What does the research say about the effectiveness of cryotherapy?

Cryotherapy is full body immersion from the neck down into extremely cold temperatures. Listed below are a few of the claims made by cryotherapy providers. We will examine what the research says about these claims and if there is sufficient evidence to support each statement. 

What are the CLAIMS of cryotherapy?

• Muscle & Joint pain relief
• Optimize sleep & recovery
• Regain your natural energy
• Enhance your natural skin glow
• Brain boost & mental stabilizer
• Increase metabolism & burn calories
• Reduce inflammation​

What the RESEARCH SAYS: 
Length of treatment and sessions

1. You must be exposed to cold for at least 3 minutes for benefits to be seen & receive multiple sessions (20-30 sessions showed better results) (Rose).

Benefits of treatment

1. Quicker recovery time, however, this statistic was measured in the form of pain, quality of life and mood (Lombardi). This was started across several studies.
2. Decreased pain due to the analgesic effect of the cold (Rose).
3. Increased osteoblast and decreased osteoclast activity (Patel). Showing that bone formation was taking place. 

Unclear or mixed theories

1. Many studies examined if cryotherapy reduced inflammation, some said yes, others said no. These studies looked at several different inflammatory markers and could not state a significant difference from treatment. (Rose, Patel & Lombardi)
2. All hematological effects were transient or unclear. 

Problems with these studies

• They were all performed on athletes or very specific populations, meaning none of these studies took a group from the general population and performed the test.
• It is impossible to do a blind study. There is no “false” form of cryotherapy. Therefore, studies did not have a placebo. 

Comparison between research & “claims or believed benefits”

• Muscle & Joint Pain relief
  • Research supports this statement (Rose).
• Optimized Sleep 
  • Research suggests that sleep may be improved due to decreased pain (Douzi).
• Regain your natural energy
  • Not supported by research (claim is too broad).
• Enhance your natural skin glow
  • There is no evidence in the literature to support the above statement. No studies found on improvement in skin quality and cryotherapy. 
• Brain booster and mental stabilizer
  • A few studies did examine the mental health benefits of cryotherapy. The only substantial physiological change noted was an increase in norepinephrine (due to the cold). This was trainsent. (Patel)
• Increase metabolism and burn calories
  • There is a transient rise in metabolic activity BUT there is no change to the resting metabolic rate (Lombardi).
• Reduce inflammation
  • There is evidence to support that it does help to reduce some types of inflammation. However, this may be counterproductive in those seeking muscle hypertrophy (inflammation after exercises is needed to promote muscle growth) (Lombardi).

Takeaway:
For most of these claims there is not sufficient evidence. While it does provide some pain relief, it requires an ABUNDANCE of sessions to actually achieve any type of therapeutic benefit. While going through the research, I found one article that suggested “an icepack is a much cheaper option”. 

References
Douzi, Wafa, et al. "3-min whole body cryotherapy/cryostimulation after training in the evening improves sleep quality in physically active men." European Journal of Sport Science 19.6 (2019): 860-867.

Lombardi, Giovanni, Ewa Ziemann, and Giuseppe Banfi. "Whole-body cryotherapy in athletes: from therapy to stimulation. An updated review of the literature." Frontiers in physiology 8 (2017): 258.

Rose, Catriona, et al. "Whole-body cryotherapy as a recovery technique after exercise: a review of the literature." International journal of sports medicine 38.14 (2017): 1049-1060.

Patel, Karan MD; Bakshi, Neil MD; Freehill, Michael T. MD; Awan, Tariq M. DO. Whole-Body Cryotherapy in Sports Medicine. Current Sports Medicine Reports 18(4):p 136-140, April 2019. | DOI: 10.1249/JSR.0000000000000584