Cold therapy for better health

Cold therapy or ice therapy is the application of cold to the body's tissues after injury. This practice is as old as medicine itself. Nowadays, local cold application may be applied by the use of various forms, such as ice packs, ice towels, immersion in cold water, ice cube massage, ice spray and cold gels. Often skin temperature is reduced to 10 C°.

The Circulatory Response

The initial skin reaction to cooling is an attempt to preserve heat. It is accomplished by an initial vasoconstriction. This haemostatic response has the effect of cooling of the body part. After a short period of time, the duration depends on the area involved, a vasodilatation follows with alternating periods of constriction and dilatation. This reaction of “hunting” for a mean point of circulation is called “Lewis’s Hunting Reaction”.

The Neural response

The skin contains primary thermal receptors. Cold receptors are several times more numerous than warm receptors. The cold receptors respond to cooling by a sustained discharge of impulses, the rate of which increases with further cooling.

Uses of cryotherapy

1. Reduces pain through the cold receptors.
2. Reduces spasticity by reduced  velocity of nerve conduction.
3. Reduces muscle spasm by depressed sensitivity of receptors such as the muscle spindle.
4. Reduces swelling through compression and elevation along with cryotherapy by means of lymphatic flow.
5. Promote repair of the damaged tissues.
6. Provide excitatory stimulus to inhibited muscles

Application of cryo or cold therapy

1. Determine that cryotherapy is not contraindicated for the patient or condition.
2. Inspect the area to be treated for skin integrity and assess sensation.
3. Select the appropriate cooling agent i.e. cold pack, ice packs, ice cups, controlled compression units.
4. Use towels or pillow cases for hygiene, skin protection, and/or insulation.
5. Apply cryotherapy over the affected area for 10 to 20 minutes and repeat every 1 to 2 hours.
6. Reassess the patient after the treatment and check for any signs of adverse effects of the intervention.
7. Consider combining with compression, elevation, and rest (RICE) to enhance effectiveness

Commonly used cryotherapy agents

Cold pack - filled with silica gel, which conforms to body contours. Plastic bags of frozen vegetables can also be substituted for cold packs.

Ice packs - made of crushed ice placed in a plastic bag, which provides more aggressive cooling.

Cold Compression Unit - alternately pumps cold water and air into a sleeve that is wrapped around a patient’s limb - most commonly used directly after surgery for the control of postoperative inflammation and edema.

Contra indications

Cryotherapy is not recommended for those with cardiac conditions, psychological trauma, peripheral nerve injuries, vasospastic disease, peripheral vascular disease, and cold sensitivity.