By Edd Lee LAc LMT MS
"Do you have a bathtub? Do you use it? Can you take a hot bath tonight?" A set of questions that will be familiar to my regular patients. For more than 15 years, I have been asking these questions of each and every patient after their treatment. The more curious patients will counter with, “Why a hot bath?”, to which I respond with a couple of points off the cuff. I thought it is about time to pull together all the information I can find regarding baths, so I can justify my incessant hot bath advocacy. Hot Baths in History & Around the World Hot bath traditions date back to antiquity around the world. In Europe, the Romans spread the practice of bathing across their once vast empire. Actually the word spa is an acronym for the latin phrase Sanus Per Aquam, which translates to health through water. In Germany, doctors often prescribe soaking at hot springs resorts—called kurorts—to patients to reduce stress or treat chronic conditions such as rheumatism. “Kurs” usually last for three consecutive weeks and the cost is covered by health insurance. Turkish baths, called Hammam are often associated with the culture of the Ottoman Empire. Hammam rituals typically begin with relaxing in a heated room to induce perspiration. Bathers typically move progressively to a hotter rooms, then wash in cold water, often followed by a massage. In traditional hammams, bathers are nude and genders are separated for modesty. Japan has a long history of bathing, not surprising given the number of natural hot springs found in the Japanese islands. The springs were originally used by Buddhist monks for purification rituals. As the healing properties were discovered, people brought their ill relatives to soak. Over time public bathing became commonplace and a practical way to stay clean. These days, indoor plumbing has solved hygienic problems, but Japanese continue to be big fans of public bathing. Soaking in Japan’s onsen is done in the buff, prior to entering the water, visitors are expected to thoroughly wash themselves with soap and water. Men and women are often separated by gender and those with tattoos are typically turned away. In Taiwan, hot springs called Wen Quan are clustered around the city of Beitou, where the active volcano Yang Ming Shan is the source of the thermal waters. Unlike Japan, however, swimsuits are required to soak in the public pools. You might spot people placing small towels on top of their heads; theoretically, doing so will prevent you from fainting by lowering the temperature differential between your body and the geothermal water. Given the long history and expansive reach, what do we know about the benefits of taking hot baths? Surprisingly, quite a few. Here’s what I was able to find. Mental health benefit Soaking in a warm bath could have a positive impact on mental health and relaxation, according to a small study of 38 participants published in the journal Evidence-Based Complementary and Alternative Medicine in 2018. The participants also reported reduced feelings of tension, anger, hostility, depression, and dejection. “Through a randomized study, the researchers found that baths can have a greater effect on mental health and anxiety than showering as a form of bathing,” says Michael I. Jacobs, MD, a board-certified dermatologist, and associate professor of dermatology at Weill Cornell Medical College. Along the same lines, a small pilot study of 45 participants published in BMC Psychiatry in 2020 found that taking warm baths twice a week, for as few as two weeks, can result in “clinically relevant improvement in depression severity,” when the person continues their usual mental health care routine. Cardiovascular benefit Taking hot baths may improve your cardiovascular health, according to a 2020 study out of Japan published in the journal Heart. The researchers observed more than 30,000 people between the ages of 40 and 59 over a span of 19 years, and found that participants who took warm baths frequently had a decreased risk of cardiovascular events, Dr. Warner says. There is also research suggesting that taking hot baths regularly may have a positive effect on a person’s vascular health, meaning the blood vessels, veins, and arteries responsible for blood flow. For example, a small 2016 study from the Journal of Physiology found that after eight weeks of testing, daily hot baths resulted in lower blood pressure and increased artery health for the 10 participants. “Hydrotherapy in a warm bath will increase peripheral blood flow, and this promotes healing of any irritated or damaged tissues,” Dr. Warner adds. According to Thomas Pontinen, MD, LCP-C, a double board-certified anesthesiologist and pain management specialist, physician and co-founder of Midwest Anesthesia and Pain Specialists, taking warm baths also increases vasodilation, which improves circulation. “Improved circulation comes with numerous health benefits, but from a pain management perspective, it’s important because blood is what carries essential nutrients and molecules to your