Sauna and Your Musculoskeletal Health: Where Does Heat Fit?

by Osteopath Carien Boshoff

Saunas have become increasingly popular in gyms, recovery centres and wellness spaces.

Whether it is a traditional sauna, infrared sauna, or simply using a heat pack at home, many people use heat because it makes them feel relaxed, less stiff, or more comfortable after exercise.

But what is actually happening when we expose our body to heat? And where might sauna use fit from a musculoskeletal and osteopathic perspective?

Traditional vs infrared sauna: what's the difference?

Traditional saunas generally heat the air around you, often reaching temperatures of approximately 65-90°C. Your body then responds to the hot environment by increasing skin blood flow and sweating to help regulate body temperature.

Infrared saunas work a little differently. Rather than primarily heating the surrounding air, infrared radiation transfers heat to the body. They generally operate at lower environmental temperatures than traditional saunas.

While the experience may feel different, both involve passive heat exposure and place some degree of thermal stress on the body.

What happens to your body when you get hot?

As your body temperature rises, several normal physiological responses occur. These can include:

• Increased blood flow to the skin

• Widening of peripheral blood vessels

• Increased heart rate

• Increased sweating

• Changes in cardiovascular demand

• A temporary feeling of reduced muscular stiffness or increased relaxation

These responses are part of the body's normal thermoregulation system. This is also why sitting in a sauna can sometimes feel surprisingly similar to exercise from a cardiovascular perspective, even though your muscles aren't actually doing the work.

Importantly, sauna isn't a replacement for exercise. Exercise provides mechanical loading and adaptations to muscles, bones, tendons, and the cardiovascular system that simply sitting in a hot room cannot replicate.

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Why can heat feel good when you're stiff or sore?

Have you ever noticed that a hot shower or heat pack makes a stiff back or tight muscles feel a little easier to move?

Heat may temporarily alter pain perception and tissue extensibility while increasing local circulation. For some people, this can make an area feel more comfortable, and movement feel easier. This doesn't necessarily mean that the sauna has “fixed” the tissue or addressed the underlying reason you are experiencing symptoms.

Instead, heat may provide a temporary window of comfort. For example, if someone experiences lower back stiffness, they may find that warmth makes it easier to complete some gentle mobility exercises or go for a walk.

From an osteopathic perspective, this is where heat can become one part of a broader management strategy rather than the treatment itself.

What about sauna after exercise?

Sauna use is commonly promoted as a recovery tool, but the research here is still developing. Researchers have investigated post-exercise heat exposure, including sauna bathing and hot water immersion, for its potential effects on recovery and training adaptations.

Repeated heat exposure may have a role in heat acclimation, particularly for athletes preparing to train or compete in hot environments. But when it comes to everyday recovery, don't forget the less exciting basics:

• Sleep

• Appropriate nutrition

• Hydration

• Progressive training

• Rest and recovery

• Strength and conditioning

A sauna can complement these things, but it doesn't replace them.

Does sweating “detox” your body?

This is one of the biggest claims you may hear about saunas. Sweating is primarily your body's way of regulating temperature. Your liver and kidneys play major roles in processing and eliminating substances from the body, so it isn't accurate to describe sauna use as a way to “detox” your body.

You also shouldn't judge a sauna session's effectiveness by how much you sweat. More sweat doesn't necessarily mean more benefit.

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Could sauna help you prepare for exercising in the heat?

This is an interesting area of sports science research, particularly here in Queensland.

Repeated exposure to heat can cause physiological adaptations that improve the body's ability to cope with hot environments. This is known as heat acclimation or heat acclimatisation.

Depending on the protocol, adaptations may include changes in sweating, cardiovascular responses and perceptions of heat during exercise. For someone preparing for an endurance event or regularly training in hot conditions, appropriately planned heat exposure may therefore be relevant.

However, heat preparation should still be individualised. More heat isn't automatically better, particularly when you're already managing a high training load.

Where does osteopathy fit?

Your osteopath isn't there to prescribe a sauna as a cure for your pain. Instead, we may discuss heat as one of several self-management strategies if it is appropriate for you and your presentation.

For example, your osteopath may consider:

• Whether heat makes your symptoms feel better or worse

• When you're using heat in relation to training

• Your current exercise and rehabilitation program

• Your hydration and recovery habits

• Whether heat helps you move more comfortably

• Whether there are reasons heat may not be appropriate for you

Management may also include hands-on treatment where appropriate, exercise rehabilitation, mobility or strengthening exercises, education and advice around modifying aggravating activities.

