Medical Resources

This medical resource page is provided to give you a basic overview of the many conditions and afflictions effecting persons that have bathing difficulties. Many of these medical conditions may be alleviated by the use of a Seabridge walk-in bath, slide-in bath or walk-in bath with power seat. The resource links that accompany these conditions are valuable in determining if bathing will help with your condition, ailment or difficulty.

Arthritis Alzheimer's Back and Neck Pain Dementia Epilepsy Fibromyalgia or Fibrositis Falls and Hip Fractures Getting Stuck in the Bath Gout Legionnaires Lumbago Lupus

More Health Benefits of Bathing Multiple Sclerosis Muscle and Joint Pains Osteoarthritis Osteoporosis Parkinson’s Pontiac Fever Rheumatoid Arthritis Sciatica Sleep Disorders Stress

Arthritis

Arthritis is joint inflammation and consists of more than 100 different conditions. These can be anything from relatively mild forms of tendonitis (as in 'tennis elbow') and bursitis to crippling systemic forms, such as rheumatoid arthritis. There are pain syndromes like fibromyalgia and arthritis-related disorders, such as systemic lupus erythematosus, that involve every part of the body. There are forms of the disease, such as gout, that almost nobody connects with arthritis, and there are other conditions - like osteoarthritis, the misnamed 'wear and tear' arthritis - that a good many people think is the only form of the disease.

Many older people do have arthritis, but its not just a disease of the old. Some forms of arthritis affect children still in diapers, while thousands of people are stricken in the prime of their lives. The common denominator for all these conditions is joint and musculoskeletal pain, which is why they are grouped together as 'arthritis.' Often that pain is a result of inflammation of the joint lining.

Inflammation is involved in many forms of arthritis. It is the body's natural response to injury. The warning signs that inflammation presents are redness, swelling, heat and pain. These are the same kinds of reaction the body has to a sliver in the hand, for example. When a joint becomes inflamed, it may get any or all of these symptoms. This can prevent the normal use of the joint and therefore it can cause the loss of function of that joint.

Arthritis is one of the most pervasive diseases in the United States and Canada and is the leading cause of disability. According to the Centers for Disease Control and Prevention one out of every three Americans (an estimated 70 million people) is affected by one of the more than 100 types of arthritis.

For most people arthritis pain and inflammation cannot be avoided as the body ages. In fact, most people over the age of 50 show some signs of arthritis.  Joints naturally degenerate over time. Fortunately, arthritis can be managed through a combination of medication, exercise, rest, weight-management, nutrition, and, in some cases, surgery. Your doctor can tell if you have arthritis through blood tests and x-rays. He or she will then be able to help you decide on the best treatment for your case.

Arthritis is a chronic disease that will be with you for a long time and possibly for the rest of your life. Your treatments will probably change over time and medication may be adjusted. Having a positive mental outlook and the support of family and friends will help you live with arthritis and be able to continue to perform your daily activities.

The Arthritis Society of Canada
http://www.arthritis.ca/

Arthritis Foundation
http://www.arthritis.org/

Arthritis Physical and Occupational Therapy Health Center
http://www.medicinenet.com/arthritis_physical_and_occupational_therapy/index.htm

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Fibromyalgia or Fibrositis

Fibromyalgia is a chronic condition causing pain, stiffness, and tenderness of the muscles, tendons, and joints. It is also characterized by restless sleep, awakening feeling tired, fatigue, anxiety, depression, and disturbances in bowel function. Fibromyalgia was formerly known as fibrositis.

Fibromyalgia is widespread pain in the muscles, ligaments and tendons.  Ligaments and tendons connect muscles to bones. Fibromyalgia also causes people to have trouble sleeping and feel very tired all the time.

Although fibromyalgia is a relatively recent term, this syndrome has been known by several other names over the past years, including soft tissue rheumatism, fibrositis and non-articular rheumatism.

The effects of balneotherapy on fibromyalgia patients.

A.K.U. Arastirma Hastanesi, Fiziksel Tip ve Reh A.D. Inonu Bulvan; 03200 Afyon, Turkey. ezgievcik@ixir.c

Fibromyalgia syndrome (FMS) is a very common rheumatological diagnosis. There are various treatment modalities. This study was planned to investigate the effects of balneotherapy in the treatment of FMS. A total of 42 primary fibromyalgia patients diagnosed according to American College of Rheumatology criteria were included in the study. Their ages ranged between 30 and 55 years.

