Cryotherapy is a rising trend offered by spas and wellness centers. It’s gaining popularity for its supposed beneficial effects on eczema, depression, anxiety, exercise recovery, and more. Studies support some of these uses but also warn about important risks. This article reveals the benefits, side effects, and limitations of whole body cryotherapy (WBC).
What Is Whole Body Cryotherapy?
Cryo comes from the Greek word cryo, or (κρύο), and means cold. Cryotherapy refers to any form of medical treatment that relies on cold exposure. Whole Body Cryotherapy (WBC) is most commonly utilized in the field of sports medicine as a mode of muscle recovery and pain relief.
Whole Body Cryotherapy (WBC) involves immersing the body in a cold chamber, which emits vapors at extremely low temperatures ranging from -110℃ to -160 ℃ (around -160℉ to -220℉). This is usually done for an interval of 2 to 4 minutes [1, 2].
When in the cryogenic chamber, individuals are undressed with the exception of underwear, socks, and gloves to protect the extremities .
- Reduces pain and inflammation
- Improves joint function
- May help with mental disorders
- May support exercise recovery and performance
- May cause frostbite
- May increase blood pressure
- May impair breathing
- Long-term safety is unknown
What Is a Cryo-chamber?
The cryo-chamber is an individual, tube-shaped enclosure that covers a person’s body with an open top to keep the head at room temperature. The frigid environment is generated by the emission of cool air, but some cryogenic chambers generate these temperatures by forced convection, which involves pumping the cool air from an external circuit [4, 4].
Mechanism of Action
The fundamental change in the body caused by whole body cryotherapy is the reduction of tissue temperature .
The change in tissue temperature also causes a reduction in core body temperature. This sensory shock leads to an activation of the autonomic, or unconscious, nervous system. This is characterized by rising norepinephrine levels, increased blood pressure, and heart rate variability [6, 7].
When the body is exposed to extreme cooling, the blood vessels are constricted and reduce blood flow to the areas of inflammation. Once outside of the cryogenic chamber, the vessels expand, and an increased presence of anti-inflammatory proteins (IL-10) are found in the blood [8, 9].
Two literature reviews on whole body cryotherapy support the claims that the induced cold body temperatures can help reduce pain, inflammation, and improve recovery [10, 11].
Health Benefits of Cryotherapy
In three studies, ranging from 10 to 45 subjects, cryogenic chamber treatment increased the presence of anti-inflammatory proteins (cytokines IL-6, IL-1Ra, and IL-10) and decreased pro-inflammatory cytokine levels (IL-1α). These changes lasted longer for those who completed more cold chamber sessions [8, 12, 13].
In a study of 12 athletes, a reduction in inflammatory proteins (tumor necrosis factor α) and improvements in tennis strokes were recorded among the cryotherapy group .
WBC treatment increased the number of anti-inflammatory cytokines (IL-1Ra and IL-10), while pro-inflammatory components (IL-1β and CRP) decreased in two studies following 11 and 18 young athletes. This protein profile in combination with restricted blood flow helped reduce exercise-induced inflammation [15, 16].
Another controlled study examined the effects of WBC prior to exercise. These 18 athletes also showed a decreased presence of pro-inflammatory proteins (IL-1β in the blood after exercise .
Prolonged inflammation can lead to impaired blood flow, increased pain, and less mobility .
2-3) Pain Reduction and Joint Mobility
Cryotherapy may reduce pain by decreasing inflammation, improving antioxidant balance, and increasing beta-endorphins .
In two trials of 176 elderly men with chronic back pain, those receiving consistent cryogenic chamber experienced a significant pain reduction and improvements in mobility after a 3-month period [20, 19].
In a randomized study, 30 individuals with a frozen shoulder (adhesive capsulitis) engaged in either physical therapy treatment or standard therapy in conjunction with cryogenic chamber treatment. There was a significant improvement in shoulder mobility, rotation, and functionality in the whole body cryotherapy group .
In one trial, there was a significant improvement in post-exercise pain relief after 5-day cryosauna treatment. However, the results are not wholly supportive of its use as recovery enhancement .
42 patients with lower back pain engaged in cryogenic chamber treatment in conjunction with physical therapy exercises. Pain sensation and spinal mobility improved, but only in the male group .
4) Rheumatic Diseases
Rheumatic diseases cause chronic pain and inflammation in joints and muscles, the most well-known of which is rheumatoid arthritis.
In three studies of 168 rheumatoid arthritis patients, whole-body cryotherapy brought significant improvements in [24, 25, 26]:
- Pain reduction
- Disease activity
Cryo chamber treatment reduced pain and the need for medication in 50 patients with different forms of arthritis. Additionally, well-being and mobility of the patients improved .
WBC significantly reduced pain and disease activity in two studies of 70 patients with varying rheumatic disorders. Patients also had higher functionality in their joints, and pain reduction lasting up to 2 months (especially in women) [28, 29].
Ankylosing Spondylitis (AS) is a form of arthritis in the spine .