musculoskeletal tissues,” he explains. “In instances where pain is coming from trauma to muscle tissue or connective tissue, circulation expedites the process where the body heals itself.” Reducing Muscle and Joint Pain Bathing can provide some much-needed relief for people dealing with painful muscles, joints, ligaments, and tendons, Dr. Pontinen says. This is because the warm water can help the tissues in your musculoskeletal system relax, which helps you heal faster, he explains. This is especially true of mineralized water, like the kind found in natural hot springs (or in your tub, after adding water-soluble mineral sources, like Epsom salts), according to a 2021 study out of Ethiopia with more than 1,000 participants, published in the journal Inquiry. The researchers found that bathing in hot springs for three or more days can “have significant therapeutic effects on patients with musculoskeletal disorders” including rheumatoid arthritis—which affects approximately 1.3 million adults in the U.S. “One of the main benefits is to help the body relax, help muscles to recover and heal, and to reduce pain,” Dr. Warner says. “Joints and stiff connective tissues will also feel better after a warm bath.” In addition to pain, bathing can also alleviate other types of muscular discomfort. “For sore muscles, a hot bath can reduce built-up tension, tightness, pain, and soreness,” Dr. Purdy adds. Improved Sleep Given that taking a warm bath can help some people relax, it’s not surprising it can also help promote a good (or at least better) night’s sleep. “Taking a bath at night may help you fall asleep and stay asleep, increasing your overall sleep quality, which is vital for your body to reset for the next day,” Dr. Purdy says. “It’s a great way to wind down, as it triggers the body and your mind to relax, which in turn can help you fall asleep.” One way bathing accomplishes this is by supporting the body’s nightly temperature adjustment. “The body naturally undergoes a cooling phase when you begin to sleep, and a hot bath can give you a head-start with that phase,” Dr. Pontinen explains. These benefits aren’t strictly anecdotal: A 2019 review of the findings of 17 studies on the effects of bathing on sleep concluded that taking a warm full-body bath, foot bath, or shower before bed for at least 10 minutes can improve sleep quality. Better skin You may not think of bathing as part of a skincare routine, but whether you opt for a bath or a shower, that’s exactly what it is. In addition to removing dirt on the surface of your skin, bathing in warm water also opens up your pores, allowing you to wash away built-up grime, according to the Cleveland Clinic. Plus, it softens the layers of dead skin cells on the outer surface of the skin, so that they slough off easily with a washcloth (or prepare your skin for your exfoliation method of choice). “[Bathing] can also help you clear away the bacterial and fungal load from contact in your environment,” says Amy Zack, MD, a family physician at the Cleveland Clinic. “As that accumulates, it increases your risk of infection.” Once again, the research on the dermatological benefits of bathing is limited, but the 38 participants in the small 2018 study published in the journal Evidence-Based Complementary and Alternative Medicine mentioned above reported an improvement in their skin’s condition after two weeks of bathing regularly. Additionally, taking warm mineral baths can help treat acne and seborrheic dermatitis, according to a 2020 review of studies investigating the effects of bathing in warm, mineralized water for people with chronic inflammatory skin diseases, published in the Journal of Clinical Medicine. The article also concluded that warm baths in mineralized water can be especially beneficial for people living with atopic dermatitis and psoriasis. Immune benefits Immunology studies have found that soaking 20-30 minutes in a bath raises your core body temperature increasing white blood cell production and strengthening your body's ability to fight off infection. It's long been accepted that an increase in body temperature is helpful in fighting infection and inflammation. That's one of the main avenues our bodies respond to infections——by literally heating up with a fever! Researchers at the Roswell Cancer Institute found that lymphocytes, (particularly CD8+cytotoxic T-cells which are highly effective in destroying virus-infected cells) are significantly intensified in their ability to fight off infection by an increase in body temperature. So it's not surprising that recent studies utilizing hydrotherapy— particularly baths and saunas— have found that a 30-40 minute soak results in an increase in your body's production of these important infection-fighting white blood cells. So you can see, there are so pretty significant arguments for taking hot baths regularly, particularly as an active New Yorker. Will this get you take baths more often? I can only hope. But I do hope this helps you to, at the very least understand, why I always ask you take a bath.
