Cryotherapy
Encyclopedia
Cryotherapy is the local or general use of low temperatures in medical therapy or the removal of heat from a body part. The term "cryotherapy" comes from the Greek cryo (κρυο) meaning cold and the word therapy (θεραπεια) meaning cure. It has been around since the 1880-1890s.
Its goal is to decrease cellular metabolism, increase cellular survival, decrease inflammation
, decrease pain
and spasm, promote vasoconstriction
, and when using extreme temperatures, to destroy cells by crystallizing the cytosol
. The most prominent use of the term refers to the surgical treatment, specifically known as cryosurgery
. Other therapies that use the term are cryogenic chamber therapy and ice pack therapy.
is usually used to freeze the tissues at the cellular level. The procedure is used often because of its efficacy and low rates of side effects.
with reflexive vasodilation
, decreased local metabolism
and enzymatic activity, and decreased oxygen demand. However, by not reducing below 10°C, the lymphatic drainage is not disturbed, nor is the creation of fibroblasts and the microcirculation
, all of which cease to function during the normal application of ICE and when the tissue falls below the 10°C. Hilotherapy is commonly used for the recovery of orthopedic surgery
, plastic surgery
and Oral and maxillofacial surgery
.
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.
chamber for a short duration (i.e. no more than three minutes, which is comparable to ice swimming), and if used properly, will not destroy tissue. Whole body cryotherapy originated in Japan in 1978. However, it was a group of Polish scientists who took the idea and made whole body cryotherapy the physical therapy it is today. The Olympic rehabilitation centre in Spala, Poland opened in May 2000 and has been used as a training and injury rehabilitation centre for many sporting bodies.
The chamber is cooled, typically with liquid nitrogen
, usually to a temperature of -120 C—although temperatures of -140 C or even -160 C have been used. The patient is protected from acute frostbite with socks, gloves and mouth and ear protection, but in addition to that, wears nothing but a bathing suit. The patient spends a few minutes in the chamber. During treatment the average skin temperature drops to 12 °C (53.6 °F), while the coldest skin temperature can be 5 °C (41 °F). The core body temperature remains unchanged during the treatment, however it may drop slightly afterwards. Therapy triggers the release of endorphin
s which induce analgesia (immediate pain relief).
Patients report that the experience is invigorating and improves a variety of conditions such as psychological stress, insomnia, rheumatism
, muscle and joint pain, fibromyalgia
, itching, and psoriasis
. The immediate effect of skin cooling and analgesia lasts for 5 minutes, but the release of endorphins can have a lasting effect, where the pains and signs of inflammation as found in blood tests remain suppressed for weeks. The effects of extreme cold and endorphin release are scientifically studied. Curiously, some patients compare the feeling to sauna
at 110 °C (230 °F). Wales rugby union international
Sam Warburton
, who along with his teammates used the Spala facilities whilst training for the 2011 Rugby World Cup
, has dubbed the chambers "evil saunas", but added:
Its goal is to decrease cellular metabolism, increase cellular survival, decrease inflammation
Inflammation
Inflammation is part of the complex biological response of vascular tissues to harmful stimuli, such as pathogens, damaged cells, or irritants. Inflammation is a protective attempt by the organism to remove the injurious stimuli and to initiate the healing process...
, decrease pain
Pain
Pain is an unpleasant sensation often caused by intense or damaging stimuli such as stubbing a toe, burning a finger, putting iodine on a cut, and bumping the "funny bone."...
and spasm, promote vasoconstriction
Vasoconstriction
Vasoconstriction is the narrowing of the blood vessels resulting from contraction of the muscular wall of the vessels, particularly the large arteries, small arterioles and veins. The process is the opposite of vasodilation, the widening of blood vessels. The process is particularly important in...
, and when using extreme temperatures, to destroy cells by crystallizing the cytosol
Cytosol
The cytosol or intracellular fluid is the liquid found inside cells, that is separated into compartments by membranes. For example, the mitochondrial matrix separates the mitochondrion into compartments....
. The most prominent use of the term refers to the surgical treatment, specifically known as cryosurgery
Cryosurgery
Cryosurgery is the application of extreme cold to destroy abnormal or diseased tissue. The term comes from the Greek words cryo and surgery meaning "hand work" or "handiwork"....
. Other therapies that use the term are cryogenic chamber therapy and ice pack therapy.
Cryosurgery
Cryosurgery is the application of extreme cold to destroy abnormal or diseased tissue. Cryotherapy is used to treat a number of diseases and disorders, most especially skin conditions like warts, moles, skin tags and solar keratoses. Liquid nitrogenLiquid nitrogen
Liquid nitrogen is nitrogen in a liquid state at a very low temperature. It is produced industrially by fractional distillation of liquid air. Liquid nitrogen is a colourless clear liquid with density of 0.807 g/mL at its boiling point and a dielectric constant of 1.4...
is usually used to freeze the tissues at the cellular level. The procedure is used often because of its efficacy and low rates of side effects.