Two controlled studies assessed the effectiveness of the cryo chamber in comparison to normal physical therapy techniques in AS patients. The results showed significant improvements in mobility and disease activity [31, 32, 33].
A review of all WBC treatments of rheumatic diseases indicates that cryo chambers should be used as a complementary approach to prescribed treatment measures, such as corticosteroid and nonsteroidal anti-inflammatory medication .
5) Multiple Sclerosis Symptoms
Multiple sclerosis (MS) is characterized by the degeneration of nerves by one’s own immune system (autoimmune), and it’s partly induced by oxidative stress. Symptoms include, but are not limited to :
- Weak muscles, fatigue, and painful spasms
- Numbness and dizziness
- Mood changes and depression
In two studies, 50 patients diagnosed with MS were treated with 10 cold chamber sessions. Cryosauna treatment significantly reduced oxidative stress [36, 37].
In a study of 48 MS patients, cryotherapy sessions improved functional status and fatigue. Those with higher fatigue levels experienced a more significant change .
Whole-body cryotherapy improved exercise ability and fatigue in another trial of 24 MS patients .
6) Oxidative Stress
In a randomized control study of 32 healthy males, cryo chamber treatment decreased the markers indicating oxidative stress and increased the presence of antioxidants in the blood .
In two studies of 50 multiple sclerosis patients, 10 cryosauna treatments significantly reduced oxidative stress [36, 37].
One study involving 9 kayaker women found that antioxidant activity is higher when cryogenic treatment is practiced after training .
After 20 WBC treatments, there was an increase in superoxide dismutase in 30 healthy volunteers. However, there was also a decrease in glutathione and GPx activity, which assist in breaking down harmful free radicals .
Fibromyalgia is a disorder that can lead to severe pain in the muscles and bones, fatigue, and difficulty sleeping .
In a controlled study, 100 patients with fibromyalgia continued routine medication plans, while half were also treated with whole body cryotherapy. The WBC group reported significant improvements in quality of life .
Another controlled study examining 24 patients with fibromyalgia reported similar improvements in quality of life, lasting for at least one month after treatment .
The above results are promising, but they are mostly based on subjective measures. Further research should test the objective effects of cryotherapy in fibromyalgia patients.
8) Anxiety and Depression Treatment Support
In one study, 23 adults suffering from depression received whole body cryotherapy sessions while continuing their prescribed medication plan. WBC treatment reduced all symptoms of depression, except for day-night mood fluctuations. This was a preliminary trial lacking a control group .
In a study of 60 patients over 3 weeks, WBC improved the symptoms of depression and anxiety and increased overall life satisfaction when added to standard treatment [47, 48].
Cryotherapy appears to be a promising complementary approach to anxiety and depression, but well-designed trials are needed to verify its safety and effectiveness.
No valid clinical evidence supports the use of cryotherapy for any of the conditions in this section. Below is a summary of up-to-date animal studies, cell-based research, or low-quality clinical trials which should spark further investigation. However, you shouldn’t interpret them as supportive of any health benefit.
9) Exercise Recovery
Whole-body cryotherapy is being studied for exercise recovery among athletes, due to its ability to reduce pain and inflammation. Studies have shown varying results on the effectiveness of WBC in muscle and joint recovery.
In a randomized crossover trial of 11 athletes, those athletes who engaged in cryotherapy performed better on an exercise test, indicating quicker muscle regeneration. In addition, WBC increased blood-oxygen levels in the thigh and decreased heart rate and perceived exertion .
Nine trained runners regained maximal muscle strength and sensation post-high-endurance exercise after the first cryo chamber session. In comparison to far infrared and passive methods, the cold chamber provided the most effective recovery .
One study monitored for signs of overtraining in 10 elite swimmers that performed WBC daily for 2 weeks. They presented better sleep patterns, less fatigue, and increased exercise capacity .
Ankle-localized cryotherapy in 23 participants led to slower conduction of nerve signals in the treatment site and improvements in pain threshold and tolerance .
However, a study of 14 soccer athletes found no indicators of improvement after a single session in the cryo chamber .
In another trial, 64 young adults tried various recovery methods, including whole body cryotherapy, passive recovery, and cold-water immersion. After the uniform exercise routine, the study found very low-quality evidence for a reduction in muscle soreness and pain sensation within the WBC group .
36 subjects were analyzed for muscular force, extension, and soreness in their left knee after performing an exercise routine the day before and engaging in 2 cold chamber sessions. However, there was no measured improvement in knee function or in muscle soreness .
When considering the use of cryotherapy, it is important to understand the distinction between subjective recovery and functional recovery. In a 2014 review, it was found that cryotherapy led to a reduction in pain and soreness (subjective sensations), but produced little evidence in actually repairing the tissue (functional) .
A 2015 Cochrane review considered the experimental guidelines, study groups, and collected evidence from major whole body cryotherapy studies. The review found that there is insufficient evidence in its effects on decreasing muscle pain and soreness. It also criticizes the lack of focus on female subjects or elite athletes in these studies .
10) Exercise Performance
The effects of 10 sessions of whole-body cryotherapy on aerobic and anaerobic exercise capacity of 30 subjects (15 m/15w) were examined. The treatment improved only the anaerobic capacity and only among male participants .