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Meet My New Assistant Rachel Casiano LAcI am thrilled to introduce you to my new Assistant, Rachel. She will be working on Tuesday and Fridays, helping me with logistics and administration. Thanks to her help, I am now able to see more people on the days she works - which means more opportunities for you to get in for your treatments! Please join me in extending a warm welcome to the newest member of Manhattan Sports Acupuncture! Before her training in acupuncture, Rachel worked as a health educator and patient navigator in HIV services at a community health clinic and did outreach on a mobile testing van. Primarily serving queer and trans sex workers and transient people, this experience solidified her view that centering the health needs of the most marginalized people means better care for everyone.
She learned about acupuncture while volunteering with syringe exchange programs in upper Manhattan and the Bronx and seeing how acupuncture was used for detox, PTSD, and stress. The history of radical/collective uses of acupuncture, harm reduction philosophy, and her witness to the opioid epidemic in her hometown inspired her to pursue learning acupuncture. All these influences continue to guide her practice. She received her Master of Science in Acupuncture and classical Chinese herbal medicine from Tri-State College of Acupuncture, and has worked in several community acupuncture settings since then, including Brooklyn Open Acupuncture and Third Root, and a syringe exchange program in the Bronx The Placebo effect has been a topic I have had to deal with for much of my professional career - as an advocate for medical research, understanding basic scientific research concepts like the placebo effect was a critical part of my work. And traveling around the world talking about such subjects gave me a unique vantage point on the idea of the placebo effect, and public opinion on the subject. For me, people too often choose to frame this idea as a negative. "Are you sure this really works, or is it just a placebo effect?", a common question I've heard around the world. But we know, through research that the placebo effect generally has a 30% effect - which is why good statisticians typically power studies to take into account this 30%. But if the goal is to find ways to achieve a desired effect - one can actually think of the placebo effect as an easy 30% bonus towards our goal. If we just believe. I posit that the placebo effect is actually scientific documentation of the impact mental focus and attitude can have on a desired goal. This is an idea I suggest you keep in mind as you read the article below, and as you engage in your training routines. Edd Study finds placebo effect also applies to exercise trainingby University of Agder April 25, 2023 You can get a better effect from your training if you believe that the training program you are following has been put together especially for you, according to Kolbjørn Andreas Lindberg, a research fellow at the University of Agder in Norway. "If you believe that the training program you are following has been optimized for you, that in itself will have an effect, regardless of the content of the program. It is exactly the same as the placebo effect we know from medicine," says Lindberg who has conducted a pilot study on the effect this can have on training. The results have been published in the journal Scientific Reports. Have you ever taken paracetamol to relieve a pounding headache, only to feel better even before the pill has had a chance to work? Then you have experienced the placebo effect. Placebo is the name for the somewhat strange phenomenon that occurs when medication or treatment works better if you believe it will work. "The placebo effect has been studied for over 70 years, but looking at it in the context of exercise research is new," Lindberg says. Placebo drugs are an important part of clinical research. In so-called blind trials, the active drug and placebo are administered to patients according to a code, so neither the researchers nor the subjects know who has been given what. In this way, researchers can objectively evaluate the effect of the medication. Forty people participated in the study by Lindberg and his colleagues. After a series of physical tests in the laboratory, they were all given different training programs. Half of the participants were told that the training program they received had been specially adapted to them based on the tests that were carried out. This was the intervention group. The other half, the control group, did not receive such a message. The participants were all given training programs that varied with regard to weight and the number of repetitions, but on average the programs of the two groups were similar. After