Cryotherapy / Whole Body cooling
Our modern society lives by trends. Whether it’s in the field of reading, movies, technology (especially), each period brings its share of novelties. And from a medical point of view, we are no exception.
For those who remember, there was the era of vitamins, massively ingested in order to improve our general health. We then observed another trend concerning anti-oxidant molecules with the purpose to fight against oxidative stress in our tissues and cells. For several years now, a new technique (or technology in some cases) that associates the brutal immersion of the human body in an icy environment has been gradually appearing in our societies. It is however important to recall that all these different ‘waves’ and trending reported above is not entirely unfounded and several serious publications had shown at the time the possibility of having beneficial health effects.
What is cryotherapy?
Cryotherapy, as its name indicates, consists in delivering a treatment using cold. The idea of treating the body with cold is ancient since Hippocrates (460-370 B.C.) already recommended the use of cold to treat certain pathologies and relieve pain.
Moreover, the first studies date back to the 1970’s when Toshima Yamauchi, a Japanese doctor had the idea of using cryotherapy cabins to treat rheumatoid arthritis.
In fact, the name cryotherapy is quite general and covers a whole range of techniques to tackle a variety of diseases. Cryotherapy can even be used in healthy people. In order to clarify this text and to avoid any confusion with other medical techniques (cryotherapy in dermatology for example), when we speak about cryotherapy here, it describes the technique of immersing the whole body in a cold/icy environment. Cryotherapy thus consists in immersing the whole body either in an ice bath, or for a certain amount of time in cold water (cold showers for example), or to use the latest available technologies such as cryotherapy cabins/saunas which start to appear little by little in the cities.
The principle is quite simple, it consists of placing the entire body (except for the head) in an icy environment, brutally and for a certain period of time which can be very brief and gradually become longer . The cold environment can be frozen air (administered with liquid nitrogen), an ice bath (with ice cubes) or simply very cold water. Each method is different and has both positive and negative points. For example, in the case of cryotherapy cabins, the machines emit air cooled to -140° or even -180° for two to three minutes. It is important to protect the extremities of the body (feet, toes, hands and fingers) to avoid lesions potentially associated with this extreme cold. In the case of the ice bath (whole body cooling), the exposure to cold is less intense and can be prolonged for a slightly longer period of time.
The goal from a medical point of view is to provoke a thermal shock on the organism with as a consequence the activation of repair mechanisms at the cellular and tissue level. The first studies on whole body cryotherapy were mainly focused on sportsmen and athletes to study if it was possible to accelerate the healing of muscular injuries and to better manage pain. Subsequently, studies have expanded to focus on general well-being, the immune system, and even possible anti-aging benefits. A recent review of the literature by the Cochrane group did not allow for medically validated conclusions, but other studies are still underway. Medical experts point out that it is difficult to draw formal conclusions because of the great diversity of patients and techniques used. Thus, one cannot compare an ice bath of about ten minutes with a cryotherapy session that lasts 2 to 3 minutes. In the same way, a sportsman does not have the same metabolism as a sedentary man. In the future, it will be important to specify to which groups of individuals this (or these) technique(s) are intended.
Empirical evidence and theoretical perspectives
A recent study by Banfi on the whole-body cooling technique showed a modification of biochemical and physiological parameters in athletes with a reduction of pro-inflammatory molecules and a reduction of the oxidative state. Similarly, in the case of muscle damage (which can occur in an athlete), an increase in the level of muscle repair enzymes was observed.
Another recent study conducted in France showed a positive impact on the cognitive abilities of individuals through the stimulation of brain oxygenation.
Other supposed indications of cryotherapy concern fibromyalgia, nervous breakdown, migraines, aging, improvement of the efficiency of the immune system, management of chronic pain, …
For the moment, even if some results show interesting results for some specific indications such as muscle recovery, management of muscle pain or production of endorphins causing a feeling of well-being, most of the studies are not conclusive for other medical indications. As always in this case, further studies and analyses will have to be carried out to validate the effectiveness (or not) of this technique and especially to specify real medical indications that could benefit from it.
Joanna Rymaszewska, Katazyna M Lion et al. Efficacy of the Whole-Body Cryotherapy as Add-on Therapy to Pharmacological treatment of Depression – A randomized controlled study. Front Psychiatry. 2020. Jun 9 ; 11 :522
Dimitri Theurot, Benoit Dugué et al. Impact of acute partial-body cryostimulation on cognitive performance, cerebral oxygenation, and cardiac autonomic activity. Sci Rep. 2021; 11: 7793.
Carol Garcia, Jay Karri et al. Use of Cryotherapy for Managing Chronic Pain: An Evidence-Based Narrative. Pain and Therapy. 10, pages 81–100 (2021)
Joseph T Costello, Philip RA Baker et al. Whole‐body cryotherapy (extreme cold air exposure) for preventing and treating muscle soreness after exercise in adults. Cochrane Database of Systematic Reviews 2015, Issue 9. Art. No.: CD010789.
Giuseppe Banfi, Giovanni Lombardi et al. Whole-body cryotherapy in athletes. Sports Med. 2010 Jun 1;40(6):509-17. doi: 10.2165/11531940