Patients were randomly assigned to two groups. None of them had had a cardiovascular disease before. Group 1 n=22) received 20-min bathing, once a day and five times per week. Patients participated in the study for 3 weeks (total of 15 sessions). Group 2 (n=20) was accepted as the control group. Patients were evaluated by the number of tender points, Visual Analogue Scale for pain, Beck's Depression Index for depression, and Fibromyalgia Impact Questionnaire for functional capacity.

Measurements were assessed initially, after the therapy, and at the end of the 6th month. In group 1, there were statistically significant differences in numbers of tender points, Visual Analogue scores, Beck's Depression Index, and Fibromyalgia Impact Questionnaire scores after the therapy program (P<0.001). Also, 6 months later in group 1, there was still an improvement in the number of tender points (P<0.001), Visual Analogue scores, and Fibromyalgia Impact Questionnaire (P<0.005). But there was not a statistical difference in Beck's Depression Index scores compared to the control group (P>0.05). Patients with FMS mostly complain about pain, anxiety, and the difficulty in daily living activities. This study shows that balneotherapy is effective and may be an alternative method in treating fibromyalgia patients.

Learn about Balneotherapy here (http://www.balneotherapy.com/therapy.shtml)

Fibromyalgia Network
http://www.fmnetnews.com/

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Gout

Gout is a type of arthritis that results from too much uric acid in the body. Uric acid is a waste product that naturally occurs in the body. It is normally flushed from the body by the kidneys through urine.

With gout the body either makes too much uric acid or does not excrete enough. The uric acid forms into crystals that, because these have nowhere else to go, deposit in different parts of the body.

Often the excess uric acid crystals deposit in the joints. This causes pain, swelling and tenderness in the area. This is called inflammation.

Most typically the joint affected is that of the big toe, but gout can also affect the ankle, knee, foot, hand, wrist and elbow. Uric acid crystals may also form deposits in other areas such as under the skin or in other soft tissues, and in the kidney or urinary tract.

Gout - Mayo Clinic
www.mayoclinic.com/health/gout/DS00090

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Lupus

Lupus is the name of a group of diseases. The most common and serious type of lupus is called systemic lupus erythematosus. Many people just call this type by the name lupus. It can also be shortened to SLE.

With SLE, the body’s immune system stops working properly. The immune system’s job is to fight off germs and disease. With SLE, the immune system that normally protects the body from germs, viruses, and bacteria begins to malfunction. It generates antibodies that attack healthy tissue in different parts of the body. This attack on healthy tissues causes them to become swollen and painful. This is called inflammation.

Inflammation can happen in the skin, muscles or joints. The heart, lungs, kidneys, blood vessels or the nervous system can also be attacked by the immune system.

With SLE, there may be periods of inflammation, called flare-ups, and then periods where there is little or no inflammation, called remissions.

Lupus is the name given to a group of chronic autoimmune diseases. Systemic lupus erythematosus (SLE) is the most common and serious type of lupus. These tissues become inflamed as a result. Inflammation can occur in the skin, muscles, joints, heart, lungs, kidneys, blood vessels and the nervous system. SLE can fluctuate between active periods (flare-ups or exacerbation), and times of minimal symptoms or no symptoms (remission).

Lupus Canada
http://www.lupuscanada.org/

Lupus Foundation of America, Inc
http://www.lupus.org/

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Multiple Sclerosis

Multiple sclerosis (MS) is thought to be an autoimmune disease that affects the central nervous system (CNS). The CNS consists of the brain, spinal cord, and the optic nerves. Surrounding and protecting the nerve fibers of the CNS is a fatty tissue called myelin, which helps nerve fibers conduct electrical impulses.

In MS, myelin is lost in multiple areas, leaving scar tissue called sclerosis. These damaged areas are also known as plaques or lesions. Sometimes the nerve fiber itself is damaged or broken.

Myelin not only protects nerve fibers, but makes their job possible. When myelin or the nerve fiber is destroyed or damaged, the ability of the nerves to conduct electrical impulses to and from the brain is disrupted, and this produces the various symptoms of MS.

MS Society of Canada
http://www.mssociety.ca

National Multiple Sclerosis Society
http://www.nmss.org/

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Osteoarthritis

Osteoarthritis is the most common form of arthritis. It is caused by the breakdown of cartilage.  Cartilage is the tough elastic material that covers and protects the ends of bones.  Bits of cartilage may break off and cause pain and swelling in the joint between bones.  This pain and swelling is called inflammation.

Over time the cartilage may wear away entirely, and the bones will rub together.

