Sauna may provide some relief to patients with asthma and chronic bronchitis, and may also alleviate pain and improve joint mobility in patients with rheumatic disease. The sauna does not cause drying of the skin, and may even benefit patients with psoriasis, although sweating may increase itching in patients with atopic dermatitis. Contraindications to sauna include unstable angina pectoris, recent myocardial infarction, and severe aortic stenosis. Sauna is safe, however, for most people with stable coronary heart disease. It is not harmful to the aged or young even infants over 3 months in moderation and does not effect wound healing. Sauna can help prevent the common cold, it increases performance in endurance sport, increases plasma volume and red cell volume in athletes, decreased systolic blood pressure, significantly improved exercise tolerance, increased peak respiratory oxygen uptake, and enhanced anaerobic threshold in chronic conditions. Sauna may reduce chronic pain more effectively than cognitive behaviour therapy. It is indicated for rheumatic pain (with cold shower) but not for neuropathic pain. Is effective for appetite loss and mild depression. Indicated in reducing symptoms in Chronic Fatigue Syndrome, and rheumatoid arthritis, and indicated for anorexia nervosa. Sauna improves function in conditions such as, congestive heart failure, and high blood pressure, improves vasodilation, improves heart arrhythmia, and reduces heart rate on exercise. Sauna has been proposed for treatment of other conditions such as, glaucoma, Sjogren syndrome, chronic fatigue syndrome, fibromyalgia, anorexia nervosa, obstructive lung disease, recuperation after childbirth, and also for lifestyle related diseases of, diabetes, arteriosclerosis, obesity, hypertension, hyperlipidemia, atherosclerosis and smoking induced symptoms. Therapeutic sauna adaptation improves neuroendocrine and immune function with increases in cortisol, DHEAS, and lower cytokines. Women show higher neuroendocrine response than men. Sauna has also been found to reduce sympathetic activity, stress hormones adrenalin and noradrenalin and to trigger a well defined neuro-endocrine reaction which includes raising the hormones found low in CFS and some other chronic conditions (ACTH, cortisol and beta endorphin), interestingly cortisol remained elevated after other hormones had returned to prior levels. Other conditions with low cortisol include fibromyalgia, PTSD, inflammatory bowel diseases. Sauna has been found to increase the hormone testosterone in men. Sauna also found to reduce prostaglandin F2alpha and protect against oxidative stress. It enhances activation of monocytes to bacteria and endotoxins. Other benefits of saunas; It has shown that regular saunas combined with exercise therapy can efficiently clear organic chemicals, solvents, drugs, pharmaceuticals even PCBs and heavy metals from the body. Such environmental toxins increase allostatic load on the body. In addition a sauna followed by a cold shower has been shown to reduce pain in rheumatoid arthritis where pain is mediated by sensitised c-fibre sympathetics, pain in other chronic conditions such as CFS and fibromyalgia may be similar. Low beta endorphin is also associated with pain. Regular saunas have also been found to improve micro circulation reduce vasoconstriction and hypertension. Many symptoms of chronic illnesses may be due to vasoconstriction effects eg. cold sensitivity, pain even mood states, and sauna improves microcirculation and blood supply to constricted areas.
