Living with rheumatoid arthritis (RA) can significantly affect your mobility and quality of life. Many people turn to therapies and treatments, including soaking in a hot tub, to relieve symptoms.

Rheumatoid arthritis (RA) is a chronic autoimmune condition that occurs when the immune system mistakenly attacks healthy body tissues. It primarily targets the joints, leading to:

  • inflammation
  • pain
  • joint stiffness
  • progressive joint damage

Let’s explore the potential benefits and risks of soaking in a hot tub for RA, including what you need to know before trying it.

Limited studies have been conducted on what effect soaking in a hot tub has on RA symptoms. Yet some research suggests that this form of water-based therapy (called hydrotherapy) might be beneficial.

These benefits may include:

Improved joint mobility and flexibility

Soaking in a hot tub may enhance joint mobility and flexibility, which is important for people with RA. The buoyancy of the water decreases pressure on your joints, allowing for more comfortable movement.

Pain reduction

Soaking in a hot tub for 15–20 minutes may help ease the chronic pain associated with RA. The warm water relaxes muscles and joints, which may reduce discomfort and make it easier for you to move.

Reduced inflammation

A 2018 study involving people with RA suggests that hot tub therapy, in the form of spa therapy, has shown promising results in reducing joint inflammation. This may also reduce swelling and tenderness.

Improved sleep

Soaking in a hot tub may help enhance sleep quality by relaxing your body, which might help reduce pain and discomfort.

Potential side effects or risks associated with using a hot tub for RA include:


Soaking in a hot tub for too long or at high temperatures may lead to overheating, especially if you have certain medical conditions or are taking medications that affect body temperature regulation. That’s why it’s essential to monitor the hot tub’s temperature and avoid staying in for too long.

Infection risk

People with RA have a compromised immune system and are more susceptible to infections. If not properly maintained, hot tubs can increase your risk of getting bacteria like Cryptosporidium or Legionella, which can cause infections.


Spending time in a hot tub can increase fluid loss, leading to dehydration as the body sweats to regulate its temperature. Staying hydrated by drinking water before, during, and after soaking in a hot tub is essential.

Skin irritation

Some people may experience skin irritation or sensitivity to the chemicals used to maintain water quality in hot tubs, or in contaminated water. It’s important to be aware of any allergies and ensure the chemicals used are safe.

Here are some recommendations to keep in mind:

  • Time in the water: Start with shorter sessions and gradually increase the time spent in the hot tub. About 15–20 minutes is a good starting point, but listen to your body and adjust accordingly.
  • Water temperature: Keep the water temperature within a safe range, typically between 92–98°F. Higher temperatures may lead to overheating and worsen symptoms.
  • Positioning: Find a comfortable position that relieves pressure on your affected joints. You may want to experiment with different sitting or reclining positions to identify what works best for you.
  • Practice gentle exercises: In the hot tub, perform gentle range-of-motion exercises to improve joint mobility and flexibility. Avoid strenuous or abrupt movements that may make pain worse.

In addition to swimming, several other water-based activities can benefit people with RA, including:

  • Water aerobics: Water aerobics involves performing aerobic exercises in a shallow pool or during water-based fitness classes. The buoyancy of the water reduces stress on the joints while providing resistance for strength training.
  • Water walking: This low impact activity involves walking in waist-to-chest-deep water. It helps strengthen muscles and increases flexibility without putting excessive strain on the joints.
  • Water yoga: This activity combines the benefits of yoga with the buoyancy and resistance properties of water. This gentle and therapeutic exercise may improve flexibility, balance, and joint range of motion while relieving stress.
  • Water jogging: Mimicking jogging or running in place in deeper water can be an excellent cardiovascular workout. Using a flotation belt can add buoyancy and reduce the impact on the joints.

While these activities are generally considered beneficial for people with RA, consider speaking with a doctor to ensure your safety before starting any new exercise program.

Here are some frequently asked questions about spa treatment for RA.

Is sauna good for rheumatoid arthritis?

Saunas may provide temporary pain relief and relaxation for people with RA, but limited scientific evidence supports their long-term benefits.

Can a hot tub aggravate rheumatoid arthritis?

A hot tub can temporarily relieve RA, but extreme temperatures or prolonged heat exposure may worsen symptoms by causing dehydration and overheating.

Is cold or hot water better for RA?

Both hot and cold water can be beneficial for managing RA symptoms. Hot water can help relax muscles and relieve stiffness, while cold water can reduce inflammation and numb pain.

Will health insurance pay for a hot tub?

Health insurance does not typically cover the cost of a hot tub for RA because it is considered a nonmedical treatment. But consider checking with your specific insurance provider to understand your coverage and any potential exceptions.

Additionally, with a prescription from a doctor, you may offset the costs with tax deduction or pay for them for using funds from a health savings account.

Soaking in a hot tub for RA may provide several benefits, including reduced pain, increased joint mobility, and improved quality of life. Hot tubs can also help relieve stress and aid in better sleep.

While it’s not a replacement for medical treatment, incorporating regular hot tub sessions into your arthritis management plan may significantly relieve and enhance your overall quality of life.