Cryotherapy

and Martina Feichter, medical editor and biologist

Martina Feichter studied biology with an elective subject pharmacy in Innsbruck and also immersed herself in the world of medicinal plants. From there it was not far to other medical topics that still captivate her to this day. She trained as a journalist at the Axel Springer Academy in Hamburg and has been working for since 2007 - first as an editor and since 2012 as a freelance writer.

More about the experts All content is checked by medical journalists.

In cryotherapy (cold therapy), cold is used to treat various ailments and diseases. The possible uses range from freezing warts to cold compresses and cold chambers. Here you can find out everything you need to know about the possible forms of treatment, when they are carried out and what the risks are.

What is cryotherapy?

The Greek word “cryo” means “cold” - cryotherapy consequently describes a medical treatment using cold. It is one of the so-called thermal therapies and has been used by people since ancient times. The temperature difference between the body and its surroundings or a cold object is used to cool it down as a whole or only in certain places. This essentially has the following effects:

Reduced blood flow: In the first five to ten minutes of local cryotherapy, superficial vessels contract. If the cold has a longer effect, vessels in deeper tissue layers also follow. The blood supply is reduced as a result, which also reduces the accumulation of fluid (formation of edema).
Inhibition of inflammation: Long-term cryotherapy of one to two hours not only reduces blood flow, but also dampens metabolic and inflammatory processes.
Relief of pain: As the tissue cools down, it becomes more and more insensitive to pain - the subjective feeling of pain is reduced. If the skin has a temperature of 15 ° C, it is completely painless.
Change in muscle tension (muscle tone): Although the muscle tension increases briefly in the first few seconds of cryotherapy, it increasingly decreases with an exposure time of 15 to 20 minutes. This can help reduce pain.

Local cryotherapy

Local cryotherapy, for example, is only carried out on a joint or an extremity or over a very small area on an area of skin (e.g. warts). In addition to the above-mentioned effects, the local cold treatment also triggers "remote effects", i.e. changes in the body away from the cooled areas as a result of counter-regulation of the body: Depending on the duration and intensity of the cryotherapy, the blood pressure can increase or the heart rate can decrease (bradycardia). Breathing, muscles and the conduction speed of the nerves are also influenced.

Whole body cryotherapy

In some cases, instead of just exposing one part of the body, the entire organism is exposed to the cold. This can be done in a cold chamber, for example, into which the patient goes for a few minutes (see below).

When is cryotherapy performed?

Local cryotherapy is used to treat superficial changes in the skin, such as warts, acne or blood sponges. It can also be used for injuries (e.g. bruises, strains, broken bones), tennis elbow, heel spurs, inflammatory diseases of the musculoskeletal system and rheumatism.

If a selected tissue area is deliberately surgically destroyed using extreme cold (e.g. using a cryoprobe with liquid nitrogen), this is called icing (cryosurgery). In addition to harmless warts, it can also be used to treat rapidly growing scar tissue, skin cancer (and precursors), other tumors (such as prostate cancer) and small areas of heart muscle tissue in the case of cardiac arrhythmias.

Whole-body cryotherapy can also help with a wide variety of diseases. These include ligament, joint and muscle injuries, joint and spinal column diseases caused by wear and tear (such as osteoarthritis), rheumatic diseases (such as Bechterew's disease), spastic muscle tension as well as fibromyalgia, neurodermatitis and psoriasis (psoriasis). The comprehensive pain-relieving and anti-inflammatory effects of whole-body cold therapy can also be useful after operations.

What do you do with cryotherapy?

The procedure depends on whether only a certain area of the body (locally) or the entire body is being treated with cold.

Local cryotherapy

Local cryotherapy can be performed using many different media (objects). Ultimately, all of them lead to a cooling of the tissue due to the removal of heat. The possible "coolants" differ in their own temperature, the duration of use and the areas of application. Examples:

Ice granules (around -0.5 to -1.0 ° C) in a cloth bag that is placed on the skin: The skin temperature drops by 5 to 8 ° C within 20 minutes.
Plastic ice packs with a mixture of water and ice (approx. 0 ° C): The skin temperature is only approx. 10 ° C after 20 minutes.
Partial ice bath (approx. 1 to 12 ° C), for example in an arm or foot bath.
Ice roller with a handle (about -0.5 to -1.0 ° C) for dabbing or rubbing the skin, for example after previous lymphatic drainage.
Cold compresses (around 1 to 3 ° C): are easily deformable and can be optimally adapted to joints, for example.
Gel packs (around -15 to -20 ° C): A dry kitchen towel between the skin and the gel pack prevents superficial frostbite.
Cold spray (approx. -0.5 to -1.0 ° C): The evaporation cold has a strong cooling effect, but only for a short time. Cold sprays are mostly used as a first measure for acute sports injuries.
Cold gases (cold air with a temperature of -30 ° C or nitrogen with up to -160 ° C): These are used in particular for rheumatic complaints.
Cold compress (around 0 to 15 ° C): Known as an old home remedy. A cold wrap can be made, for example, with kitchen towels soaked in ice water or with cool quark.
Cotton swabs with liquid nitrogen (down to -195 ° C): is soaked in liquid nitrogen before use and then gently pressed onto the area to be frozen (up to a maximum of 45 seconds)
Cryoprobe (down to -195 ° C): Liquid nitrogen is passed through the probe. The area touched by the probe tip freezes and the tissue dies. The cold probe can be used on the skin or during operations inside the body.
Open spray method with liquid nitrogen (down to -195 ° C): Liquid nitrogen is sprayed at high pressure onto the area to be frozen. However, the treatment area cannot be narrowed down as well as with cotton swabs or cryoprobe.

