10 Practical Tips to Start Water Therapy Exercises for Back Pain

Don’t Miss Out on this – Start Aquatic Therapy Today

Therapeutic exercise programs done in a warm pool – called water therapy or aquatic therapy – is an excellent choice for anyone who has too much back pain and/or joint pain for land-based physical therapy.

The warm water in the pool provides buoyancy and support for your spine and joints and provides a gentle form of friction to make the exercise effective.

Here is a recent study that concludes “patients with chronic low back pain who received therapeutic aquatic exercise showed greater improvement in terms of function, pain, quality of life, sleep quality, and mental state than those who underwent physical therapy modalities.”¹Meng-Si Peng et al., Efficacy of Therapeutic Aquatic Exercise vs Physical Therapy Modalities for Patients With Chronic Low Back Pain https://pmc.ncbi.nlm.nih.gov/articles/PMC8742191/, PMCID: PMC8742191 PMID: 34994794

The sticking point for many people is how to find a water therapy program and get started.

Here are 10 quick tips to get started in an aquatic therapy program:

1. Consult with Your Physician

• Why: Before beginning water therapy, get medical clearance to ensure it is safe for your condition.
• How to Ask: Request a referral to a physical therapist or water therapy program if your doctor agrees it’s appropriate.

2. Get a Medical Letter of Necessity

• Why: A letter of medical necessity may be required for insurance coverage or eligibility for health savings account (HSA) of flexible spending account (FSA) reimbursements.
• How to Obtain It: Ask your treating physician to outline the medical benefits of water therapy for your back pain.

3. Find a Local Water Therapy Class or Instructor

• Where to Look:
  • Contact local rehabilitation centers or physical therapy clinics
  • Look at the websites for any local fitness centers in your area to see if they offer these programs
  • Search online using phrases such as “Aquatic therapy near me”
  • Look up local YMCA programs
• Questions to Ask:
  • Is the instructor certified in aquatic therapy or water exercise?
  • Do they have experience working with back pain patients?
  • Do they have experience with my specific condition, e.g. lumbar spinal stenosis, spinal osteoarthritis?

4. Understand the Costs and Insurance Options

• Check Coverage: Contact your insurance provider to ask if water therapy is covered with a physician’s referral
• Use HSA/FSA: Verify if aquatic therapy qualifies for reimbursement through your HSA or flexible spending account (FSA)

5. Choose the Right Facility

• Look for:
  • Warm water pools (between 83°F and 90°F) as the warm water relaxes muscles, reduces stiffness, and adds to the overall therapeutic effect
  • Accessibility features that you might need, like ramps or lifts if mobility is a concern, and easy parking

6. Know What to Expect in a Class

• Structure: Classes typically last 30 to 60 minutes and may include exercises like:
  • Gentle stretches for flexibility
  • Walking or jogging in place to develop core stability
  • Resistance exercises using water weights to build strength
• Supervision: A certified instructor provides instruction on how to do the exercises, and monitors your movements for safety and correct form

7. Bring the Right Gear

• Swimsuit: Choose a comfortable, non-restrictive swimsuit
• Water Shoes: Wear water shoes that provide traction and reduce the risk of slipping
• Towel and Robe: Bring your own for drying off and staying warm afterward
• Flotation Devices (if needed): Most pools provide flotation devices but check ahead

8. Start Slowly and Listen to Your Body

• Begin with gentle exercises to avoid strain
• Water therapy is low-impact, but overstretching or sudden movements can still cause discomfort
• Ask questions of the instructor, as needed
• If needed, bring a letter from your physical therapist and/or treating physician explaining your condition and rehabilitation needs and goals

9. Track Your Progress

• Record any improvements in pain levels, flexibility, or mobility after each session
• Share these updates with your treating physician

10. Stay Consistent

• Regular sessions are key to seeing benefits.
• Aim for 2–3 times per week, depending on your healthcare provider’s recommendation

By following these steps, you’ll be well-prepared to make the most of aquatic therapy for back pain, osteoarthritis, post-surgery rehabilitation, and general fitness.

Research has shown there is both immediate and long term benefits in terms of pain relief and better ability to function in everyday life, so get started today!