The goal is to look at the bigger musculoskeletal picture, rather than relying on one recovery tool.

How long should you stay in a sauna?

There isn't one timeframe that will be appropriate for everyone. How long you spend in a sauna will depend on factors such as the temperature, type of sauna, your experience, hydration status, and individual tolerance.

As a general guide:

• Beginners: Consider starting with around 5-10 minutes to see how your body responds to the heat.

• General sauna use: For many healthy adults who tolerate heat well, sessions of approximately 15-20 minutes are commonly used.

• More experienced users: Some people choose to complete multiple shorter rounds, such as 10-15 minutes at a time, with cooling and recovery periods between rounds rather than one prolonged exposure.

Longer isn't necessarily better, and these timeframes shouldn't be treated as a target that you need to reach. Published safety advice similarly emphasises short initial exposures, hydration, cooling periods and stopping based on symptoms rather than trying to achieve a particular duration. Always listen to your body and exit the sauna if you feel dizzy, light-headed, nauseous, faint or uncomfortable.

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Hydration matters

Saunas increase sweating and fluid loss, which means hydration is important.

Going into a sauna already dehydrated, particularly after a long run, gym session or training in the Queensland heat, may increase the likelihood of feeling dizzy, light-headed or unwell.

Before and after sauna use, consider your overall fluid intake and how much you have already sweated through exercise.

Is sauna suitable for everyone?

No.

Heat exposure places additional demands on your body's temperature regulation and cardiovascular systems. People with certain cardiovascular conditions, blood pressure concerns or other medical conditions may need medical advice before using a sauna. Australian sauna-safety guidance also recommends additional caution for people with heart disease, low blood pressure, diabetes, pregnancy or medications that may affect responses to heat.

Additional caution may be appropriate if you:

• Are pregnant

• Have recently undergone surgery

• Are currently unwell or have a fever

• Are dehydrated

• Take medications that affect blood pressure, hydration, sweating or temperature regulation

• Have been advised by a healthcare professional to avoid significant heat exposure

If you feel dizzy, nauseous, faint, unusually fatigued or generally unwell during a sauna session, get out and allow yourself to cool down.

Take home message

Sauna and heat exposure can be an enjoyable part of a recovery routine, and many people find warmth helps them feel relaxed, less stiff and more comfortable moving. From an osteopathic perspective, we're interested in where heat fits into the bigger picture. If heat helps you feel more comfortable moving, that's useful. But your long-term musculoskeletal health still relies on things such as appropriate movement, progressive loading, strength, sleep, nutrition, hydration, and recovery.

Think of heat as another tool in the toolbox, not the whole toolbox.

Importantly, sauna use isn't appropriate for everyone. Some people may need to use additional caution or avoid significant heat exposure depending on their health and medical history. If you have a cardiovascular or other medical condition, are pregnant, have recently undergone surgery, take medications that may affect blood pressure, hydration, or temperature regulation, or are unsure whether sauna use is appropriate for you, speak with your GP or appropriate healthcare professional before using a sauna.

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References

Ahokas, E. K., Hennessy, R. S., Hanstock, H. G., Kyröläinen, H., & Ihalainen, J. K. (2025). Effects of post-exercise heat exposure on acute recovery and training-induced performance adaptations: A systematic review. Sports Medicine - Open, 11, 106. https://doi.org/10.1186/s40798-025-00910-0

Hussain, J., & Cohen, M. (2018). Clinical effects of regular dry sauna bathing: A systematic review. Evidence-Based Complementary and Alternative Medicine, 2018, 1857413. https://doi.org/10.1155/2018/1857413

Laukkanen, J. A., Laukkanen, T., & Kunutsor, S. K. (2018). Cardiovascular and other health benefits of sauna bathing: A review of the evidence. Mayo Clinic Proceedings, 93(8), 1111–1121. https://doi.org/10.1016/j.mayocp.2018.04.008

Solomon, T. P. J., & Laye, M. J. (2025). The effect of post-exercise heat exposure (passive heat acclimation) on endurance exercise performance: A systematic review and meta- analysis. BMC Sports Science, Medicine and Rehabilitation, 17, 4. https://doi.org/10.1186/s13102-024-01038-6