3 Cryotherapy Benefits for Quick Pain Relief, its Risk

When we use extremely cold temperatures to treat body pain and swelling, we call is as cryotherapy. It is extremely useful in treating acute injury and research says that it is also beneficial in chronic pain². However, it is important to learn both cryotherapy benefits and its risks to make an informed decision.

In this article, we are going to learn about cryotherapy. We will learn how different methods are in use to give cryotherapy? How does it help in the reduction of pain and swelling? What are the different modes of application of cold therapy?

But, let’s first start with a question, what is cryotherapy?

Cryotherapy benefits and risks

Cryotherapy is the superficial application of cold as a therapeutic agent widely in sports medicine for post-exercise recovery in a variety of sports to cope with fatigue and/or delayed-onset muscle soreness¹.

Have you observed during a cricket match when a sportsperson is injured, a team physiotherapist would rush to the field to treat him. The first thing the physiotherapist does to manage such acute pain/injury is the application of an ice pack. It immediately helps in pain relief, controlling the swelling or oedema and much more. To understand how cryotherapy benefits in all these conditions we first need to learn how it affects our body.

Cryotherapy benefits and its mechanism of action

We know the benefits of cryotherapy but its mechanism of action is still uncertain. However, there are few theories that can explain its action². Let’s try to understand them.

#1 Anti-inflammatory: Reduces inflammation and oedema

In chronic musculoskeletal conditions such as rheumatoid arthritis, ankylosing spondylitis, multiple sclerosis the main cause of pain is chronic inflammation. Inflammation increases the permeability of blood vessels due to which the fluid enters extravascular space. This causes swelling that leads to mechanical stimulation of pain.

When our body is exposed to cold it causes a decrease in blood vessel permeability and reduction of blood flow due to vasoconstriction (narrowing of the blood vessels due to constriction of vessel wall). So, when we apply cryotherapy to the affected area it reduces swelling and thereby reduces pain by the combination of these two effects.

#2 Anti-analgesics: Reduces nerve transmission velocity in pain fiber

Cryotherapy is also believed to reduce nerve transmission velocity in pain fibres. This can be the reason for pain reduction with the application of pain therapy.

#3 Anti-oxidants: Reduces oxidative stress

Oxidative stress is an imbalance between free radicals and antioxidants in your body. Oxidative stress can lead to a number of diseases like diabetes, High BP, heart diseases etc. Oxidative stress also leads to more inflammation and pain. Studies have found that cryotherapy may reduce oxidative stress.

Indications of cold application

Here is the list of conditions where cold therapy is most beneficial.

1. Sports induces muscle pain and for muscle recovery. Whole-body cryotherapy is widely accepted mode of treatment in sports medicine. It is used for Recovery from injuries (e.g., trauma, overuse) and after-season muscle recovery ³.
2. Cryotherapy is used for preventive strategy against the deleterious effects of exercise-induced inflammation and soreness.
3. Acute traumatic inflammation- That is inflammation or swelling due to fresh injury.
4. Chronic traumatic inflammation- Swelling which remains even after the healing of an old injury. It can also be a post-operative condition with swelling.
5. Muscle spasm
6. Thermal burn.

Contraindication of cryotherapy

1. Skin over body part where there is impaired sensation like hemiplegic or any paralytic condition with loss of sensation.
2. The person with impaired blood circulation.
3. Peripheral vascular diseases.

Cryotherapy risks

Although cold has many benefits if it is applied carelessly and for a longer time then it has also some adverse effects. Have to be careful not to apply cold on one single spot for more than 5 to 10 minutes. Preferably, change the spot every 5 minutes.

If applied carelessly, it can have these potential side effects:

• Ice burn
• Cold urticaria.

Techniques of local cold application

There are different modes of application. Depending on the availability or the condition of the injury, you may adopt any of these modes.

1. Cold gel packs: Nowadays cold packs come with a gel material. This gel has the property of retaining cold for a longer period which we need to keep inside the deep freezer. Cold gel packs are sometimes called ice gel packs.
2. Ice packs: The ice pack is prepared from ice cubes. Ice cubes are crushed and wrapped in a terry towel and applied over the affected part. It also comes ready-made which is handy to use. Just fill in with water and keep it in the freezer (pic).
3. Ice towel: Dip a clean terry towel is in a mixture of cold water and ice. Now, squeeze out the extra water from the towel and apply it over the painful part.
4. Vaporcoolant spray: A volatile liquid that evaporates on contact with the skin, causing a local refrigerant effect and helps relieving pain.
5. Whole body cryotherapy: A brief full body exposure to dry air at cryogenic temperatures lower than −110°C has become widely popular in sports medicine, often used to enhance recovery after injuries and to counteract inflammatory symptoms resulting from overuse or pathology³.

Keep reading: Contrast bath therapy: Protocol for edema, hand swelling

Sunit. S. Ekka

Dr Sunit Sanjay Ekka is a physiotherapist in practice for the last 15 years. He has done his BPT from one of the premium Central Government physiotherapy colleges, ie, SVNIRTAR. The patient is his best teacher and whatever he gets to learn he loves to share it on his Youtube channel and blog.