Regular hot baths could alleviate common circulatory disease
Researchers at are investigating whether a regular soak in a hot bath could help to improve a common painful circulatory disease, thanks to funding from us.
The team behind the project are investigating whether immersion in hot water may relieve the symptoms of peripheral artery disease, which affects one in five people over the age of 60 in the UK to some degree. At least 400,000 people in the UK have been diagnosed with the condition.
Researchers are hosting regular hot tub sessions to test out the heat therapy - submerging people up to their shoulders in 40C water for an average of around 40 minutes.
Peripheral artery disease (PAD) is a condition where the arteries carrying blood from the heart are narrowed by a build-up of fatty material. It usually affects arteries in the legs, causing leg pain when walking even short distances.
Frequent heat therapy - such as a bath or hot tub session - can restore some blood flow to the legs, so could improve people’s pain and help them walk further, transforming their quality of life.
Hot tub therapy
The Manchester study, called HEATPAD (HEAT Therapy for Peripheral Artery Disease), which aims to recruit 70 people and has already begun, asks volunteers to bring their swimming costumes and sit in a hot tub three times a week. They will do this for eight weeks. One of the participants, Ken Heywood, was able to tackle his ‘Everest’ - a steep hill in his local park – after taking part.
Amy Harwood, professor in clinical exercise physiology at Manchester Metropolitan University Institute of Sport, leads the project, with co-supervision provided by Dr Tom Cullen from the University of Hull.
Professor Harwood said: “People with PAD are often advised to exercise to increase the blood flow to their legs. But the pain they experience can make walking and exercise less than enjoyable.
“If a hot tub or bath can provide similar benefits to exercise, then that could be much more pleasurable for people.
“It is up to people how they take their bath, and whether they want to include bubbles or a rubber duck, but the hot water is the important element, which we know has important cardiovascular benefits. We hope we will find evidence that it can relieve the pain of PAD, and improve people’s quality of life.”
People with PAD who are considering changing their bathing schedule should consult their GP, as being in hot water for long periods can cause blood pressure to drop and lead to dizziness. Many people with PAD also have cardiovascular disease, making this more of a risk.
Researchers will closely monitor the blood pressure of people in the new research project along with feelings of dizziness. However they hope to find a significant increase in people’s mobility as a result of the heat therapy.
Increased independence
Some people with PAD can manage no more than 30 steps (22 metres) before they are in pain, and walk only half the length of a football pitch (59 metres) before they have to stop. Being able to walk further could increase independence and greatly improve their quality of life.
In order to cool down, when you are in a hot bath or hot tub, heat is carried in your blood to the surface of the skin, so it can escape from the body. The blood vessels expand to do this, increasing blood flow. This may relieve the symptoms of PAD, because more oxygen-rich blood reaches the leg muscles.
The team will measure how far people can walk before and after eight weeks of regular bathing, as well as changes in leg and foot pain, and discomfort from pins and needles, cold feet and ulcers caused by a lack of blood flow.
The project volunteers will report if everyday tasks like washing and dressing or doing housework, become easier. They will fill out questionnaires on limitations doing activities like sports and socialising, feelings of anxiety and depression, and PAD-related fears about becoming housebound or losing a limb.
Researchers hope these measures may improve following regular hot tub sessions.
New strategies
Regina Giblin, our senior cardiac nurse, said: “Soaking in a bath or hot tub can be a good way to relax and there is evidence that doing this regularly may be good for the heart. So it will be very interesting to see if hot baths could also help to alleviate the symptoms of peripheral artery disease.
“Living with pain, which strikes after walking only a short distance, has a real impact on people’s wellbeing and independence. They may find physical activity uncomfortable, so it would be incredibly useful to find other strategies for managing PAD which could help alongside exercise.
“Until there are results from this project, however, we would always advise people with cardiovascular concerns to speak to their GP or cardiac nurse before using hot tubs or taking very hot baths, especially if they’ve experienced angina, arrhythmias, or unstable blood pressure.”
The study is recruiting people aged 18 and over, who have PAD and intermittent claudication, and have received treatment within Manchester University NHS Foundation Trust.
Ken Heywood, who climbed a hill with 60 steps after taking part in a heat therapy trial for peripheral artery disease
Getting into his swimming trunks and sitting in a hot tub for 45 minutes became one of Ken Heywood’s favourite activities during his involvement in the HEATPAD project, which he described as "nice and relaxing" to be involved in.
The 75-year-old, from Stockport, Greater Manchester, had lived with PAD for almost 40 years, and his condition became much worse two years ago, when he could only walk 100 yards with his dog without needing to stop because of the leg pain.
He said: “My stride shortened, I got more wobbly on my feet, and I could only walk 100 yards without needing to stop, usually for five or six minutes, until the pain subsided and I could walk again. I had some male pride about that - I felt embarrassed, and would pretend to be looking in a shop window or hold my phone up to my ear, so it looked like I’d stopped for a reason.”
Before taking part in the current trial, Ken had physiotherapy for his PAD, then signed up for an exercise programme. Both involved walking on a treadmill, climbing stairs, sitting and standing, as exercise helps to reduce the severity and frequency of his symptoms. Afterwards, he more than doubled how long he could walk on a treadmill before needing to stop - from around three minutes to seven minutes.
Next, he signed up to the heat therapy trial, with the target of improving his pain enough that he could climb a steep hill in his local park.
He said: “After the heat therapy, I finally reached the top of my Everest - the Vernon Park hill - in August. I even managed to climb all the steps running alongside it, of which there are about 60. I immediately sent a text message to the researcher leading the study to tell him I’d done it!
‘It may sound small, and I still had to stop a couple of times, but it felt like a huge achievement.”