A Scientific Overview of Cold Exposure as a Treatment for Acute and Chronic Pain
Cold exposure has been shown to help reduce pain for both acute and chronic conditions including arthritis and fibromyalgia. This is mainly as cold exposure lowers skin temperature which slows conduction velocity of peripheral nerves (those outside of the brain and spinal cord) reducing or completely resolving pain. Furthermore, exposure to cold temperatures will help to reduce pain by helping to resolve inflammation and swelling through a process called vasoconstriction where the blood vessels will constrict reducing blood flow to your arms and legs. As well as this cold exposure will stimulate the release of hormones such as beta endorphins and adrenaline which have analgesic (pain relieving) effects.
Step by Step Guide on How to Use Ice Baths to Manage Pain:
Acute Pain from Injury:
1. Temperature:
Colder temperatures sub 10°C are recommended for acute pain conditions such as muscle sprains and strains. This is because it will cause the body to experience a stronger vasoconstrictive response which will have a greater impact at reducing swelling and inflammation.
2. Duration:
You should aim to be in the ice bath for 3-5 minutes as if you can stay in the ice bath any longer it means that the ice bath is not cold enough to help reduce acute pain.
3. Frequency:
For the first 48-72 hours post injury you should aim to have an ice bath twice daily as there will be higher levels of swelling and inflammation acutely after injury. If you are looking to keep pain as low as possible then you should apply an ice pack directly to the site of injury for 15-20 minutes 3 hours after every ice bath.
4. Time of Day:
You should try to have an ice bath immediately after the injury and aim to have another ice bath 6 hours later.
5. Progression:
After the initial 48-72 hour period aim to have ice baths on a daily basis to keep on top of pain management.
Chronic Pain:
1. Temperature:
For individuals suffering with chronic pain it is best to start off at warmer temperatures between 15-20°C . This is because people with chronic pain conditions often have hypersensitive nervous systems due to them being overstimulated for long periods and warmer temperatures will prevent them from being overstimulated.
2. Duration:
Aim to stay in the ice bath for 10-15 minutes to ensure that your skin temperature has been sufficiently lowered.
3. Frequency:
You should try and have an ice bath every day to help keep the pain levels under control.
4. Time of Day:
It would be best to have the ice bath first thing in the morning or if activities such as work is provoking your symptoms a lot after a long day of work.
5. Progression:
Gradually aim to lower temperatures over time as if you become to acclimated to the cold your body won’t release as much of the feel good hormones such as endorphins and norepinephrine which help to reduce pain.
Here’s a comprehensive overview of scientific research on cold exposure techniques and pain:
1. Study- Cold Water Immersion Alleviates Pain to Promote Quality of Life in Indonesians with Gout Arthritis: A Community-based Randomised Controlled Trial.
Objective:
The purpose of this study is to investigate the effects of cold-water immersion on pain, joint mobility, physical activity, stress, anxiety, depression, and quality of life in acute gout patients.
Theory:
Cold water therapy can be used to aid gout arthritis management by reducing inflammation. This reduces pain, which increases physical activity and decreases stress, anxiety, and sadness.
Findings:
Cold water therapy has been shown to alleviate pain and improve quality of life in those living with chronic pain.
(Kurniasari et al, 2022)
2. Study- Cold intervention for relieving migraine symptoms: A systematic review and meta‐analysis.
Objective:
The purpose of this study is to evaluate the effectiveness of cold intervention for relieving migraine symptoms.
Theory:
Cryotherapy will cause a reduction in skin temperature which will reduce the speed of nerve conductions increasing the pain threshold.
Findings:
Cold intervention is an effective regimen to reduce migraine pain instantly. More research is needed on the long-term effects of cryotherapy on migraines.
(Hsu et al, 2023)
3. Study- Cryotherapy in Knee Arthroplasty: Systematic Review and Meta-Analysis.
Objective:
The goal of this study was to review the literature on the efficacy of cryotherapy in knee arthroplasty.
Findings:
It can be concluded that cryotherapy is indicated to reduce pain in the postoperative period of knee arthroplasty.
(Krampe et al, 2023)
4. Study- Shall we use cryotherapy in the treatment in surgical procedures, in acute pain or injury, or in long-term pain or dysfunction? – A systematic review.
Objective:
This review aimed to evaluate the certainty of evidence for the use of cryotherapy in patients with musculoskeletal disorders and post-surgical patients.
Theory:
A reduction in temperature blocks the nociception, pain signals, within the spinal cord.
Findings:
It can be concluded that cryotherapy can be used safely to relieve acute and chronic pain in those with musculoskeletal disorders.
(Klintberg et al, 2021)
Conclusion:
In summary, these studies highlight strong scientific evidence supporting the use of cold exposure to help alleviate pain in a variety of conditions such as gout arthritis, migraines, and post knee arthroplasty. Additionally, they demonstrate how helping to alleviate pain for people with these conditions can significantly improve their quality of life.
References
1. Kurniasari, M. D., Monsen, K. A., Weng, S. F., Yang, C. Y., & Tsai, H. T. (2022). Cold Water Immersion Directly and Mediated by Alleviated Pain to Promote Quality of Life in Indonesian with Gout Arthritis: A Community-based Randomized Controlled Trial. Biological research for nursing, 24(2), 245–258. https://doi.org/10.1177/10998004211063547
2. Hsu, Y. Y., Chen, C. J., Wu, S. H., & Chen, K. H. (2023). Cold intervention for relieving migraine symptoms: A systematic review and meta-analysis. Journal of clinical nursing, 32(11-12), 2455–2465. https://doi.org/10.1111/jocn.16368
3. Krampe, P. T., Bendo, A. J. P., Barros, M. I. G., Bertolini, G. R. F., & Buzanello Azevedo, M. R. (2023). Cryotherapy in Knee Arthroplasty: Systematic Review and Meta-Analysis. Therapeutic hypothermia and temperature management, 13(2), 45–54.
https://doi.org/10.1089/ther.2022.0043
4. Klintberg, I. H., & Larsson, M. E. (2021). Shall we use cryotherapy in the treatment in surgical procedures, in acute pain or injury, or in long term pain or dysfunction? – A systematic review. Journal of bodywork and movement therapies, 27, 368–387. https://doi.org/10.1016/j.jbmt.2021.03.002