Hilotherapy
Hilotherapy is a treatment, which allows the controlled application of cooling to selected areas of the face and body. A cuff is wrapped around the traumatized area, which is connected to the device that allows the traumatized area to be cooled at a specific temperature. The difference between Hilotherapy and other cryotherapy approaches is the range of temperature and the constant application. By controlling the temperature between 10°C and 20°C, the typical benefits from cryotherapy occur, such as immediate vasoconstrictionVasoconstriction
Vasoconstriction is the narrowing of the blood vessels resulting from contraction of the muscular wall of the vessels, particularly the large arteries, small arterioles and veins. The process is the opposite of vasodilation, the widening of blood vessels. The process is particularly important in...
with reflexive vasodilation
Vasodilation
Vasodilation refers to the widening of blood vessels resulting from relaxation of smooth muscle cells within the vessel walls, particularly in the large arteries, smaller arterioles and large veins. The process is essentially the opposite of vasoconstriction, or the narrowing of blood vessels. When...
, decreased local metabolism
Metabolism
Metabolism is the set of chemical reactions that happen in the cells of living organisms to sustain life. These processes allow organisms to grow and reproduce, maintain their structures, and respond to their environments. Metabolism is usually divided into two categories...
and enzymatic activity, and decreased oxygen demand. However, by not reducing below 10°C, the lymphatic drainage is not disturbed, nor is the creation of fibroblasts and the microcirculation
Microcirculation
The microcirculation is a term used to describe the small vessels in the vasculature which are embedded within organs and are responsible for the distribution of blood within tissues; as opposed to larger vessels in the macrocirculation which transport blood to and from the organs...
, all of which cease to function during the normal application of ICE and when the tissue falls below the 10°C. Hilotherapy is commonly used for the recovery of orthopedic surgery
Orthopedic surgery
Orthopedic surgery or orthopedics is the branch of surgery concerned with conditions involving the musculoskeletal system...
, plastic surgery
Plastic surgery
Plastic surgery is a medical specialty concerned with the correction or restoration of form and function. Though cosmetic or aesthetic surgery is the best-known kind of plastic surgery, most plastic surgery is not cosmetic: plastic surgery includes many types of reconstructive surgery, hand...
and Oral and maxillofacial surgery
Oral and maxillofacial surgery
Oral and maxillofacial surgery is surgery to correct a wide spectrum of diseases, injuries and defects in the head, neck, face, jaws and the hard and soft tissues of the oral and maxillofacial region. It is an internationally recognized surgical specialty...
.
Ice pack therapy
Ice pack therapy is a treatment of cold temperatures to an injured area of the body. An ice packIce pack
An ice pack or gel pack is a plastic sac of ice, refrigerant gel or liquid, or, in an emergency, even frozen vegetables. The refrigerant, usually non-toxic, can absorb a considerable amount of heat, since its enthalpy of fusion is high...
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
Vasoconstriction
Vasoconstriction is the narrowing of the blood vessels resulting from contraction of the muscular wall of the vessels, particularly the large arteries, small arterioles and veins. The process is the opposite of vasodilation, the widening of blood vessels. The process is particularly important in...
with reflexive vasodilation
Vasodilation
Vasodilation refers to the widening of blood vessels resulting from relaxation of smooth muscle cells within the vessel walls, particularly in the large arteries, smaller arterioles and large veins. The process is essentially the opposite of vasoconstriction, or the narrowing of blood vessels. When...
, decreased local metabolism
Metabolism
Metabolism is the set of chemical reactions that happen in the cells of living organisms to sustain life. These processes allow organisms to grow and reproduce, maintain their structures, and respond to their environments. Metabolism is usually divided into two categories...
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.
Cryogenic chamber therapy
According to Costello et al. (2011) a relatively new modality of cryotherapy, called whole body cryotherapy (WBC), is currently being offered by clinicians as an alternative to cold water immersion or ice packs. Administered through the use of a cryogenic chamber, WBC is a treatment whereby the patient is placed in a cryogenicCryogenics
In physics, cryogenics is the study of the production of very low temperature and the behavior of materials at those temperatures. A person who studies elements under extremely cold temperature is called a cryogenicist. Rather than the relative temperature scales of Celsius and Fahrenheit,...
chamber for a short duration (i.e. no more than three minutes, which is comparable to ice swimming), and if used properly, will not destroy tissue. Whole body cryotherapy originated in Japan in 1978. However, it was a group of Polish scientists who took the idea and made whole body cryotherapy the physical therapy it is today. The Olympic rehabilitation centre in Spala, Poland opened in May 2000 and has been used as a training and injury rehabilitation centre for many sporting bodies.
The chamber is cooled, typically with liquid nitrogen
Liquid nitrogen
Liquid nitrogen is nitrogen in a liquid state at a very low temperature. It is produced industrially by fractional distillation of liquid air. Liquid nitrogen is a colourless clear liquid with density of 0.807 g/mL at its boiling point and a dielectric constant of 1.4...