The effects of cryotherapy on exercise performance appear to be weak and require further investigation.
In a study of 15 active young men, 10 sessions of whole-body cryotherapy increased white blood cell count (especially lymphocytes and monocytes) and interleukin-6, a protein that has both pro and anti-inflammatory effects .
More research is needed to evaluate the effects of cryotherapy on the immune system.
12) Eczema (Atopic Dermatitis)
In a study of 18 patients with eczema, WBC reduced dermatitis and skin dehydration. Women showed more improvement than men. However, one patient stopped due to a worsening condition .
Due to conflicting results, well-designed studies should investigate the effects of WBC on the skin further.
13) Restless Leg Syndrome
In a randomized study of 35 patients with restless leg syndrome, whole body cryotherapy, in comparison to localized cryotherapy, led to significant improvements in symptoms and quality of life. Further research is warranted .
Cryotherapy Side Effects
Blood Pressure and Heart Function
In 25 young male participants, cryo chamber treatment increased blood pressure immediately after each session and decreased heart rate .
After 21 cryo chamber sessions, a significant rise in blood pressure was recorded in another study. Although there were no long-term effects in either study, it is suggested that patients who have a heart condition or issues with blood pressure should be cautious with cold chamber exposure .
One study followed 39 participants, 13 of whom had untreated hypertension. WBC caused strong cardiovascular changes in both groups, but adaptations after were inconsistent. The disparity suggests to caution against WBC for those with cardiovascular conditions .
A 56-year-old patient experienced a stomach aortic dissection (tear to the inner wall of a large artery) after 15 cold chamber sessions. Given no previous history of heart complications, this case could be considered a severe side effect of cryotherapy .
In 25 young men engaged in 3 months of WBC, there was a visible decrease in the breath rate immediately after treatment that became more significant over the next 3 months. WBC may cause minor constrictions in these pathways and should be used with caution .
A 63-year-old male experienced a case of transient global amnesia (a brief loss of memory) after engaging in whole-body cryotherapy. Although the man fully recovered, this case illustrates there are insufficient studies and presents the possible risk of cryotherapy on cognitive function .
Experts from the FDA have warned about the potential side effects from nitrogen gas vapors in cryo-chambers. They underlined the fact that cryotherapy is not studied well enough, so it’s essential to consult with your doctor before trying it out .
Other Types of Cryotherapy
Cryotherapy generally refers to the application of cold temperatures on the body for therapeutic treatment. Cryotherapy can be used in dermatology treatment, surgery, and even refers to ice bath immersion and ice pack application to combat muscle soreness [67, 68].
Localized cryotherapy also produces a significant decrease in inflammation in other parts of the body, such as the mouth and lips .
Cryosurgery is often a minimally invasive surgical procedure. It uses cold probes to kill infected and cancerous cells in the organ systems, especially in the kidney and prostate [70, 71, 72].
Limitations of Whole-Body Cryotherapy
Although whole-body cryotherapy presents the largest temperature gradient, its ability to cool the body is compromised by air’s poor conduction ability .
For instance, one randomized crossover study following 10 patients found that cold-water immersion led to greater reductions in the skin, deep tissue, and core temperature in comparison to whole-body cryotherapy .
However, another study states that the cold chamber and cold-water immersion lead to remarkably similar reductions in both muscle and core temperature readings. Additionally, whole body cryotherapy lowered skin temperature more significantly than cold water immersion .
Studies also found that cryo chamber treatment leads to a lower recorded body and skin temperature in female participants in comparison to males. Men may experience greater increases in blood pressure after exposure in comparison to women .
How, Where, and How Often
Keep in mind that cryotherapy is still in the investigational phase, and it’s not approved by the FDA. Speak with your doctor before trying it out and make sure the procedure is run by a qualified healthcare professional.
Whole-body cryotherapy must always be performed under careful supervision. Be sure to wear underwear, socks, and a headband. Never enter the chamber with any wet clothing – even sweat can lead to frostbite .
The optimum time for each session should be around 2 minutes, but the evidence is weak. Anything less will not be enough to induce the biological changes associated with body cooling .
It is important to take precautions before entering the cryo chamber. A study following 14 athletes advised prior screening because of the incidence of skin damage in one of the participants. Also, one review states that the WBC-induced increase in blood pressure is a reason for prior screening, especially for those suffering from cardiovascular disorders [78, 10, 62].
Traditional means of cold exposure may be a safer starting point with equally promising health perks.
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Some users have shared that whole body cryotherapy is effective in managing chronic pain issues, such as rheumatoid arthritis. The ability to overcome the pain in the long term was described to increase with each session. Users have also described the treatment as revitalizing, aiding in sleep and providing energy throughout the day.
Other users have provided cautionary tales of the cold chamber. Some patients reported exaggerated pain sensations after exposure to extreme temperatures.
Others state that the shock of sub-Arctic temperatures is almost unbearable. Another point of criticism was the difference in price and accessibility in comparison to an ice bath or ice packs, which can provide similar results.