Osteoarthritis can affect any joint but usually affects hips, knees, hands and the spine.

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Osteoporosis

Osteoporosis is a disease where bone breaks down over time. The bones become thin, brittle and break easily. The bones in the wrist, hip and spine are most often affected by osteoporosis.

Over time the bones in the spine can collapse.  When a bone in the spine collapses it is called a compression fracture.  This can result in a person becoming shorter. Osteoporosis can cause a person to stoop forward and appear to have a hump on his or her spine.

'Osteo' means bone, and 'porosis' thinning or becoming more porous, so osteoporosis literally means 'thinning of bone.' It is commonly confused with the word osteoarthritis, which is a form of arthritis that results in breakdown of the cartilage covering the ends of bones. In contrast, osteoporosis is a condition where bone itself breaks down.  Bones then become thin, brittle and easily broken. For example, sneezing can cause a person's rib to break or stumbling can lead to fracture of one of the bones in the spine. Hip fractures are also common in people with osteoporosis, and can lead to immobility and hospitalization.

Magnitude and duration of the effects of two spa therapy courses on knee and hip osteoarthritis: an open prospective study in 51 consecutive patients.

Forestier R.

OBJECTIVE: To evaluate the effects of spa therapy on knee and hip osteoarthritis by studying patients given the same treatment on two different occasions.

PATIENTS AND METHODS: A prospective study of two medically-supervised, 3-week spa therapy courses performed at an interval of about 1 year in 51 consecutive patients with knee and/or hip osteoarthritis, most of whom were overweight (mean body mass index, 30 +/- 5 kg/m2). Mean age was 66 years. Study data were collected over a 17-month period.

RESULTS: Lequesne's algofunctional index was significantly improved 5 and 8 months after the first course (by 1.74 +/- 2.2, P < 0.0001; and by 0.89 +/- 2.4, P = 0.017; respectively) and 5 months after the second course (by 1.26 +/- 3, P = 0.008). Walking distance showed comparable improvements. The decrease in medication use was not significant. No significant differences were found between the effects of the two courses after 20 days and 5 months. The advantages and drawbacks of the repeated treatment design used in this study are discussed.

CONCLUSION: Although some sources of bias could not be eliminated, our data suggest that spa therapy may be effective in knee and hip osteoarthritis. The repeated treatment design may prove useful for evaluating treatments to which patients cannot be blinded.

Osteoporosis Canada
http://www.osteoporosis.ca

National Osteoporosis Foundation(NOF)
http://www.nof.org/

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Rheumatoid Arthritis

RA is an autoimmune disease. This means that your immune system attacks other parts of your body.

Rheumatoid arthritis (RA) causes redness, pain, swelling or a hot (or warm) feeling in the lining of a joint, the place where 2 or more bones come together.

This redness, pain, swelling and heat around the joint is called inflammation.

The inflammation may also affect other internal organs, such as the eyes, lungs, or heart.

RA can affect any joint, but the most common places are the hands or feet.

The body’s immune system attacks healthy joints. This causes inflammation in the lining of the joints. It can also affect other parts of the body, such as the eyes, lungs or heart. The inflammation can be painful. It can lead to permanent damage if the disease is not treated and controlled.

Joint damage can occur even in cases where the pain is not severe. It can happen even in the early stages of the disease. For many people with RA, damage has shown up on X-rays of the hands and feet within two years of the onset of the disease. But it may be too late to fix by the time X-rays discover the problem. One study found that damage got worse more quickly during the first two years, and 75 per cent of all damage happened in the first five years.

Severe damage can lead to permanent joint deformity and disability. It can cause so much pain and swelling that you may have difficulty walking. You may have trouble using your hands for routineactivities, such as dressing and cooking.  

Rheumatoid Arthritis – Mayo Clinic
http://www.mayoclinic.com/health/rheumatoid-arthritis/DS00020

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Back and Neck Pain

Thousands of people have back and neck pain, but usually there’s no problem with the spine and medical treatment is not needed. Occasionally, back and neck pain can be due to a serious problem, so visit your doctor if you have any of the signs listed under ‘Consult your doctor if:’.

Signs and symptoms

• Non-serious back and neck pain can cause any of the following symptoms:
• Pain in one spot of the upper or lower back, often worse when you bend or cough
• Pain spreading down the back of the thigh to the ankle (sciatica)
• A stiff or painful neck.
• If you are upset or have pain somewhere else, the back or neck pain may feel worse.