completing the eight to 10 weeks of training, the participants were again tested in the laboratory. "It turned out that those who thought they had received an individually adapted training program got better results on average than the control group. Even though the two groups had followed the same program on average," Lindberg says. The researchers found differences between the two groups, especially with the squat exercise and general muscle thickness. "It may be a little surprising that placebo also applies to exercise. But when you think about it, it makes sense," Lindberg says. "There were indications that the participants who thought they were following a personal program trained a little more and with a higher intensity. Many such small factors can affect the result." He also believes that the testing itself may have had an impact on the result: The intervention group may have felt that they had to perform since the program was supposed to give them results. "The placebo effect is largely overlooked when researching the results of exercise. It can be difficult to conduct a blind study when comparing training twice a week with training four times a week," he says. This can be a problem when new training approaches appear to offer good results. "There is good reason to be skeptical of new fancy training approaches that are hyped up in the media. Especially considering that virtually no such studies have been controlled for the placebo effect," Lindberg says. More information: Kolbjørn Lindberg et al, The effects of being told you are in the intervention group on training results: a pilot study, Scientific Reports (2023). DOI: 10.1038/s41598-023-29141-7
Journal information: Scientific Reports Getting past the latest surge: Changes to Manhattan Sports Acupuncture's COVID-19 Safety Protocols3/9/2022 COVID-19 new infections and hospitalizations have been dropping significantly in New York. This is great news!
In light of this positive turn of events, many of you may have noticed Federal, State and City mandates have been loosening in response to these changes. While it is exciting to feel like we are starting to get ahead of the pandemic, it is important to keep in mind there are still some mandates in place. Specifically, face masks are still required in health care settings, including acupuncture clinics. Manhattan Sports Acupuncture's COVID-19 Safety Protocols have changed a bit too. Here is short review our current protocol. Manhattan Sports Acupuncture COVID-19 Safety Protocol
While these protocols do require some effort, I want to recognize they have been the reason I have not been infected by COVID-19 over that last two years. I find a lot of security in this and hope you do too. This year on Friday, February 12th the moon will complete another annual cycle ending the Year of the Metal Rat and starting the Year of the Metal Ox.
Lillian Pearl Bridges gives us a look into the coming year. "The Ox is the second animal in the Chinese Zodiac and is a respected animal valued for its ability to work hard and endure. The Ox is credited with the values of constancy and cooperation. These are usually slow moving animals, even tempered and placid unless provoked. The element for Ox is Yin Earth as it an animal long associated with farming. The element of the year if Yin Metal, which is harmonious with the Earth element. This implies a calmer, more stable year with less anger, less contentious behavior and much less potential for violence. Yang behavior will simply not be supported or be sustainable. Yin Metal is about the future and out hopes and dreams, which can inspire us again. The overall outlook for the year is positive, especially toward the latter part of the year. Harvest comes from the summer and fall months, which also correspond with the elements of the year. So there is hope that life will get better in many ways for many people as the year progresses." To read her full prediction, click here. In celebration I have painted this Metal Ox, based on one of my favorite statues in Kyoto, Japan. Located in Nishiki Market in central Kyoto, many visitors will suddenly happen upon the beautiful Ninshiki-Tenmangu Shrine in the middle of the shopping mall. Enshrined here is Fujiwara-no-Michizane, the Thunder God or God of Learning and as such, this shrine is popular with those who are taking exams. The cow is considered the divine servant of Michizane and statues of cows are common in shrines dedicated to him. The statue in Ninshiki-Tenmangu is my personal favorite. Happy New Year! |
On PointBlog & newsletter for Manhattan Sports Acupuncture and Edd Lee LAc LMT MSOM. Striving to be a source of information on health, fitness and medicine. Check out the FB feed below or like our page @ManhattanSportsAcupuncture
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