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The Benefits of Below-Freezing: A Deep Dive into Cryotherapy

Over the past few years, cryotherapy has become an up-and-coming trend used by athletes and celebrities alike. Yet, there is research suggesting that cryotherapy can confer copious health benefits. Today I wanted to share my deep dive into whole-body cryotherapy so that you can consult with your physician and decide if that may be worthwhile exploring as a supplemental treatment for an invisible illness.

Cryotherapy literally means cold therapy. It is a medical treatment that involves short exposures of extreme, cold air, often below -166°F (-110°C). These low temperatures are reached with the aid of liquid nitrogen. Whole-body cryotherapy was invented in 1978 by Professor Toshiro Yamauchi, who noticed that the combination of cold and physical exercise was beneficial for the clinical outcomes of treatments received by the rheumatoid arthritis patients. It was originally marketed as therapeutic for rheumatic conditions, but the list of ailments that cryotherapy claims to have therapeutic effects on has expanded vastly.

The concept of cryotherapy dates back to 2500 B.C. when Egyptians used cold to treat injuries and inflammation. In the modern era, between 1845 and 1851, Dr. James Arnott of Brighton, England reported the benefits of localized cold application for headaches and neuralgia, among other conditions. He also utilized a salt and crushed ice solution at below-freezing temperatures to freeze breast, cervical, and skin cancers, observing shrinking of the tumors and decreasing pain. The first clinical application of liquid air, which exists at -310°F (-190°C) by Dr. Campbell White through a swab, spray, and brass roller device as a means to treat diverse skin conditions. Liquid nitrogen became commercially available around 1950 and has been introduced in cryosurgical apparatuses in dermatology and oncology.

Whole-body cryotherapy was conceptualized with the same principles of local cryotherapy such as ice packs in mind. Icing a region of the body lowers tissue temperatures, dampening pain and constricting blood vessels to reduce inflammation. Localized treatments are typically used for acute injury situations, whereas whole-body cryotherapy is sought for chronic conditions or general reduction of muscle pain and fatigue in athletes.

There are two main forms of whole-body cryotherapy: cryosaunas and cryochambers. A cryosauna encases patients from the shoulders down in a metal tube in which temperatures drop to -256°F, whereas a cryochamber is essentially a walk-in freezer in which temperatures range from -112 to 180°F. Patients are typically exposed to those low-temperature environments for 3-5 minutes. this induces major physiological changes within a short timeframe, including vasoconstriction of blood from the limbs, a reduction of inflammatory mediators, and the release of fight-or-flight hormones causing an endorphin boost.

The following is a summary of available research regarding the potential effects of cryotherapy for the treatment of various chronic medical conditions:

1. Rheumatoid Arthritis

Rheumatoid Arthritis (RA) is an autoimmune disease that primarily affects the joints, causing them to be painful and swollen. Three studies of the use of whole-body cryotherapy on RA patients have suggested that it had a positive effect on measures of inflammation, pain, disease activity score, fatigue, and morning stiffness. Another study of 64 female RA patients focused on rehabilitation programs that involved traditional electromagnetic and instrumental therapy as compared to cryotherapy. Both groups showed improvement after 3 weeks of therapy and 3 months after completing rehabilitation, but the group that received cryotherapy treatment actually experienced better outcomes than the traditional rehabilitation group. Although larger-scale studies are needed, there is significant evidence that cryotherapy helps to alleviate pain and inflammation in RA patients.

2. Multiple Sclerosis

Multiple Sclerosis (MS) is a condition of the central nervous system that can result in muscular spasms, coordination and balance issues, neurological and psychological symptoms, and fatigue. A review of cryotherapy studies for MS patients demonstrated that it can ameliorate spinal mobility, fatigue, and functionality while also increasing uric acid levels, which is beneficial because lower uric acid levels are associated with longer disease duration and relapse. One of the investigations revealed that MS patients that had previously reported high or low levels of fatigue both reported significant improvements in their functional status in addition to levels of fatigue after 10 whole-body cryotherapy sessions. Early research has supported the idea that cryotherapy may be used as short-term adjuvant therapy to lessen the symptoms and biological markers of MS. However, additional investigations are crucial to determine whether or not whole-body cryotherapy can confer long-term health benefits to MS patients.