Causes

Most back and neck pain is caused by stiffness or spasm in the muscles around the spine. This is usually caused by doing activities you are not used to, or by sleeping in an uncomfortable position. Other causes include:

• Pregnancy
• Being overweight
• Incorrect techniques (e.g. lifting)
• One of the discs between the bones of your spine moving out of position and pressing on a nerve (sciatica).

Prevention

• Keep active. A strong back is less likely to get damaged by normal day to day activities.
• Change your position every so often if you have to stand, sit or stoop for a long time.
• Sleep on a firm mattress.
• Lift correctly - crouch down, and then straighten your knees, while keeping your back straight. If your job involves heavy lifting, ask for proper training.
• Keep to a healthy weight

Home treatment

• Try and avoid bed rest if possible - if you can't stay up and about then limit your stay in bed for a day or two at most. Too much bed rest will cause your muscles to stiffen and lose strength.
• Apply warmth, and massage the painful area.
• Take a painkiller like paracetamol or an anti-inflammatory like ibuprofen.
• Take gentle exercise (e.g. swimming on your back).
• Make sure your posture is good. If necessary, get advice from a physiotherapist.
• Don’t be stressed. Try gentle relaxation or exercises such as yoga.
• Lose weight if you’re overweight
• Do exercises to strengthen your stomach, neck, back and side muscles.

Effectiveness of spa therapy in chronic low back pain: a randomized clinical trial.

Institute of Hydrology, University of Nancy I, Faculty of Medicine, France.

OBJECTIVE. To assess the overall effectiveness of spa therapy compared with usual routine drug therapy in chronic low back pain (LBP).

METHODS. One hundred and twenty-one patients were randomly allocated to treatment (n = 59) and control (n = 62) groups. In the treatment group, patients underwent routine drug therapy and spa therapy 6 days/week for 3 consecutive weeks in Saint-Nectaire, France. In the control group, patients received routine drug therapy. Effectiveness was assessed based on clinical measures, duration and intensity of pain, Roland and Morris' disability questionnaire, the patient's overall evaluation of back health, and drug consumption (analgesic and antiinflammatory). Groups were compared using analysis of covariance with repeated measures.

RESULTS. At 3 weeks, patients in the treatment group had significant improvement in all outcome variables (p < 0.0001) except for the Schober index and analgesic and antiinflammatory drug consumption. At 6 months, improvement was still significant for the same outcome variables (p < 0.0001), plus a significant reduction in analgesic consumption.

CONCLUSION. This study suggests both immediate and 6 month effectiveness of spa therapy in chronic LBP. Spa therapy may be beneficial in the management of chronic LBP.

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Dementia

Bathing. Pleasure or pain?

Department of Psychology, University of Alberta, Edmonton, Alberta, Canada.

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Epilepsy

Epilepsy is the third most common neurological disorder seen in the elderly population after dementia and stroke. Accordingly, epilepsy in the elderly is a significant public health issue since there will be a growing number of elderly patients over the next several decades.

Causes of Seizures in the Elderly

Although epilepsy has generally been thought to be a pediatric disease with onset in childhood it is apparent that there is a second peak in the incidence and prevalence of epilepsy in elderly patients. The causes of epilepsy, however, in the elderly are different than in children or younger adults. The most frequently reported cause is cerebrovascular disease such as stroke. Other less common causes of seizures in elderly patients include tumour and metabolic disturbances, and some seizures are of unknown origin.

Patients with epilepsy: a high-risk population prone to severe burns as a consequence of seizures while showering.

Unglaub F, Woodruff S, Demir E, Pallua N.

Department of Plastic Surgery, Hand and Reconstructive Surgery, Medical Faculty of the University of Technology, Burn Center, Aachen, Germany.

We document the severe burns sustained by three patients with epilepsy who suffered seizures while showering. On the basis of the circumstances of these accidents, we suggest preventative measures to help other patients with epilepsy avoid similar burn injuries. Patient data collected from January 1987 to May 2004 by the Burn Unit of the Department of Plastic Surgery, University of Aachen, Germany, were reviewed.

Three patients with epileptic disorders were found who suffered severe burn injuries caused by seizures that occurred while showering. Scald location and depth was assessed. Three patients (two women, one man) sustained extensive scald injuries after epileptic seizures while showering. Burn extent ranged from 20% to 35% TBSA. Scalds primarily affected the trunk, legs, arms, and buttocks. Two of the three patients used showers with levers for controlling water temperature. Safety devices for limiting water temperature were absent. All patients used shower cubicles.

