Cryotherapy was created by a Japanese doctor in 1978 to help treat Rheumatoid Arthritis. Since then it has greatly evolved from local procedures to whole body treatments and to treat a variety of different symptoms as well as conditions. It has gained popularity in the West over the past few decades but is still not approved by the Food and Drug Administration (FDA). Which begs the common question – are there actually any benefits of cryotherapy? And do the benefits outweigh the risks?
What is Cryotherapy?
Cryotherapy is a technique that involves exposing the body to freezing temperatures over a span of a few minutes (generally for 3-4 minutes).
Cryotherapy is also known as cryogenic therapy or cold therapy.
There are three forms of cryotherapy:
- Whole body cryotherapy
- Local cryotherapy
- Cryosurgery
Whole-body cryotherapy (WBC) involves the person stepping inside a chamber that is infused with liquid nitrogen. Each session is about 3-4 minutes long and temperatures are between minus 160-300 degrees Fahrenheit. Once inside the cryo-chamber, individuals are required to wear only certain items; underwear, gloves, ear mitts and socks to protect the extremities from frostbite. Note that a cryotherapy chamber will be enclosed all the way around but open at the top so that the individual’s head is still at room temperature.
Local cryotherapy implies that only a localized, small portion of the body is exposed to ice cold temperatures. This can be done using ice packs or something like a cooling spray.
Differences between the two do exist. Whole body will cost money because the individual will have to go to a facility with a cryotherapy chamber in order to get it done. While local, it can be done in the comfort of your home using just a pack on a sore muscle or a spray. However keep in mind that the benefits from both will differ as well.
Cryosurgery on the other hand is a minimally invasive procedure involving the use of a cold probe to kill cells that are infectious and/or cancerous. This technique is frequently used to kill cancer cells effectively.
How Does Cryotherapy Work?
The mechanism of action is that upon entry of a cryotherapy chamber, an individual’s tissue and core body temperatures are rapidly reduced. This shocks the autonomic nervous system (fight or flight response) leading to an increase in:
- Blood pressure
- Norepinephrine
- And heart rate variability
These changes are the result of blood vessel constriction leading to reduced blood flow (especially to areas of inflammation).
Blood circulation then increases as vessels expand once the person exits the cryo-chamber causing the release of anti-inflammatory proteins into the bloodstream. This method leads to increased recovery speed from muscle soreness and pain.
What Are The Benefits of Cryotherapy?
Benefits of cryotherapy will depend on the severity of the condition you are seeking treatment for. Generally 15-20 sessions of continuous cryotherapy sessions are needed for optimum results.
Listed below are the specific benefits:
1. Improves Athletic Performance
Nowadays whole body cryotherapy (WBC) is a widely used treatment modality in sports medicine. Besides its purported effects of speeding up recovery post workout or injury, researchers have begun to test its effects as a warm up intervention as well.
When used in conjunction with traditional warm up exercises, researchers have found that WBC could promote athletic performance before a competition.
In 2014 researchers concluded that when whole body cryotherapy was combined with exercise, the potential for increased athletic performance existed.
However in the future, larger sample sizes and more extensive analysis are needed.
2. Improves Pain In Blocked Joints
Cryotherapy improves pain in muscles and a painful joint by actively reducing inflammation.
Both local and whole body cryotherapy are easy alternatives to add in the management for acute pain (experienced directly after an injury) and chronic pain (in carefully selected patients such as those suffering with rheumatologic diseases).
And when used in conjunction with other efforts (i.e. pain relievers), cryotherapy has a positive effect on alleviating acute and chronic lower back pain as well.
Patients with Ankylosing Spondylitis have noticed a 40% reduction in their symptoms when using cryotherapy (+ kinesiotherapy) consistently compared to only 15% reduction when using kinesiotherapy alone!
This also held true in the case of elderly men suffering with ankylosing spondylitis. Researchers noted that the participants had less pain and increased lower back mobility after doing whole-body cryotherapy.
And researchers in The International Journal of Sports Medicine reviewed literature that found muscle pain decreased by 80% with multiple sessions of whole-body cryotherapy.
3. Burns Fat
Cryotherapy may burn fat by freezing the fat cells in the body. This eventually leads to cell death and fat loss.
By exposing your body to cold temperatures, a substance known as brown adipose tissue (BAT) burns fat to help make energy in order to counteract the coldness. And this effect can then eventually lead to weight loss.
Researchers in 2016 found that cryotherapy actually didn’t have much of a significant impact on body fat loss.
After long term use of cryotherapy, researchers in 2018 discovered what is now referred to as cold induced thermogenesis. Cold induced thermogenesis produces a 3% reduction in total body fat (particularly around the waistline).
A recent study in 2020 also demonstrated the positive effects of cryotherapy in reducing abdominal obesity in menopausal women after 20 whole-body cryotherapy sessions. The weight loss achieved after undergoing atleast 20 sessions of cryotherapy were the result of loss in total body mass.
However to prove if a direct link between cryotherapy and weight loss actually exists more randomized control trials are needed.
4. Relieves Anxiety and Depression
Mood disorders when treated with whole-body cryotherapy (as an add on to medical treatment) reduced depressive symptoms, and improved quality of life.
In 2008, researchers found that 1/3rd of participants undergoing cryotherapy had a 50% reduction in both their anxiety and depression.
And in 2016, researchers found that cryotherapy had a positive effect on overall wellness.
