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Cryotherapy FAQ

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Aug. 13, 2019 -- Whole-body cryotherapy is a growing trend at spas and wellness centers, partly because it’s popular with athletes and celebrities. Besides speeding recovery, people who promote the idea of exposing yourself to subzero temperatures claim it can relieve arthritis, asthma, and anxiety, and give you more youthful-looking skin.

But the FDA has not approved any whole-body cryotherapy device as safe and effective to treat medical conditions, and the American Academy of Dermatology doesn’t recommend whole-body cryotherapy.

And exposing your body for about 2 to 4 minutes in temperatures minus 200 F or colder can have side effects without proper precautions, as NFL star wide receiver Antonio Brown found out. Brown, of the Oakland Raiders, recently posted an image of his blistering, discolored feet on Instagram. News reports attributed his foot problems to frostbite from a recent cryotherapy session.

During a whole-body cryotherapy session, a person stands in a can-like enclosure open at the top. That keeps your head out but exposes the rest of your body to the frigid temperatures. Centers typically ask people to wear dry socks, gloves, and other protective gear before a session.

What else to know:

Q: What is the rationale behind cold therapy?

Cold therapy is commonly used for an acute injury such as an ankle sprain, says Chris Juneau, DPT, a board-certified sports physical therapist at the Memorial Hermann Ironman Sports Medicine Institute in Houston. He did not treat Brown. "It lowers the tissue temperature and slows down what we call secondary injury, the blood collecting in tissues. It will limit the amount of bleeding and may help with bruising."

Cold water immersion -- or ice baths -- is also used for recovery and for such emergencies as heatstroke, he says.

For whole-body cryotherapy, the premise is that being in the chamber reduces your whole body temperature, and ''as you get out of the chamber, it sends all this supercharged or oxygenated blood outward, providing an improved state of healing or recovery,” Juneau says.

But "there is scant evidence that whole-body cryotherapy is better than immersion therapy for anything," Juneau says.

Q: Are there any studies on whole-body cryotherapy?

The research is mixed. In one study from 2015, researchers who looked through medical databases found four small studies that compared whole-body cryotherapy with passive rest, no treatment, cold water immersion, or other treatments. They concluded that the evidence was not strong enough to support using whole-body cryotherapy for muscle soreness after exercise. It also said that the best ''dose'' as well as its safety are unknown.

But other researchers evaluated 16 published studies and concluded that the treatment could ease muscle pain and help recover athletic performance.

Q: What are the main risks?

Tissue damage can happen, ranging from mild to frostbite. It could be dangerous for people with any condition that decreases sensations, such as diabetic nerve pain, Juneau says. People with heart conditions may also be at extra risk, he says.

At least one user reported a frozen arm after the treatment, according to the American Academy of Dermatology. As her arm thawed, painful swelling, blisters, and third-degree burns developed.

Another user reported a rash after having eight sessions within 2 weeks. It began on his lower legs and spread to his thighs, belly, and arms. It was itchy and painful. His doctor diagnosed him with cold panniculitis, which happens when the deepest layer of the skin, the fatty tissue, is injured by the cold.

In Las Vegas, a woman who worked at a whole-body cryotherapy center reportedly died inside the chamber when she used it after hours with no one present.

Q: What if you decide to try it for athletic recovery?

Many athletes ask Juneau about using whole-body cryotherapy for recovery, and he tells them to check with their health care provider first. Even though evidence that it helps recovery is scarce, Juneau says the risks can be low if people practice some precautions.

Be sure a staff person is standing by, and consider a facility that is affiliated with a sports medicine center. Be sure the facility staff is familiar with your medical history. After the session, be aware of any signs of skin or tissue breakdown, and get it looked at by a doctor if it happens.

Wearing wet or sweaty socks in the chamber increases the risk of tissue injury, Juneau says. "If anything is wet, it is going to magnify the cold temperature and can lead to skin breakdown or frostbite."

Q: What does frostbite look like, and how is it treated?

Frostbitten skin is cold and numb and can appear red, white, bluish-white, or grayish-yellow. Depending on how bad it is, treatment may include rewarming the skin in a warm-water bath, oral pain medicine, removal of the damaged tissue to allow proper healing, oral antibiotics to prevent infection, and whirlpool therapy to speed healing. During rewarming, patients may notice stinging, burning, and swelling. In more severe frostbite, fluid-filled blisters may appear hours to days after rewarming the skin.

WebMD Health News Reviewed by Neha Pathak, MD on August 13, 2019

Sources

Chris Juneau, DPT, board-certified sports physical therapist, Memorial Hermann Ironman Sports Medicine Institute, Houston.

American Academy of Dermatology: “Whole body cryotherapy can be hazardous to your skin.”

FDA: “Whole Body Cryotherapy (WBC): A ‘Cool’ Trend that Lacks Evidence, Poses Risks.”

International Journal of Sports Medicine: December 2017.

Cochrane Review: Sept. 18, 2015.

Sports Illustrated: Aug. 7, 2019.

NFL.com: Aug. 12, 2019.

Mayo Clinic: “Frostbite.”

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