Patients with epilepsy may sustain serious burns, typically affecting the trunk, legs, arms, and buttocks, when a seizure occurs while showering. We suggest that individuals with epilepsy use showers designed with pirouetting taps, rather than levers, to regulate water temperature. Pirouetting taps are less likely to be shifted out of position during a seizure. We also recommend that epileptic patients have safety devices installed in their water heaters that limit maximum water temperature. Such safety devices prevent scald injury. And, finally, we suggest that people with comparable disorders generally avoid using shower cubicles. Instead, showers with curtains should be used, which may allow occupants to escape from dangerously hot shower water more easily.

Epilepsy in The Elderly
http://www.epilepsytoronto.org/seniors.html

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Lumbago

Lumbago is a general term used to describe pain in the lumbar region, or lower back. It is defined as a mild to severe pain or discomfort in the area of the lower back. Ranging in severity from acute (i.e. sudden and severe) to chronic (if it has lasted for more than three months) lumbago can occur in any age group, but is common among younger people who engage in hard physical work and also among people of retirement age.

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Pontiac fever

Pontiac fever is a flu-like illness caused by the bacterium Legionella pneumophila and is contracted by breathing mist that comes from a water source (such as air conditioning cooling towers, whirlpool spas, showers) contaminated with the bacteria. The incubation period is short, from a few hours to 2 days, before the onset of fever and muscle aches. Persons with Pontiac fever do not have pneumonia. They generally recover in 2 to 5 days without treatment. Pontiac fever is so-named because of an outbreak in 1968 in Pontiac, Michigan. It is a milder form of legionellosis than Legionnaire disease which is caused by the same bacterium.

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Sciatica

Sciatica—pain along the large sciatic nerve that runs from the lower back down the back of each leg—is a relatively common form of low back pain and leg pain. This pain along the sciatic nerve can be caused when a root that helps form the sciatic nerve is pinched or irritated.

Sciatica.org
http://www.sciatica.org/

http://www.spine-health.com

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Sleep Disorders

Bathing before sleep in the young and in the elderly

Kiyoko Kanda A1, Yutaka Tochihara A2, Tadakatsu Ohnaka A3

A1  School of Health Sciences, Faculty of Medicine, Gunma University, 3-39-15 Showamachi, Maebashi 371-8514, Japan JP

A2 Department of Ergonomics, Kyushu Institute of Design, 4-9-1 Shiobara, Minami-ku Fukuoka 815-8540, Japan JP

A3 Department of Living Environmental Sciences, School of Human Environmental Sciences, Fukuoka Women's University, 1-1-1 Kasumigaoka, Higashi-ku, Fukuoka 813-8592, Japan JP

Abstract:

In this study we investigated the effects of bathing on the quality of sleep in 30 elderly people (ages 65–83 years) and in 30 young people (ages 17–22 years) in their homes. Room temperature did not vary significantly during the nights that data were acquired, ranging from 8 to 12°C. After bathing and at the beginning of sleep, the mean (SE) rectal temperatures of the young and the elderly were 37.8?(0.08) and 37.5?(0.07)°C, respectively, and were higher by 0.7?(0.13) and 0.6?(0.07)°C, respectively, than when the subjects had not bathed.

At the beginning of the sleep after bathing in the young subjects, skin temperature was 32.5?(0.24) and 1.5?(0.34)°C higher than when those subjects had not bathed. In the elderly, however, there were no significant differences in skin temperature with and without prior bathing because they used electric blankets during sleep. After bathing, the young people reported “warmth” in their hands and/or legs, while the elderly more often reported “good sleep” or “quickness of falling asleep”. During the first 3?h of sleep, body movements were less frequent after bathing for both the young and the elderly subjects. The results suggest that a bath before sleep enhances the quality of sleep, particularly in the elderly.

Effects of bathing and hot footbath on sleep in winter.

Department of Ergonomics, Kyushu Institute of Design.

The effects of daily bathing and hot footbath (immersion of feet in hot water) in winter on the sleep behavior of nine healthy female volunteers were studied. Subjects were assigned to three sleep conditions: sleep after bathing (Condition B), sleep after hot footbath (Condition F), and sleep without either treatment (Control). Polysomnograms (consisting of electroencephalograph, electrooculograph, and electromyograph) were obtained, and body movements during sleep were measured while monitoring both the rectal and skin temperatures of subjects. In addition, subjective sleep sensations were obtained with a questionnaire answered immediately by the subjects on awakening. The rectal temperature increased by approximately 1.0 degree C under Condition B, but this elevation was not observed under Condition F compared with Control.

