From athletes sitting in ice baths after sports events to ice packs used on sprained ankles and sore backs, the application of cold temperatures to reduce pain and other ailments is not so much a new notion than a go-to remedy in many households. Each time an ice pack is used to reduce swelling or Arnica Ice is applied to relieve pain, a form of cryotherapy is being used. 

There are treatment centres dedicated solely to the use of this therapy, from whole body cryotherapy (WBC) to localised treatments (cryotherapy focusing on specific parts of the body) and even cryofacials; the wellness benefits claimed by cryotherapy are, allegedly, vast and varied and the procedure is slowly gaining popularity, but does it work?

What is cryotherapy?

Stemming from the Greek word kryo, meaning cold, cryotherapy is a wellness treatment that exposes the body, or part of the body, to below-freezing temperatures ranging from -75˚C to -160˚C for short periods of time (between two to four minutes), allowing the skin to rapidly cool down to about 5˚C.

Sports nutritionist, specialised kinesiologist and holistic health adviser Amina Farzee explains that cryotherapy in healthcare is used to reduce pain, create a potent anti-inflammatory response and harness the body’s potential to accelerate healing by up to 50%.

While some cryotherapy treatments have only recently been claiming aesthetic benefits, US News highlights that it has been used to treat muscle conditions such as multiple sclerosis and rheumatoid arthritis in Japan since 1978.

In a podcast episode of Found My Fitness focusing on cryotherapy, biomedical scientist Dr Rhonda Patrick refers to the positive effects that stress can have on our bodies, which is referred to as eustress. In other words, at the right dose, even things that can be harmful in higher doses can trigger a net gain in resilience. This applies to cryotherapy.

While most cryotherapy uses cooling methods on localised parts of the body, placing ice packs on small areas of concern such as a sprained ankle or sore shoulder, WBC involves exposing the entire body to sub-zero temperatures by standing in a tank that emits vapours, keeping the temperature in the tank consistent for the two to four minutes of total bodily exposure.

A research study by the Open Access Journal of Sports Medicine states that although WBC has become increasingly more accessible for athletes, additional clinical effects have not yet been proven. Yet, there has been observational evidence that WBC modifies many important biochemical and physiological parameters in athletes, as well as research indicating that WBC can be used to treat anxiety and depression, inflammation, inflammatory bone and joint conditions such as arthritis and assist in weight-loss.  

Muscle-healing and pain relief

A review of literature covering WBC as a “Recovery Technique after Exercise”, published in the International Journal of Sports Medicine in 2017, indicated that muscle pain was reduced in 80% of studies following WBC and that these results suggest the treatment may improve recovery from muscle damage, from pain and loss of muscle function, depending on the number of times WBC is undergone.

Farzee says the frequency of cryotherapy treatments depends on the severity of the injury as well as the area that requires the treatment. The average number of treatments required for injuries, as experienced by Farzee in her cryotherapy sessions conducted at The Pink Orchid Integrated Wellness Centre, is three sessions in successive days.

Weight-loss 

The theory that WBC or localised cryotherapy may assist in losing weight is based on the cold temperatures forcing the body to work harder to stay warm, which leads to an increase in calorie-burning.

“One of the body’s ways of responding to cold is to increase metabolism, not to produce energy in the form of adenosine triphosphate, also known as ATP, but to produce heat to warm the body and in the process, burn fat,” explains Patrick. The process is also referred to as cold thermogenesis.

Despite the fact that cryotherapy encourages the body to increase its metabolism for the two to four minutes that it is subjected to the freezing temperatures, the use of cryotherapy for weight-loss has yet to be approved by medical research companies and the US Food and Drug Administration.

Mood-enhancing

Usually, when people think about cryotherapy, they associate the treatment with muscle-soreness and recovery and the speeding up of the metabolism.

Patrick adds another layer of interest, looking at the effects of WBC on the brain. She says there is anecdotal evidence that exposure to cold improves mood. 

“One of the most consistent and profound physiological responses to cold exposure is a robust release of norepinephrine into the bloodstream. What makes norepinephrine so interesting is that not only is it a hormone but also a neurotransmitter and is involved in vigilance, focus, attention and mood. The cold induces this robust increase in norepinephrine and is a response mediated by the sympathetic nervous system,” she explains in the podcast.

Norepinephrine also allegedly has profound effects on pain, metabolism and inflammation, the last point being relevant to how cryotherapy can be used to enhance our mood, considering inflammation has the quality of also being able to inhibit the release of serotonin, also known as the happy hormone.

Inflammation reduction

According to Patrick, inflammation has been identified as the key driver of the ageing process – in fact, a 2018 review describes the term “inflammaging” as a new immune-metabolic viewpoint for age-related diseases.

“A recent study looked at a variety of different biomarkers in old people – centenarians, people who are 100 years old, semi-super centenarians who are 105-plus years old and supercentenarians who are 110-plus years old – and found that low inflammation was the only biomarker that predicted survival in cognitive capability across all age groups,” she explains.

Another role norepinephrine may play when the body is exposed to extremely cold temperatures, or eustress caused by extreme cold, is in reducing inflammation.

“Norapinephrine inhibits the inflammatory pathway by decreasing tumour necrosis factor alpha (TNF alpha), a very potent molecule that increases inflammation; some of the pain-alleviating effects of cold exposure, particularly in the case of whole-body cryotherapy may, in fact, be due to increased norepinephrine, since inflammation itself causes pain,” she adds.

Is it safe and does it work?

While many reviews and studies have been conducted on the effects of cryotherapy, the FDA does not have evidence that WBC effectively treats diseases or conditions like Alzheimer’s, fibromyalgia, migraines, rheumatoid arthritis, multiple sclerosis, stress, anxiety or chronic pain.

“We simply don’t know,” says FDA scientific reviewer Anna Ghambaryan, MD, PhD. “At this time, there’s insufficient publicly available information to help us answer these questions.” Although the benefits of WBC have yet to be proven, an article published by the American Academy of Dermatology explains that cryotherapy is an accepted medical procedure and, when performed by a person skilled in cryotherapy, such as a board-certified dermatologist, cryotherapy is very effective and safe.

Note from the writer: Should you wish to try whole body cryotherapy, dermatologists and specialists recommend you consult your doctor first as there are some medical conditions that can worsen when undergoing WBC. ML