3. Fibromyalgia

Fibromyalgia is a chronic condition characterized by widespread musculoskeletal pain accompanied by fatigue, sleep, memory, and mood issues and is believed to affect the way the brain processes pain signals. A study of 100 patients with fibromyalgia examined the effect of whole-body cryotherapy on the health status of subjects after 15 sessions in comparison to a control group. The results revealed that cryotherapy had a positive effect on all the quality of life indexes, likely due to the known direct effect of cryotherapy on the balance between pro- and anti-inflammatory mediators that have roles in the modulation of pain. A different study of patients with fibromyalgia ultimately had similar results, and the researchers actually found that the self-reported improvements after 15 sessions over a period of three weeks lasted longer than a week after the final cryotherapy session, which was a better outcome than expected. Thus, the observed effect was pronounced and long-lasting and will likely lead to further studies. More information is certainly needed to better understand the effects of whole-body cryotherapy on disease markers of fibromyalgia, but preliminary studies appear to be quite promising.

4. Ankylosing Spondylitis

Ankylosing spondylitis (AS) is an inflammatory disease and rare type of arthritis that causes pain and stiffness in the spine and regions of the body where the tendons and ligaments attach to bones, and it can manifest in systemic issues with the eyes, skin, bowel, and lungs. One study of whole-body cryotherapy among AS patients sought to determine whether cryotherapy should be utilized as adjuvant therapy for AS in addition to kinesiotherapy. Patients enrolled in the study were assessed through standardized clinical measures of pain, fatigue, mobility, and functionality from two AS indices, and patients that underwent 10 whole-body cryotherapy sessions demonstrated significant improvement in both the BASDAI and BASFI indices, as well as in pain intensity and spinal mobility parameters. Patients with AS are also known to be at a higher risk for cardiovascular morbidity and mortality, and a different study of whole-body cryotherapy demonstrated that measures of hsCRP (a marker of inflammation associated with the presence of heart disease) and CER (ceramides, which increases the likelihood of heart attack and stroke) decreased significantly in AS patients after 10 cryotherapy sessions. The researchers also observed a decrease in oxidative stress with whole-body cryotherapy, meaning that systemic inflammation is reduced, and a study of healthy subjects resulted in similar findings.

Cryotherapy may also help patients with non-rheumatic or neurological conditions. Due to the fact that the ultra-cold temperatures in whole-body cryotherapy cause the release of adrenaline, noradrenaline, and endorphins, studies suggest that cryotherapy is effective as a short-term treatment for mood disorders such as anxiety and depression. It has also been hypothesized that whole-body cryotherapy could help prevent dementia and Alzheimer's disease because of its anti-oxidative and anti-inflammatory effects.

Whole-body cryotherapy is still in need of significant research in order to validate the significant health benefits that it claims to have. The limitations with the existing studies are that they are primarily short-term investigations, meaning that extensive months and years-long studies should be pursued to elucidate its effects. Additionally, many of the studies were conducted with small sample sizes, necessitating well-designed investigations that incorporate larger groups of patients in order to acquire stronger correlations.

Unfortunately, whole-body cryotherapy does come with risks. It is recommended that people with poorly controlled high blood pressure, major heart or lung disease, poor circulation, allergy symptoms triggered by cold, and neuropathy in the legs or feet avoid cryotherapy treatments. Local irritations and skin burns have been reported, although this is easily avoidable with careful supervision.

Overall, it appears that whole-body cryotherapy can have a variety of beneficial effects on patients with and without chronic conditions. I expect that as more data are published that examine the health outcomes of cryotherapy, it will become even more popular. I am certainly intrigued by the purported benefits of whole-body cryotherapy, and perhaps I will try it soon and write about my experience.

Stay tuned for more comprehensive analyses of alternative therapies for invisible illnesses soon!

Next week's blog: an interview with a special guest (!!!) about living with Ankylosing Spondylitis, from their diagnosis journey to their outlook on life.

*Disclaimer: This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or another qualified health provider with any questions you may have regarding a medical condition or treatment.


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