Research has also shown that adaptation to cold through short term cold stimulus, as in cold swimming, immersion (or showers) has the added benefit of improving the body’s anti oxidant capabilities, with increases in glutathione and reduction of uric acid, which may mean better handling of the stresses of illness. Those that are shown to involve reduced glutathione or increased glutathione use, include; cardiovascular conditions, pulmonary diseases, diabetes, inflammatory bowel diseases, cancer, osteoporosis, aging, and after pesticide exposure. Conditions involving oxidative stress include neuro degenerative diseases, CFS, bone fracture and others. Conditions in which increased uric acid may be a risk factor include, gout, metabolic disease and vascular diseases. A reported study from the Thrombosis Institute in London into the effects of the cold bathing found that volunteers that followed a disciplined daily regime had increased immune white blood cells and the level of the bodies natural blood thinning enzymes substantially increased, improving micro circulation. It also stimulated the production of hormones such as testosterone, the hormone that regulates sexual drive and potency in men, and boosted the women’s production of oestrogen, a hormone regulating fertility and involved in other medical conditions. They found this treatment alone considerably improved many chronic conditions. Cold water immersion raises thresholds of pain tolerance, and aids adaptation to cold, reduces muscle spasm, can influence the frequency of respiratory infections and improve subjective well-being. It may cause an immunological modulation in terms of the Th1-type pattern, which is a proinflammatory cytokine profile. It is involved in diseases such as arthritis, diabetes, inflammatory myopathies, inflammatory bowel disease, psoriasis, CFS, fibromyalgia, chronic pain, fatigue conditions, auto immune disease and other inflammatory conditions. Cold water adaptation reduced total cholesterol and LDL cholesterol, lowered plasma viscosity and blood pressure rate product. Cold water immersion reduces recovery time in athletes, enhances repeat performance and reduces exercise induced muscle damage. Cold water exposure challenges both the neuro-endocrine and the immune systems, reduces stress hormones and attenuates their response. Increases ADH and cortisol and increases immunomodulatory cytokines. Cold water exposure and adaptation can modify the sensory functions of hypothalamic thermoregulatory centres to lower heat loss and produce less heat during cold exposure and have immunostimulating effects. The thermogenic action of adrenaline in cold exposure produces heat and may reduce this stress hormone. An important effect is the ability of sauna to use up excess sympathetic nerve tone in both the central and peripheral nervous systems and just as importantly use up excess levels of local tissue hormones involved in feedback loops to the hypothalamus, thus aiding recovery in chronic illness.
The therapeutic sauna with hot cycle followed by a cold cycle brings the benefits of both and in fact induces the body to switch from sympathetic to parasympathetic mode. Forcing all the blood to flow gently and evenly outwards to the skin to cool off in the heat of the sauna, and then forcing it to flow evenly inwards to protect and heat the vital organs of the body when suddenly cooled, this effect helps break down one of the nastier aspects of chronic illness; imbalance of blood supply due to vasoconstriction. With sauna, sections of the body with chronically deprived blood, increase supply and reduce oxidative stress. As the blood supply cycles into the organs and then out to the skin it acts like a pump bringing stored chemical toxins from remote areas of the body through the microcirculation to the skin to be removed in sweat. The skin of our bodies is in effect another eliminatory organ so even when other organs are compromised in chronic illnesses or contamination, the skin through sweating can rid the body of such toxins. The parasympathetic system governs sweat glands secretion and is increased by sauna. It has been shown with drugs such as caffeine, that delayed metabolic clearance was offset by a sizeable elimination in sweat by sauna. Sweat tests have shown pharmaceutical drugs are eliminated in sweat, narcotics, alkaloids and barbiturates are eliminated in sweat, and elimination increased with heat. Sweat analysis is also used for diagnosis of some disease, toxic metal excretion in sweat is used in diagnosis of chronic disease the result of contamination, and sweating used to eliminate toxic metals. Iron loss in sweat increases with exercise in athletes. The beneficial effects of therapeutic sauna are both temporary and long term, during treatment some benefits will last about 24 hrs so the treatment needs to be repeated daily for the best result. Adaptation and detoxification will occur after longer use when the practice can be suspended but regular use if beneficial is advised. Procedure
How carry out therapeutic sauna to best effect A regular schedule of
at least 5 days a week and preferably daily is required for a minimum
of one month, preferably three. In some countries the local gymnasium
is usually the closest and most convenient and some pool, major sport,
or even resort complexes also contain a sauna. Therapeutic Sauna is
best carried out after gentle exercise within the capability of the
person without exacerbating symptoms and the gym can be ideal for this
where both can be included into a daily program. Dress in your bathers
and take at least two towels, one to take into the sauna and other to
dry yourself afterwards. When in the sauna you can sit on a towel or
put a towel over your head if your face feels too hot but your body
feels comfortable. In the beginning, until you know how much heat you
need, if possible sit in the lower benches - not too close to the
heater elements, and not right up the top either, as the heat rises and
will be hotter there. Provided the sauna is not crowded try lying on a
bench, for that way the temperature will be more even over your body.
