Cryotherapy Guidelines

Developed by:
A. Hoens, Physical Therapy Knowledge Broker (UBC Department of Physical Therapy, Physiotherapy Association of BC, Vancouver Coastal Health Research Institute, Providence Health Care Research Institute)
M. Paul, Clinical Nurse Educator (OASIS Program, Vancouver Coastal Health)

When, Why, and How

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Key Considerations

Inflammation, edema and swelling

These terms are NOT synonymous

• Each symptom is associated with a different phase in the ‘continuum of resolving inflammation’
• The specific clinical problem and the desired mechanism of action should guide the selection of the intervention
  

Is there an optimal ‘dosage of cryotherapy?’

There is no optimal dosage that is ideal for all body locations. Consider the nature of the tissue when icing:

• The duration of icing for a small area with minimal fat and muscle, such as a finger, would be significantly less (~3‐5 minutes) than that for a larger area and deeper tissue such as at the hip (~20 minutes)
• Intermittent icing (e.g., 10 minutes on: 10 minutes off) may be more effective for management of acute inflammation than icing for 20 consecutive minutes

Type/duration of cooling dependent upon the goal

Cooling to reduce pain will likely require less intense (ice pack) and shorter durations (5 minutes)

• Cooling to reduce metabolism of uninjured cells will likely require more intense cooling (ice bath or ice chips in a wet towel) for longer durations (10‐15 minutes)
• The hierarchy of the efficiency of cooling from most to least: ice‐water immersion, crushed ice, frozen peas and gel pack