But do they really work? Many Epsom salts producers would have you believe a hot Epsom salt bath can solve anything. I have trained hundreds of patients to take these salty baths for muscle soreness and I have taken dozens myself, after hard workouts or long inline skates. But I got to thinking. What is the science behind these baths?
Short story, there isn’t any. When perusing the research regarding the effectiveness of Epsom salt bathing, the evidence is scant at best. But I did come across one seventeen-page article that I read word for word. Paul Ingraham, who writes for Pain Science has the best review of the Epsom salt research in an article he entitles, “Do Epsom Salts Work?” He pens with sarcasm, and a fiery wit that makes reading about the emptiness of the Epsom salt claims an absolute pleasure.
EPSOM SALT BATHS: DO THEY REALLY WORK?
So what does our friend Paul have to say? He has some very strong opinions on the subject! (Want to read it? Here is the LINK.)
But before I get to Paul’s thorough bashing of the Epsom salt myth let’s talk about the history of Epsom salts. As mentioned above, Epsom salts are made up of Magnesium Sulfate. Magnesium Sulfate is crystal formation that come from a spring in England, aptly named “EPSOM.” Do not go mixing up “Epsom salts” with “Dead Sea salts.” Dead Sea salts come from, well, the “Dead Sea” and that would be in Israel, not England. So there is that.
Okay, back to Paul and his passionate paper. Here is a sampling of his points:
- OSMOLALITY: The theory is that Epsom salt baths create an osmolality shift where fluids from in the body will cross the skin barrier into the bath. Here is the thing. Our skin is intended to be waterproof. It is one of the reasons we don’t dry out like a worm on a sidewalk on a sunny Saturday. (His analogy, Totes stole it.) To get “things” across the skin barrier we have to work very very hard. Medication patches and lotions that allow substances to cross the skin barrier are formulated to contain the teeny tiniest particles, so they can have at least a chance of them crossing. Often you have to use a carrier, like DSMO, to aid in the process. Simply put, it is not an easy job to get things across the skin.
- TOXINS: The theory is that if you take an Epsom salt bath, you are pulling “toxins” out of your body. IF, and that is a big IF, toxins are going to exit your body as a result of a salty emersion then it would be the “toxins” just beneath the surface of the skin. Unfortunately, most toxins in the body are housed in the liver and fat tissue which are far too deep for some salty bath to access. Not gonna happen. Agree with you on that one Paul.
- LACTIC ACID: The theory is that lactic acid or metabolites, that result from heavy exercise or exertion, (some argue lactic acid is not even a thing,) are found deep in the muscle tissue. Guess where the muscles are? NOT in the immediate layer under the surface of the skin. So, Paul and I are on the same wavelength here too. Your lactic acid/metabolites are not running for the exits because the sense you are in salty water.
- HEALING: The theory is that Epsom salt baths are going to speed up the healing process, decrease bruising, and cure your sprained ankle in minutes. Sitting in a hot bath is going to vasodilate the tissues which can bring healing factors to the area of injury. Perhaps the relaxation of muscles and increased circulation may provide a better foundation for healing but salt on the outside of your body is not necessarily going to get you back into the game in half the time.
- COMPLIANCE: The theory is that Epsom salt baths are better than bathing in plain water. Please gather ’round for a little story. Jim is a patient. I instruct Jim to take hot baths for his chronic low back pain. Jim says, “whatever” and does not comply. Then I say “Hey, Jim. If you get some Epsom salts and put them in your bath and soak for a full 20 minutes, your muscles are going to heal faster, and you are going to be back to your golf game in half the time.” What do you think Jim is going to do? Comply. So Paul Ingraham suspects that perhaps people follow through more with bathing instructions if they believe a magical potion poured into their bath is going to have some miraculous healing effect. Point – Mr. Ingraham.
So the unfortunate thing about all of this is that I am not stupid. I am a fancy doctor, and I have both exhaustive anecdotal evidence that these baths work, and personal experience to support my fervor. I have taken both Epsom salt baths and regular baths, and there is, indeed a difference. There are thousands of other reports to support this claim as well. But Mr. Ingraham is completely founded in his research and certainly very convincing. What is one to do??
Good news! There are no downsides to an Epsom salt bath. The literature tells us there are few to no side effects. I have had a few patients claim that the Epsom salt baths made their personal pipes move a little too quickly. With the documented diuretic effect of magnesium, I can understand why that might happen. (For the record Paul would most passionately disagree there is a connection.) But the truth about Epsom salt baths is you really cannot go wrong.
IF you are going to take an Epsom Salt bath, you better do it right. The recommendation is to make the bath saltier than your own tissues, so you want to use quite a bit of salt. There are expensive essential oil-laden salts you can use, but, you can also get Epsom salts at your local grange or farmer supply store. Apparently, they use is it for stuff. Farmer stuff, I guess.
How much salt should you use? Most people just sprinkle a little in their bath. I would suggest that with Paul’s discussion around osmolality that small amount DEFINITELY isn’t going to do anything for you. The concentration, if there is any chance of it working, needs to be significantly higher. My recommendation is at least three cups in a hot bath for twenty minutes. I use a half cup of the more expensive salts and then the other 2.5 cups I use the cheaper option.
If you are completely confused, read on!
Recap of what we know:
- Hot baths are nice.
- Hot baths with some lovely salts are even nicer.
- Perhaps we are not clear yet on the scientific efficacy of Epsom salt bathing,
- Perhaps we don’t give a crap if science can show that Epsom salts work.
- If Epsom salt baths serve as the impetus to get your butt into hot water for twenty minutes, (hot baths do have good scientific backing,) then who cares?
- Epsom salt baths can’t hurt. (Except for the occasional poopy problem.)
- So my professional recommendation is to golf clap Mr. Ingraham’s tremendous efforts in writing such an awesome article. And let’s do that respectful acknowledgment from the warm comfy confines of our Epsom Salt bath.
WOULD YOU RATHER JUST SEE THE VIDEO OF THIS POST?
This week I encourage you to try an Epsom Salt bath. Twenty minutes in a bath can calm the mind, relax the musculature and help you sleep better. Are you ensuring you are getting adequate down time in your schedule? Soaking in a bath can be a forcing function toward a little bit of stillness.
AFTER YOUR BATH YOU SHOULD RUN STAIRS! HERE IS A FREE “DESIGN YOUR OWN STAIRS CIRCUIT!”
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