Cryotherapy, sometimes known as cold therapy, is the local or general use of low temperatures in medical therapy. Cryotherapy may be used to treat a variety of tissue lesions. The most prominent use of the term refers to the surgical treatment, specifically known as cryosurgery or cryoablation. Cryosurgery is the application of extremely low temperatures to destroy abnormal or diseased tissue and is used most commonly to treat skin conditions.
Cryotherapy is used in an effort to relieve muscle pain, sprains and swelling after soft tissue damage or surgery. It can be a range of treatments from the application of ice packs or immersion in ice baths (generally known as cold therapy), to the use of cold chambers.
While cryotherapy is widely used, there is little evidence as to its efficacy that has been replicated or shown in large controlled studies. Its long term side effects have also not been studied. The term "cryotherapy" comes from the Greek cryo (κρύο) meaning cold, and therapy (θεραπεία) meaning cure.
Cryosurgery is the application of extreme cold to destroy abnormal or diseased tissue. The application of ultra-cold liquid causes damage to the treated tissue due to intracellular ice formation. The degree of damage depends upon the minimum temperature achieved and the rate of cooling. Cryosurgery is used to treat a number of diseases and disorders, most especially skin conditions like warts, moles, skin tags and solar keratoses. Liquid nitrogen is usually used to freeze the tissues at the cellular level. The procedure is used often as it is relatively easy and quick, can be done in the doctors surgery, and is deemed quite low risk. If a cancerous lesion is suspected then excision rather than cryosurgery may be deemed more appropriate.
Ice pack therapy
Ice pack therapy is a treatment of cold temperatures to an injured area of the body. Though the therapy is extensively used, and it is agreed that it alleviates symptoms, testing has produced conflicting results about its efficacy.
An ice pack is placed over an injured area and is intended to absorb heat of a closed traumatic or edematous injury by using conduction to transfer thermal energy. The physiologic effects of cold application include immediate vasoconstriction with reflexive vasodilation, decreased local metabolism and enzymatic activity, and decreased oxygen demand. Cold decreases muscle spindle fiber activity and slows nerve conduction velocity, therefore it is often used to decrease spasticity and muscle guarding. It is commonly used to alleviate the pain of minor injuries, as well as decrease muscle soreness. The use of ice packs in treatment decreases the blood flow most rapidly at the beginning of the cooling period, this occurs as a result of vasoconstriction, the initial reflex sympathetic activity.
Ice is not commonly used prior to rehabilitation or performance because of its known adverse effects to performance such as decreased myotatic reflex and force production, as well as a decrease in balance immediately following ice pack therapy for 20 minutes. However, if ice pack therapy is applied for less than 10 minutes, performance can occur without detrimental effects. If the ice pack is removed at this time, athletes are sent back to training or competition directly with no decrease in performance.
Cold spray anesthetics
In addition to their use in cryosurgery, several types of cold aerosol sprays are used for short-term pain relief. Ordinary spray cans containing tetrafluoroethane, dimethyl ether, or similar substances, are used to numb the skin prior to or possibly in place of local anesthetic injections, and prior to other needles, small incisions, sutures, and so on. Other products containing chloroethane are used to ease sports injuries, similar to ice pack therapy.
Whole body cryotherapy
It is unclear if whole body cryotherapy (WBC) has any effect on muscle soreness, or improves recovery, after exercise.
This treatment involves exposing individuals to extremely cold dry air (below −100 °C) for two to four minutes. To achieve the subzero temperatures required for WBC, two methods are typically used: liquid nitrogen and refrigerated cold air. During these exposures, individuals wear minimal clothing, which usually consists of shorts for males, and shorts and a crop top for females. Gloves, a woollen headband covering the ears, and a nose and mouth mask, in addition to dry shoes and socks, are commonly worn to reduce the risk of cold-related injury. The first WBC chamber was built in Japan in the late 1970s, but WBC was introduced to Europe until the 1980s, and has been used in the US and Australia in the past decade.
Reviews of whole body cryotherapy have called for research studies to implement active surveillance of adverse events, which are suspected of being underreported. If the cold temperatures are produced by evaporating liquid nitrogen, there is the risk of inert gas asphyxiation as well as frostbite.
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