5. Improves Sleep
Low temperatures in general are thought to improve sleep quality; hence why cryotherapy is thought to be a useful adjunct in managing poor sleep.
A study conducted in 2016 showed a positive correlation between improved sleep quality and cryotherapy. Sleep score increased from 5.14 to 7 (after 18 sessions).
And in 2019, a 3 min cryotherapy session improved both subjective and objective sleep quality in physically active individuals.
While researchers in 2021 reported that subjective sleep quality improved greatly in long distance runners who had experienced muscle damage. These results were statistically significant but from a small sample size.
The correlation between improved sleep quality and cryotherapy may also be due to the fact that individuals report less pain and fatigue and therefore may benefit from improved sleep in return.
Randomized control trials with large sample sizes are therefore needed to conclusively determine whether a direct correlation between sleep quality and cryotherapy exists.
6. Improves Energy
Energy levels are thought to increase after cryotherapy from the release of endorphins. These endorphins then lead to pain relief and less muscle fatigue and eventually to an energy boost.
This boost in energy is thought to arise from an increase in oxygen rich blood seen after cryotherapy.
However, more extensive research is needed to confirm the benefits of cryotherapy in this area.
7. Improves Skin Quality
When used as an adjunct to medical treatment, skin conditions such as eczema and atopic dermatitis can be treated with either local or whole body cryotherapy.
While wrinkles and overall skin texture may improve after undergoing cryotherapy because of increased collagen production.
8. Helps Prevent Injury
Whole body cryotherapy (WBC) and local cryotherapy both have the ability to prevent injury.
Both achieve injury prevention by reducing inflammation (caused by the release of inflammatory markers after an injury occurs).
Local compresses act by decreasing inflammation in one particular area, while WBC reduces inflammation throughout the body. Both may speed up recovery and prevent injuries in return.
Researchers have also suggested that whole body cryotherapy could play a role in preventing and recovering from fractures. However, this study only consisted of male rugby players and was of small sample size.
How Long Do The Effects of Cryotherapy Last?
The effects of cryotherapy last anywhere for 6 – 8 hours after the individual exits the cryochamber.
These effects are the result of adrenaline, and endorphins (the feel good hormones).
When a person enters a cryochamber, adrenaline gets released activating the fight or flight response. And once the person exits the chamber, endorphins are released leading to blood vessel dilation.
This mechanism acts as a natural painkiller after a whole body cryotherapy session.
Enter the cryo chamber → extreme drop in body temperature leads to the release of adrenaline → fight or flight response is activated → exit the chamber → leads to release of endorphins as the body starts to heat back up → the person feels relaxed, good, and pain free for 6-8 hours afterwards!
Note that these effects will depend upon how many sessions a person has inside a cryochamber. Researchers have found: 20 sessions at minimum and 30 sessions for optimum improvement.
Can Cause Burns
Cases of frostbite, frozen arm, rashes and burns have been reported after whole-body cryotherapy. Some of these symptoms, like a burn or rash, can also occur from local cryotherapy if done incorrectly.
For local cryotherapy, never place the cold object directly on your skin. Instead wrap the cold device in a towel or a heavy cloth. Even if the object/device is a cold pack or a frozen bag of peas – make sure to wrap it first in a towel and then apply it to the affected area.
For whole body cryotherapy, the best way to avoid any side effects is to go to a reputable clinic and have it done. Make sure to cover certain areas that are more prone to burns and/or frostbite like ears, fingertips, and/or toes. And to not be in a chamber for more than the recommended time (~3 – 4 mins).
Cryotherapy can Cause Sensory Nerve Damage
Sensory nerve damage is a rare but possible side effect after cryosurgery. And may even occur temporarily after whole-body cryotherapy. It can take anywhere from 12 to 18 months to regain full nerve function again.
Individuals with diabetes therefore have to be careful and may have to avoid undergoing this treatment modality as they are already prone to nerve damage.
Can Cause Heart Problems
People with certain heart conditions (recent myocardial infarction or arrhythmia) and/or severe hypertension (high blood pressure) should avoid undergoing whole-body cryotherapy because it can impact heart rate variability. And this in turn can exacerbate any pre-existing condition.
Note: changes in heart rate and blood pressure may revert back to normal after the procedure.
Is Cold Water Immersion and Whole-body Cryotherapy The Same Thing?
Athletes commonly use cold water immersion or an ice water bath to help reduce inflammation and muscle soreness. The process works by constricting the vessels upon entry into the bath and then dilation of the vessels upon exiting the bath. This process acts by flushing out metabolic waste faster in order to speed up recovery.
Another example of where cold water immersion is useful is in medical emergencies, such as a heatstroke.
Here the whole body comes into direct contact with ice cold water. Whereas whole body cryotherapy acts through indirect contact with liquid nitrogen. Which is where the two differ majorly.
My Opinion
My opinion on whether cryotherapy is an effective method for treating numerous conditions is not a simple yes or no answer.
Cryotherapy is effective for certain conditions. Such as those backed with statistically significant results.
Receiving around 20 sessions consistently seems to offer the most benefit and is therefore worth noting. And not for any longer than 3 minutes a session.
As always it’s imperative to discuss the procedure, especially for whole-body cryotherapy, with your primary care physician first.
Talk to your doctor before undergoing any type of new treatment. He/she will be the best person to give you advice on whether this type of treatment would be effective for your specific needs.
