy
    2 months ago

    Is there an issue with chlorinated pools with regard to breathing?

  • kbair55
    2 months ago

    I’ll bet there is as any type of fumes can trigger flare ups and chlorine would likely do that.

  • Leon Lebowitz, BA, RRT moderator
    2 months ago

    Hi kbair, and thanks for joining in the conversation in regards to wheezy’s post. You’re right on target….chlorinated pools can post an issue for people whose condition can be ‘triggered’ by exposure to chlorine. We appreciate your input here. Leon (site moderator)

  • Leon Lebowitz, BA, RRT moderator
    2 months ago

    Hi again, wheezy, and thanks for your post. I see my colleague, Lyn, has already provided a response for your genuine concern. I thought you also might find it helpful to look over this material on ‘triggers’ and COPD: I do hope you find them to be helpful. Wishing you well, Leon (site moderator)

  • Lyn Harper, RRT moderator
    2 months ago

    Hi wheezy – That’s a great question! In general, there isn’t. However, there are some people that are particularly sensitive to chlorine. If you happen to be one of those people, it could pose a problem. I’ve noticed recently a trend toward salt water pools, which eliminates the chlorine issue.
    Best – Lyn (site moderator)

  • Janet Plank moderator
    3 months ago

    Kathi, thank you for this article. When I hear water therapy I think exercise, it was nice reading the full spectrum of water therapy.

  • aldussault
    3 months ago

    One day I can accept that this is a condition for life, one day I feel good and I can do things I used to do, then on other days, I feel depleted, exhausted and cloudy.
    I am new to the condition but not new to the exhaustion…However, try as I may I find myself beating myself up for not having energy

  • kbair55
    2 months ago

    I agree, but I don’t beat “myself” up. But I sure can get tired of being tired ALL THE TIME. I just started taking a B12 & other supplements. With healthy eating….little to no processed foods, low carbs and rarely a fast foods/pizza. Been doing that for a well over a year. I have lost 20 lbs. but w/o being able to get cardio in to speak of due to advanced COPD, weight loss is very slow and almost non existant.Would love to shed 20 more.

  • Leon Lebowitz, BA, RRT moderator
    2 months ago

    Hi again, kbair, and thanks for this post. too. We appreciate you sharing your particular situation with COPD, feeling tired, eating habits and exercise with the community. It can be challenging staying active with advanced COPD. You may want to try to perform some sort of exercise, no matter how limited – just a little bit a few times a week. You might be surprised as to the progress you can make over time. Of course, you should check this out with your physician first. Wishing you well, Leon (site moderator)

  • Janet Plank moderator
    3 months ago

    aidussault, I always thought of COPD as being a yo-yo or even a roller coaster ride because we can be so up and down with the feeling good and then the light switch changes and then we are down and need to stop and rest, maybe even finished for the day.
    It’s easy to berate ourselves because we have expectations. The hardest part is accepting that we can’t do what we used to. And that it’s okay.
    I’m glad you came by. A support system is so important, a counselor or there are various online groups. Maybe you have a face to face where you are at. And we are here for you too.

    Janet (site moderator)

  • Leon Lebowitz, BA, RRT moderator
    3 months ago

    Hi again, aldussault, and thanks for joining in this conversation, responding to Kathi’s recent article. You may want to be kinder to yourself. Although we all understand and appreciate how the condition can vary from day-to-day, one has to learn to adjust to these changes. You may want to try to appreciate the days when you’re doing well. On those days when you’re not feeling up to par and somewhat depleted, listen to your body and give yourself time to recover and take it easy. Hang in there! We appreciate your input here. Leon (site moderator)

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