Contrast bathing is a physiotherapy treatment where an injury is treated with alternate periods of hot and cold. This produces alternate dilations and contractions of the blood vessels, which aid in the absorption of swelling and thus promote the healing process. It is known to provide a contrast bathing device comprising a heat exchange pad with circulation ducts for hot and cold liquids. The present invention directed towards providing a contrast bathing physiotherapy device with improved effectiveness for all modes of operation, namely heating, cooling, and contrast bathing.