In contrast, the respective increases in the mean skin temperature of participants subjected to bathing and hot footbath were greater than those of Control, although these temperature differences became negligible 2 h after subjects went to bed.The sleep onset latency was shortened under both conditions compared with Control. Body movements during the first 30 min of sleep in Control were greater than under the other conditions. Rapid eye movement (REM) sleep decreased under Condition B compared with Condition F, and stage 3 was greater under the latter condition compared with Control. As such, the subjective sleep sensations were better under the two treatment conditions. These results suggest that both daily bathing and hot footbath before sleeping facilitates earlier sleep onset. A hot footbath is especially recommendable for the handicapped, elderly, and disabled, who are unable to enjoy regular baths easily and safely.

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Stress

It is well documented that by both user and care provider undergo significant amounts of stress during bathing activity. Care Givers tell us that bathing a client is the hardest task that they perform within there job. For many users of conventional baths stress is an everyday occurrence when it comes to bath time. With a Seabridge walk-in bath or slide-in bath eliminating that stress is all important.

Soak Away Stress

Balneotherapy can elevate your bathing ritual into a therapeutic experience.

By Tracy Teare

When you add a bit of art, science, and ritual, taking a bath is much more than getting clean—its balneotherapy. A form of therapeutic bathing, balneotherapy has been practiced since the days of the ancient Greeks and Romans to preserve health and treat a range of ailments from injuries to eczema. Like yoga, its also a great way to melt away stress and bring the body back into a more balanced state. "Submersion in warm water calms the physiological part of the fight-or-flight response," says Jonathan P. DeVierville, vice president of the International Society of Medical Hydrology and Climatology and director of the Alamo Plaza Spa in San Antonio, Texas. In other words, as you soak in the tub, your blood vessels dilate, your circulation increases, your muscles relax, and your nervous system chills out.

Balneotherapy is popular overseas, especially in Germany, the Czech Republic, Spain, Russia, and Turkey, where a "bath master" typically walks you through the process. Some U.S. spas now offer balneotherapy treatments, but you can also enjoy the benefits at home. To create a therapeutic bath on your own, try these tips.

HEAT UP

GET IN DEEP

GO LONG

STAY SIMPLE

SLOW DOWN

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Muscle and joint pains

Muscle and joint pains are common and seldom need the attention of a doctor. In most cases, the problem will get better on its own, and a few steps can help reduce the pain in the meantime.

Signs and symptoms

• Pain and stiffness in a muscle or joint, especially when you move.
• Pain, swelling and bruising of a joint, which may also feel hot.

Causes and complications

In most cases, muscle pain results from a strain due to over-exertion.

Joint pain can be caused by several things:

• An injury, such as a sprain or strain
• Temporary inflammation (e.g. due to a viral infection)
• Long-term inflammation (e.g. due to arthritis)
• Inflammation of the soft tissue around a joint
• Formation of uric acid crystals in the joint (called gout)
• Wear and tear on the internal surfaces of the joint (called osteoarthritis).

A minor joint injury can cause stiffness and stop you using it properly. This may in turn affect the joint’s ability to move (e.g. frozen shoulder).

Home treatment

For muscle pain, massage the area and keep it warm. Warm baths and rest are helpful. Take simple painkillers like paracetamol or ibuprofen, which helps reduce inflammation.

For how to treat sprains and strains

For other types of joint pain, rest the sore joint and take painkillers like paracetamol, aspirin (not in children under 12 years) or ibuprofen.

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More Health Benefits

You can use baths to either immerse the entire body or simply the affected body part. Hot full-immersion baths can help with arthritic discomfort and conditions where muscles are in painful spasm, such as fibromyalgia. For a neutral (or tepid) bath the temperature should be neither too hot nor too cold. These are mainly used for relaxation purposes and to treat stress-related ailments such as insomnia, anxiety, and nervous exhaustion. Cool baths can relieve irritation and itching caused by hives or other skin disorders.

Sitz baths. Taking sitz baths involves partially immersing the pelvic region. A hot sitz bath can help reduce pain from hemorrhoids, menstrual cramps, and sciatica. A neutral sitz bath is best for bladder infections or severe itching in the anal region. A cold sitz bath constricts blood vessels and may be helpful for excess vaginal bleeding and mild constipation. A contrast sitz bath--from hot to cold--increases circulation in the pelvis and may be useful for chronic prostatitis and pelvic infections. You can buy a special sitz-bath seat to fit over your toilet seat or you can simply sit in your bathtub.

