Whole Body Cryotherapy
Original Editor - Elvira Muhic
Top Contributors - Elvira Muhic, Lucinda hampton, Kim Jackson, Angeliki Chorti, WikiSysop and Tony Lowe
Introduction
Whole body cryotherapy (WBC) is the therapeutic application of extremely cold dry air, usually between −110°C and −140°C.[1] The use of WBC for musculoskeletal conditions is growing. WBC is increasingly used for its analgesic, anti-inflammatory, and antioxidant effects. [2] Furthermore, WBC shows promise in recovery from injury in athletes [3] and providing relief in osteoarthritis and fibromyalgia patients. [4] [5] Evidence is less robust with regards to efficacy in conditions like chronic pain syndromes and osteomyelitis.[6]
Cryogenic Chambers
WBC is usually performed in a cryogenic or cryotherapy chamber, ensuring appropriate treatment conditions – temperature and humidity. While in the chamber, the patient must have regular contact with the physiotherapist, usually through glass doors and speakers. In an emergency situation, there is an installed special alarm device that allows the patient to call for help. Also, the door is built so it can be easily opened by the person inside. The chamber's interior is lined with a waterproof material. Special attention is given to walls which do not have any sharp protruding metal parts that can cause very unpleasant feelings in contact with patient's skin. [7]
- Two-stage cryogenic chamber
Two-stage cryogenic chamber consists of one or two antechambers where the temperature is approximately -60°C, and a main chamber in which the temperature is maintained within the range -110°C to -160°C (depending on the coolant).[7] - Cryochamber with cool retention effect
Cryochamber with cool retention effect is cooled with a mixture of liquid nitrogen and liquid oxygen in the proportions of atmospheric air. The air is pumped from the external tank and sprayed by specially prepared sprinklers. This design is based on the phenomenon of cold retention in a basin, which reduces the importance of thermal insulation and elimination of the antechamber, reducing the cost of materials.[7] - Cryobarrel (cryosauna)
Cryobarrel (cryosauna) is a cabin for one person where the patient is immersed in the cold vapours up to the arms and breaths air from the room with the head located outside the reach of extremely low temperatures. It has a swinging door which opens under the pressure of the body, and contact with the patient is very good.[7] - Cryochamber
Cryochamber with a compressor cooling system uses air as a coolant. The chamber consists of two antechambers with a temperature of -10°C and -60°C, and the chamber proper with a temperature of about -100°C. The chamber is isolated from the ground, so it can be installed easily either indoors or oudoors. [7]
Contraindications
Adverse events appear to be rare with regards to the extent to which WBC has grown globally. The scientific evidence of serious adverse events related to the use of WBC is still low to date. [8]
Absolute Contraindications
The following contraindications are reported for the application of cryogenic treatment as absolute contraindications to cryostimulation:
- Cold intolerance
- Cryoglobulinaemia
- Cryofibrinogenemia
- Raynaud disease
- Cold utricaria
- Open wounds and ulcers
- Gangrenous lesions
- Thromboembolic changes and inflammation in the venous system
- Agammaglobulinemia
- Central nervous system disease
- Sympathetic neuropathy
- Hypothyroidism
- Local blood flow disturbances
- Significant anaemia
- Mental disorders, which may prevent adequate co-operation with the patient in the chamber
- Emaciation and hypothermia
- Cancer
- Printzmetal syndrome
- Unstable coronary artery disease
- Valve disorders: aortic valve stenosis and mitral valve stenosis
- Diseases of the myocardium or the mitral apparatus
- Arrhythmia at a rate higher than 100 strokes per minute
- Severe forms of exertional angina pectoris and spontaneous angina
- Venous blood leaks in the lungs
- Acute respiratory diseases of various origin
- Effects of drugs, especially antipsychotics and alcohol.[7]
Relative Contraindications
Some relative contraindications also exist concerning participation in the cryogenic treatment. These include age above 65, venous thrombosis and a history of peripheral arterial embolism, excessive emotional lability, expressed inter alia, in excessive excitability.[7]
Conclusions
Controlled studies suggest that WBC may influence inflammatory mediators, antioxidant capacity, and autonomic function during sporting recovery. Some evidence exists that WBC improves the perception of recovery and soreness after various sports and exercise, this does not seem to translate into enhanced functional recovery. Further research is needed meanwhile, athletes should remain perhaps use less expensive modes of cryotherapy, such as local ice-pack application, as they offer comparable physiological and clinical effects to WBC. [9]
WBC seems to be a versatile adjuvant treatment for a wide range of conditions of rehabilitation interest. Research is still needed to fully understand the mechanisms of analgesic effect and potential actions on pain pathways, along side studies on long-term effects and potential uses in chronic pain conditions. [10]
References
- ↑ Selfe J, Alexander J, Costello JT, May K, Garratt N, Atkins S, Dillon S, Hurst H, Davison M, Przybyla D, Coley A, Bitcon M, Littler G, Richards J. The Effect of Three Different (-135°C) Whole Body Cryotherapy Exposure Durations on Elite Rugby League Players. PLoS One. 2014 Jan 29;9(1):e86420.
- ↑ Jeyaraman M, Migliorini F, Balaji S, Ramasubramanian S, Jayakumar T, Jeyaraman N. Whole-body cryotherapy in orthopaedics: current concepts. Eur J Orthop Surg Traumatol. 2024 Apr 17; 34:2245-54.
- ↑ Lombardi G, Ziemann E, Banfi G. Whole-Body Cryotherapy in Athletes: From Therapy to Stimulation. An Updated Review of the Literature. Front Physiol. 2017 May 2;8:258.
- ↑ Rivera J, Tercero MJ, Salas JS, Gimeno JH, Alejo JS. The effect of cryotherapy on fibromyalgia: a randomised clinical trial carried out in a cryosauna cabin. Rheumatol Int. 2018 Dec;38(12):2243-2250.
- ↑ Klemm P, Becker J, Aykara I, Asendorf T, Dischereit G, Neumann E, Müller-Ladner U, Lange U. Serial whole-body cryotherapy in fibromyalgia is effective and alters cytokine profiles. Adv Rheumatol 2021; 61:3.
- ↑ Mire G. Rapid Communication - Innovations in Cryotherapy and Heat Therapy for Sports Rehabilitation. J Phys Ther Sports Med. 2024; 8(5): 224.
- ↑ 7.0 7.1 7.2 7.3 7.4 7.5 7.6 Lubkowska A. Chapter 7. Cryotherapy: Physiological Considerations and Applications to Physical Therapy, Physical Therapy Perspectives in the 21st Century - Challenges and Possibilities. In: Bettany-Saltikov J, Paz-Lourido B.(Ed.). InTech, 2012.
- ↑ Legrand FD, Dugué B, Costello J, Bleakley C, Miller E, Broatch JR, Polidori G, Lubkowska A, Louis J, Lombardi G, Bieuzen F. Evaluating safety risks of whole-body cyrotherapy. Eur J Med Res. 2023 Sep 28;28(1):387.
- ↑ Bleakley CM, Bieuzen F, Davison GW, Costello JT. Whole-body cryotherapy: empirical evidence and theoretical perspectives. Open Access J Sports Med. 2014 Mar 10:25-36.
- ↑ Alito A, Verme F, Mercati GP, Piterà P, Fontana JM, Capodaglio P. Whole Body Cryostimulation: A New Adjuvant Treatment in Central Sensitization Syndromes? An Expert Opinion. Healthcare (Basel). 2024 Feb 25;12(5):546.