Contrast bathing for the hand and wrist

Who is this information for? What is its aim?

This patient information is aimed at teaching a technique to reduce swelling, pain, joint stiffness and joint inflammation.

What is contrast bathing?

Contrast bathing can help with swelling, pain, joint stiffness and joint inflammation.

Why is it useful?

Contrast bathing stimulates the opening and closing of the blood vessels which helps to reduce swelling in your hand and improves circulation.

When should it not be used?

Contrast bathing should not be used if you have any open wounds or a cardiac condition.

If you have reduced sensation/ability to detect temperatures please be careful when using warm water. Please check with your doctor before using if you have any conditions that affect your circulation, such as Raynaud’s.

What you will need:

• Two bowls/buckets/large basins (large enough to put your whole hand in).
• Warm and cool water supply.

Contrast bathing method

1. Fill one bowl with cool water from the tap. Fill the other bowl with warm water from the tap. Test the temperature of the warm water with your uninjured hand first to make sure it is not too hot.
2. Put your whole hand in warm water for about one minute, then switch to the cool water for about 30 seconds.
3. If your therapist advises you to, move your fingers/thumb when in the water.
4. Continue switching between the bowls seven times.

Follow this sequence;
Warm water for 1 minute
Cool water for 30 sec
Warm water for 1 minute
Cool water for 30 sec
Warm water for 1 minute
Cool water for 30 sec
Warm water for 1 minute
Cool water for 30 sec
Warm water for 1 minute
Cool water for 30 sec
Warm water for 1 minute
Cool water for 30 sec
Warm water for 1 minute
Cool water for 30 sec

Start date _______________________________

Repeat ______ times a day

Additional instructions

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If this treatment makes any of your symptoms worse then stop immediately and inform your therapist on; 01223 216769.

Name of therapist _____________________________________

References/ Sources of evidence

• Breger-Stanton D, Bear-Lehmann J, Graziano M, Ryan C (2003) Contrast baths: What do we know about their use? Journal of Hand Therapy, Oct-Dec 343-346.
• Hardy M & Woodall W (1998) therapeutic effect of heat, cold and tissue stretching on connective tissue. Journal of Hand Therapy, 11(2), 148-156.
• Skirven TM, Osterman AL, Fedoroczyk JM, Amadio PC. Rehabilitation of the hand and Upper Extremity. 6th ed. Mosby Inc; 2011.
• Cooper C. Fundamentals of Hand Therapy. Clinical reasoning and treatment guidelines for common diagnoses of the upper extremity. Mosby inc; 2007.

Contacts/further information

The occupational therapy department is located in clinic 30 in the Addenbrooke’s Treatment Centre (ATC). The occupational therapy reception telephone number: 01223 216769.