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Falls and Hip Fractures

How serious is the problem?

• More than one-third of adults ages 65 years and older fall each year (Hornbrook 1994; Hausdorff 2001).
• Among older adults, falls are the leading cause of injury deaths (Murphy 2000) and the most common cause of nonfatal injuries and hospital admissions for trauma (Alexander 1992).
• In 2003 more than 1.8 million seniors age 65 and older were treated in emergency departments for fall-related injuries and more than 421,000 were hospitalized (CDC 2005).

What outcomes are linked to falls?

• In 2002, nearly 13,000 people ages 65 and older died from fall-related injuries (CDC 2004). More than 60% of people who die from falls are 75 and older (Murphy 2000). 
• Of those who fall, 20% to 30% suffer moderate to severe injuries such as hip fractures or head traumas that reduce mobility and independence, and increase the risk of premature death (Sterling 2001). 
• Among people ages 75 years and older, those who fall are four to five times more likely to be admitted to a long-term care facility for a year or longer (Donald 1999). 
• Falls are a leading cause of traumatic brain injuries (Jager 2000).
• Among older adults, the majority of fractures are caused by falls (Bell 2000). 
• Approximately 3% to 5% of older adult falls cause fractures (Cooper 1992; Wilkins 1999). Based on the 2000 census, this translates to 360,000 to 480,000 fall-related fractures each year.
• The most common fractures are of the vertebrae, hip, forearm, leg, ankle, pelvis, upper arm, and hand (Scott 1990).

Who is at risk?

• White men have the highest fall-related death rates, followed by white women, black men, and black women (CDC 2004). 
• Women sustain about 80% of all hip fractures (Stevens 2000).
• Among both sexes, hip fracture rates increase exponentially with age (Samelson 2002). People ages 85 years and older are 10 to15 times more likely to sustain hip fractures than are people ages 60 to 65. (Scott 1990).

What is the effect of hip fractures? 

• Of all fall-related fractures, hip fractures cause the greatest number of deaths and lead to the most severe health problems and reduced quality of life (Wolinsky 1997; Hall 2000). 
• In 1999 in the United States, hip fractures resulted in approximately 338,000 hospital admissions (Popovic 2001).
• Most patients with hip fractures are hospitalized for about one week (Popovic 2001). Up to 25% of community-dwelling older adults who sustain hip fractures remain institutionalized for at least a year (Magaziner 2000).
• In 2000, direct medical cost totaled $179 million dollars for fatal and $19 billion dollars for nonfatal fall injuries (Stevens 2005, in press).CDC 1996).
• From 2000 to 2040, the number of people age 65 or older is projected to increase from 34.8 million to 77.2 million. For people over 85, the relative growth rate is even faster (U.S. Bureau of the Census 1998). Given our aging population, by the year 2040, the number of hip fractures is expected to exceed 500,000 (Cummings 1990).

 How can seniors reduce their risk of falling?

Through careful scientific studies, researchers have identified a number of modifiable risk factors:

• Lower body weakness (Graafmans 1996)
• Problems with walking and balance (Graafmans 1996; AGS 2001)
• Taking four or more medications or any psychoactive medications (Tinetti 1989; Ray 1990; Lord 1993; Cumming 1998). 

 Seniors can modify these risk factors by: 

• Increasing lower body strength and improving balance through regular physical activity (Judge 1993; Lord 1993; Campbell 1999). Tai Chi is one type of exercise program that has been shown to be very effective (Wolf 1996; Li 2005).
• Asking their doctor or pharmacist to review all their medicines (both prescription and over-the-counter) to reduce side effects and interactions. It may be possible to reduce the number of medications used, particularly tranquilizers, sleeping pills, and anti-anxiety drugs (Ray 1990).

Strong studies have shown that some other important fall risk factors are Parkinson’s Disease, history of stroke, arthritis (Dolinis 1997), cognitive impairment (Tromp 2001), and visual impairments (Dolinis 1997; Ivers 1998; Lord 2001). To reduce these risks, seniors should see a health care provider regularly for chronic conditions and have an eye doctor check their vision at least once a year.

 What other things may help reduce fall risk?

Because seniors spend most of their time at home, one-half to two-thirds of all falls occur in or around the home (Nevitt 1989; Wilkins 1999). Most fall injuries are caused by falls on the same level (not from falling down stairs) and from a standing height (for example, by tripping while walking) (Ellis 2001). Therefore, it makes sense to reduce home hazards and make living areas safer.