You do not need to get very hot at first until you are used to it. The
duration and the heat should only be gradually increased as you adapt
to sauna. If at any time it feels unbearably hot or you feel faint or
ill, go straight outside and sit in the cool, when you feel able have a
mild shower to cool down. Then start again but make the sauna shorter,
sit in a cooler place, use less water on the radiator, if a wet sauna,
but don’t get too hot again. Some saunas have a thermostat to adjust
temperature but the management or other users may not like you doing
this, ask first. Most adjustment of temperature in a sauna usually
comes from, - amount of water thrown on the heater - how long you stay
in the sauna - where you sit or lie in the sauna If in a wet sauna the
convection heat from the radiator is not of as great a benefit as the
heat in the steam, so put small amounts of water on the heater
regularly. You can adjust the temperature on different parts of the
body by shielding yourself from the steam radiator with a towel. Few
people can sit directly in front of the heater without getting too hot
from radiant heat, but their overall body temperature from steam is
insufficient. So sit away from the heater for treatment heat. As the
person’s body is often the coolest object in a sauna room, steam will
condense into water on the skin; this can be confused with
perspiration. In an infrared dry sauna, the heaters produce infrared
rays that penetrate the skin layers and heat more deeply, do not put
water on these types of heaters. Again if uncomfortable; sit away from
the heaters at first until you have adapted more. Become aware of your
feelings regards temperature in the sauna, in cold weather it should at
first feel pleasantly warm, then progress to feeling very warm, and
then a little too warm when you begin to perspire profusely. At first
wait another minute or so after you feel it is too hot then go outside
to the showers, or pool, you will build tolerance later, after repeated
visits. Perspiration is a sign of your autonomic responses trying to
cool you. Remember the cool down part of the cycle is as important as
the heating. In summer you can start the cycle with a cold shower.
Otherwise if you are not used to this, then at first adjust the shower
so it feels cool, not fully cold at first. Stay under until you no
longer feel hot from the sauna. If you step out of the shower and feel
cold or shiver you have probably done enough, the shiver is a sign of
the autonomic responses switching, trying to warm you. This is a signal
that you are ready for the sauna again. If however you still feel warm
from the sauna when you step out of the shower or if your skin is still
warmer than usual to touch, or if you get back into the sauna and find
that you heat up a lot quicker than the first time that day; then you
have not cooled down enough and need to stay longer in the shower or
have a colder shower next time. A longer shower is probably preferable
until you develop some tolerance for cold. Until you get used to having
a full cold shower, Start with a tepid one then over a minute gradually
make it colder so that the shock is not so great. Remember the quicker
you cool down the greater the benefit. The best effect comes in winter
when with a full cold shower from the start, or using refrigerated
water in summer, if you can find a sauna with a cooled plunge pool, so
much the better. But not while you are getting used to it, some people
take weeks, rarely months though. For the very ill the first few times
you try therapeutic sauna do only one cycle of heat then cool, but then
go to three cycles, or four if you feel good about it. Make sure you
note how you feel after the treatment, most people feel tired in a
pleasant sort of relaxed way; a sign of having burnt off the stress
hormones. If you don’t feel this by the end of that day, then you
probably need a hotter/ colder cycle. If however you feel ill later or
during that day, then the next day try a less hot sauna and warmer
longer cool down. In summer any after effects like headache or nausea
will likely come from insufficient cool down after the sauna. Sleep
disturbances can also occur if you don’t cool down properly, even
though you may not feel hot, the heat is in the core of the body and
may disrupt sleep as the body tries to cool at night. As you adjust to
the sauna temperatures on subsequent days, gradually increase the
length of stay in the sauna to around 8-12 minutes, given the room has
already heated up. If it has just been turned on for you to use it can
take a half hour or more, so go off and exercise while you wait. Learn
to gradually increase your capabilities by sitting higher in the sauna,
putting more water on, until you are warm to hot without being
unpleasant and definitely not till you feel ill. As well gradually
increase the cold of the showers. The ideal is about 10 minutes a time
in the sauna, followed by full short cold showers, to 5 minutes
depending on the time of year, repeated 3 times each daily session.
Remember also that therapeutic sauna is best in conjunction with
exercising.