Whole body cryotherapy

In addition to local cryotherapy, whole-body therapy is also used. Here, too, there are various options for exposure to the cold:

Cold chamber (around -70 to -120 ° C): The patient puts on bathing suits when going into the cold chamber. Areas that are very sensitive to cold (hands, feet, face and ears) are covered. The treatment in a cold chamber takes a maximum of three minutes, but can be repeated several times a day.
Ice plunge bath (approx. 1 to 12 ° C): full bath in cold water filled with ice cubes. Exposure for several minutes, then resting in a preheated bed. The ice plunge bath is often carried out in combination with physio treatments.

Depending on how cold the cold stimulus is, accompanying symptoms can occur - from feeling cold to burning or stabbing pain. As a rule, however, they only last a short time.

Cold baths, like cold showers, fall within the scope of hydrotherapy. Read more about it here.

Cold treatment as a home remedy

Some cooling applications are carried out on their own as quick home remedies. For example, anyone who has bruised their knee can use ice cubes wrapped in a cloth, a chilled grain pillow (cherry stone pillow) or a cold washcloth (damp and cool forehead compress) as a first aid measure. Dip the washcloth in cold water, wring it out and place it on top. This can relieve the pain and prevent the tissue from swelling and bruising. The home remedies can also have beneficial effects on headaches.

A cold or cool quark poultice can also provide quick relief for bruises - as well as for sprains and painfully inflamed joints (as a result of osteoarthritis). You can find out more about the effect and application of this home remedy in the article Quark wrap.

Cold wraps on the neck can relieve a sore throat, you can either use quark or the well-known Prießnitz neck wrap. You can read everything you need to know about it in the article Neck Wrap.

Fever can be gently reduced with cool calf compresses. The damp cold (or coolness) evaporates on the patient's warm skin and removes heat from the body. How to properly prepare and use the compresses and when they are not suitable can be read in the article Leg compresses.

Another fever-lowering home remedy for cold treatment is the pulse wrap. To do this, dip cotton towels in cold water, wring them out and wrap them around the wrists and ankles.

Also with a fever, a cold compress is sometimes placed around the chest. This can also help against stuck bronchial mucus, for example. You can find out more about the effect and application of this thermal treatment in the article Breast Wrap.

What are the risks of cryotherapy?

The risks depend in part on the type of cryotherapy. For example, using ice packs, ice compresses, cold spray, ice diving, etc. for too long or incorrectly can lead to frostbite.

In some cold applications, direct skin contact must be avoided, for example with ice compresses and ice packs: A layer of fabric between the compress / bag and the skin prevents frostbite.

In cryosurgery procedures, for example by the dermatologist, blisters and infections rarely occur after freezing. Pigment-forming cells (melanocytes) are usually destroyed in the treated area, so that the skin color remains there in the long term.

If a patient has what is known as cryoglobulinemia, there is an increased amount of special proteins (IgM autoantibodies) in their blood. They become active at low temperatures and cause undesired cross-linking of red blood cells, which then dissolve (hemolysis). Therefore, if cryoglobulinemia is known, no cold therapy should be carried out.

Cryotherapy must also be avoided in the case of cold urticaria. In this condition, the skin reacts to exposure to cold by forming itchy wheals.

Cryotherapy is also unsuitable for people with circulatory disorders such as Raynaud's syndrome (paroxysmal reduced blood flow to the fingers or toes).The same applies to sensory disorders, i.e. if someone can only perceive temperature stimuli (cold, warmth) to a reduced extent (e.g. as a result of diabetes).

You can read more warnings about special applications such as neck or calf wraps in the respective articles.

What do I have to consider after cryotherapy?

The rest of the body should be kept warm during and after a local cold application. Warmth is also advisable after whole-body cryotherapy (e.g. resting in a preheated bed).

After a local application of cold (e.g. at the dermatologist's), you should keep the treated area as clean as possible and protect it with a plaster or bandage. If blisters form on your skin, do not prick them! That would encourage colonization with germs. It is better to consult with the doctor if he has not already told you in advance what to do if a blister forms.

In general, the following applies: Follow the instructions of the attending physician or therapist on what you should observe after cryotherapy (e.g. regular bandage changes or application of an antiseptic ointment).

Tags: unfulfilled wish to have children hospital skin