What is contrast therapy? Should you try this new hot and cold wellness ritual?
Contrast therapy, involving alternating hot and cold water immersion, boosts circulation and aids recovery. But is it safe? Experts weigh in.
You must've tried dipping your feet in cold and hot water, depending on what you desire — hot water for relaxation, boost circulation, relieve pain, and soften skin and cold water to reduce swelling and inflammation, ease muscle pain, and boost circulation. But how about doing it at the same time, switching between them simultaneously? Well, it is actually a popular wellness ritual and is called contrast therapy or hot–cold immersion therapy.
With over 72k posts and reels tagged #contrasttherapy on Instagram, the term has exploded on the internet. But is it worth it or just another wellness fad?
What is it actually?
According to Dr Amit Pandey (PT), Head of Department - Physiotherapy, Asian Hospital, contrast therapy is a treatment that alternates between immersing a limb or body in hot and cold water simultaneously to boost blood circulation, reduce pain and swelling, and promote faster healing. It can be with a 10-minute hot immersion followed by a 1-minute cold immersion, repeating this cycle.
The therapy dates back to ancient times in Greece and Rome, with documented use in hot and cold baths to improve health, and is a practice that evolved into modern hydrotherapy in the 19th century. Ancient cultures in other regions, including Nordic countries, Japan, and Egypt, also utilised temperature contrast for wellness. Today, athletes use it for recovery, often in a modern "fire and ice" format involving saunas and ice baths.
Who can do it?
Contrast therapy is generally safe for adults, with some studies examining participants from age 17 and up. However, it is not for everyone, despite its potential strength. “Some people find it overstimulating, especially the cold element, and may experience anxiety, dizziness, or spikes in cortisol, which could counteract the calming or recovery effects. Although most individuals can handle it, it is not recommended for people with low blood pressure, Raynaud's disease, or certain heart issues unless under medical supervision,” exclaims Dr Amit.
Each session is customised as per the individual's needs and goals, but usually it can last up to 15 to 30 minutes.
Does it have any benefits or risks?
According to Dr Amit, research shows that contrast therapy helps lessen lactic acid accumulation, discomfort, oedema, muscle weariness, and spasms after strenuous exercise. “It might enhance the functional mobility and range of motion of joints like the hands, elbow, and knee. Contrast therapy is generally regarded as safe; however, if done improperly or inappropriately, there are certain hazards,” he adds.
Having said that, it still has some risks. Dr Amit says, overheated water can cause scalding burns, increased bleeding if the incision has internal or external blood vessel ruptures, and severe nerve pain brought on by exposure to cold in individuals with peripheral neuropathy. People with peripheral vascular disease experience more pain when exposed to the cold.
Does it help in orthopaedic conditions?
Dr Lakshya Bhaktyani, physiotherapist at PSRI Hospital, says that he finds contrast therapy most useful in conditions where swelling, stiffness and pain coexist, and where the tissues respond well to alternating vasodilation and vasoconstriction. “It can be helpful in acute injuries such as mild ankle sprains or muscle strains, especially after the initial 48–72 hours when active inflammation begins to settle. In chronic pain conditions like long-standing joint stiffness, muscular tightness, or overuse-related soreness, contrast therapy often provides relief by improving circulation and reducing residual swelling,” he adds.
How does this compare to other therapies?
Contrast therapy can be viewed as a middle-ground approach that offers both anti-inflammatory and mobility-enhancing benefits. “Cryotherapy alone is highly effective when the primary goal is to bring down acute swelling, soothe irritation, or numb pain after an injury. However, it does not promote circulation or tissue relaxation the way contrast therapy does. Contrast therapy alternates cold and heat, allowing better flushing of metabolic waste and improved blood flow, which can be helpful once the acute phase has passed,” says Dr Deepak Kumar, Consultant Orthopaedic Surgeon, Maccure Hospital.