, usually to a temperature of -120 C—although temperatures of -140 C or even -160 C have been used. The patient is protected from acute frostbite with socks, gloves and mouth and ear protection, but in addition to that, wears nothing but a bathing suit. The patient spends a few minutes in the chamber. During treatment the average skin temperature drops to 12 °C (53.6 °F), while the coldest skin temperature can be 5 °C (41 °F). The core body temperature remains unchanged during the treatment, however it may drop slightly afterwards. Therapy triggers the release of endorphin
Endorphin
Endorphins are endogenous opioid peptides that function as neurotransmitters. They are produced by the pituitary gland and the hypothalamus in vertebrates during exercise, excitement, pain, consumption of spicy food, love and orgasm, and they resemble the opiates in their abilities to produce...
s which induce analgesia (immediate pain relief).
Patients report that the experience is invigorating and improves a variety of conditions such as psychological stress, insomnia, rheumatism
Rheumatism
Rheumatism or rheumatic disorder is a non-specific term for medical problems affecting the joints and connective tissue. The study of, and therapeutic interventions in, such disorders is called rheumatology.-Terminology:...
, muscle and joint pain, fibromyalgia
Fibromyalgia
Fibromyalgia is a medical disorder characterized by chronic widespread pain and allodynia, a heightened and painful response to pressure. It is an example of a diagnosis of exclusion...
, itching, and psoriasis
Psoriasis
Psoriasis is an autoimmune disease that appears on the skin. It occurs when the immune system mistakes the skin cells as a pathogen, and sends out faulty signals that speed up the growth cycle of skin cells. Psoriasis is not contagious. However, psoriasis has been linked to an increased risk of...
. The immediate effect of skin cooling and analgesia lasts for 5 minutes, but the release of endorphins can have a lasting effect, where the pains and signs of inflammation as found in blood tests remain suppressed for weeks. The effects of extreme cold and endorphin release are scientifically studied. Curiously, some patients compare the feeling to sauna
Sauna
A sauna is a small room or house designed as a place to experience dry or wet heat sessions, or an establishment with one or more of these and auxiliary facilities....
at 110 °C (230 °F). Wales rugby union international
Wales national rugby union team
The Wales national rugby union team represent Wales in international rugby union tournaments. They compete annually in the Six Nations Championship with England, France, Ireland, Italy and Scotland. Wales have won the Six Nations and its predecessors 24 times outright, second only to England with...
Sam Warburton
Sam Warburton
Sam Kennedy-Warburton , commonly known as Sam Warburton, is a Welsh rugby union player. Warburton plays regional rugby for the Cardiff Blues and was first capped for Wales in 2009...
, who along with his teammates used the Spala facilities whilst training for the 2011 Rugby World Cup
2011 Rugby World Cup
The 2011 Rugby World Cup was the seventh Rugby World Cup, a quadrennial international rugby union competition inaugurated in 1987. The International Rugby Board selected New Zealand as the host country in preference to Japan and South Africa at a meeting in Dublin on 17 November 2005...
, has dubbed the chambers "evil saunas", but added:
"I'd be lying if I didn't say it was a pretty savage experience, but the other side of the coin is that it is definitely working and allowing us to train in a way that would be impossible under normal conditions."
Cryotherapy and headaches
A study published in the September 2000 edition of the Archives of Family Medicine showed that a combination of pressure and cold temperatures can successfully mitigate headache-related pain and also decrease the duration of a headache. Eighty-seven percent of participants (p=.004) said that the combination of pressure as well as temperature therapy was "optimally effective"; 13% said that the temperature therapy was "moderately effective". Many products exist that provide temperature therapy, many times cryotherapy, to combat headaches.See also
- CryonicsCryonicsCryonics is the low-temperature preservation of humans and animals who can no longer be sustained by contemporary medicine, with the hope that healing and resuscitation may be possible in the future. Cryopreservation of people or large animals is not reversible with current technology...
- Cold shock responseCold shock responseCold shock response is the physiological response of organisms to sudden cold, especially cold water.-Myth of sudden hypothermia:In humans, cold shock response is perhaps the most common cause of death from immersion in very cold water, such as by falling through thin ice...
- Migraine#Cryotherapy and Thermotherapy
- Ice bathIce bathIn sports therapy, an ice bath or sometimes a cold-water immersion or cold therapy is a training regimen usually following a period of intense exercise in which a substantial part of a human body is immersed in a bath of ice or ice-water for a limited duration...
External links
]- Hilotherapy, a more effective alternative to Ice
- A training course in Cryotherapy (IARC Screening Group)
- http://www.telegraph.co.uk/sport/rugbyunion/international/wales/8823153/Rugby-World-Cup-2011-How-cryotherapy-chamber-allowed-Wales-to-come-in-from-the-cold.html Rugby World Cup 2011: How cryotherapy chamber allowed Wales to come in from the cold