• Researchers have found that simply modifying the home does not reduce falls. However, environmental risk factors may contribute to about half of all home falls (Nevitt 1989). 
• Common environmental fall hazards include tripping hazards, lack of stair railings or grab bars, slippery surfaces, unstable furniture, and poor lighting (Northridge 1995; Connell 1996; Gill 1999).

To make living areas safer, seniors should:

• Remove tripping hazards such as throw rugs and clutter in walkways;
• Use non-slip mats in the bathtub and on shower floors;
• Have grab bars put in next to the toilet and in the tub or shower;
• Have handrails put in on both sides of stairways;
• Improve lighting throughout the home.

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Getting Stuck in the Bath

Survey of elderly people who get stuck in the bath

C Gooptu , Birmingham Heartlands Hospital, Bordesley Green East, Birmingham B9 5ST, a G P Mulley 

a Department of Medicine for the Elderly, St James's University Hospital, Leeds LS9 7TF Correspondence to: Dr

Many apparently healthy old people are unable to bath without help ¹ and some are not able to bath as often as they would like. 2,3 We met several elderly people who had become stuck in the bath, and we decided to investigate.

Patients, methods, and results

During one week one of us (CG) assessed all inpatients on eight wards for the elderly and all those attending the geriatric day hospital at this hospital. The patients were asked whether they had ever been unable to get out of their bath at home. Those who had were then interviewed using a standard questionnaire.

Of the 233 patients initially assessed, 43 with mental impairment (abbreviated mental test score less than 7 out of 10) and 15 with severe dysphasia were excluded, as were 28 who lived in nursing or residential homes. The remaining 129 inpatients and 18 day patients were interviewed. Twenty one of the 147 patients said that they had been unable to get out of the bath at some time. Their ages ranged from 70 to 89. The table shows the results of the questionnaire.

Most people had had difficulty getting up out of the bath after completing their bathing; one had slipped and fallen and four had lain down in the bath and then been unable to get up. In 11 cases the inability to get out of the bath was related to physical disability - usually poor mobility resulting from a previous stroke (five), osteoarthritis (four), or both (two). One patient had severe rheumatoid arthritis and three were disabled by cardiac failure. Of the 10 other patients (who were in hospital with various impairments, including respiratory infection, myocardial infarction, jaundice, and leg ulcers), six blamed a lack of bath aids - for example, not having any grab rails. Two thought that the bath sides were too high to allow them to get out easily. In two cases alarms had been fitted near the bath but were at the wrong end to be of use.

All but one person had pulled the plug out to allow the water to drain away and several had covered themselves with a towel to reduce the risk of hypothermia. The patient who was admitted to hospital with extensive pressure sores and burns (table) was unable to get out of a zinc bath in front of a fire. Every patient had vivid memories of the event. Nine described it as "a terrible experience"; six others admitted to panicking. Three remembered banging on a wall to attract attention. All had changed their bathing activities since the event. Five had abandoned having a bath and now had a strip wash; four had baths at day centres. Six bathed only with the help of a relative, while three had had showers fitted. Another three were waiting for bath aids to be fitted.

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Comment

One in seven elderly people in a geriatric unit had been stuck in the bath at home at least once. Physical complications were few but potentially severe: pressure sores may develop within a few hours and require weeks of hospital care, and hypothermia can be fatal. Plastic surgery was necessary for the burns sustained by one patient. The psychological impact was considerable, one episode being enough to deter many subjects from bathing at home again.

Elderly people should be advised not to have a bath unless someone else is in the house and to leave the bathroom door unlocked. Appropriate aids and walk in showers may also help. We could not identify those at particular risk: half of our subjects had no underlying physical disability. Furthermore, those with the most reduced mobility are not necessarily at greatest risk because they often cannot get into a bath. We suspect that many healthy old people living at home are at risk. Our future community based studies should determine the prevalence of this problem and identify those at particular risk.

1. Clarke M, Clarke S, Odell A, Jagger C. The elderly at home: health and social status. Health Trends 1984;16:3-7. [Medline]

1. Penn ND, Belfield PW, Mascie-Taylor BH, Mulley GP. Old and unwashed: bathing practices in the over 70s. BMJ 1989;298:1158-9.

1. Age Concern Greater London. Old and clean: a report on bathing services for older people in London. London: Age Concern, 1990.

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