We’re talking about cold therapy, perhaps better known as cryotherapy. As the U.S. Food and Drug Administration (FDA) explains, cryotherapy involves “super-cooling” the body for therapeutic purposes, and its proponents claim it can benefit a number of conditions, including Alzheimer’s, chronic pain, insomnia, depression, and rheumatoid arthritis.
You may have spotted fitness pros or enthusiasts posting about the trend on TikTok, Instagram, and other platforms, boasting about its muscle-recovery benefits.
You can get this chilly therapy in many ways, including plunging into a cold lake, applying an ice pack to your skin, or sitting or standing in a chamber that’s been cooled to around minus 200 degrees F, notes the FDA.
But is cryotherapy worth the chill? Here, we uncover how it works, the potential risks and benefits, and how to get started.
The use of cold for healing purposes dates back centuries. Cold water was used for therapy and relaxation in ancient Greece, while ice and snow were used to address pain during operations on soldiers in the 19th century, per a review published in February 2022 in the European Journal of Applied Physiology.
Whole-body cryotherapy (WBC) is one of the more recent therapies. It does not use cold water but rather cooling agents to chill the air around you. The first cryochambers were built in Japan around 1978 for the treatment of rheumatoid arthritis. Rheumatologist Toshima Yamaguchi, MD, had discovered that WBC rapidly lowered skin temperature, leading to a release of feel-good chemicals known as endorphins, which helped lower pain in patients with rheumatoid arthritis, according to the aforementioned review.
Gabe Mirkin, MD, may have been influenced by these and other findings when he introduced the RICE method (rest, ice, compression, and elevation) in 1978 to treat acute sports injuries. Since then, the acronym has been adapted to include variations like RICES (rest, ice, compression, elevation, and stabilization) and PRICE (protection, rest, ice, compression, and elevation).
Over the past decade, WBC has become an increasingly popular option in the sporting world for exercise recovery, per the aforementioned review.
Once elite athletes started using WBC, it spread to the general public. “People tend to follow the trends of athletes, and once you see athletes use cryotherapy, it becomes more mainstream,” says researcher Shawn Arent, PhD, a professor and chair of the exercise science department at the University of South Carolina in Columbia and a certified strength and conditioning specialist.
Today, you can get WBC and partial-body cryotherapy (PBC), a more portable form that frees the head and neck from the cold temperatures, at medical clinics, health and wellness centers, fitness clubs, and cryotherapy pop-up shops.
When your body is exposed to the cold, it responds by constricting your blood vessels (also known as vasoconstriction), so all your blood gets pushed toward your organs. “This causes the blood to acquire more oxygen and become nutrient rich,” says Gregg Larivee, Doctor of Chiropractic, and founder and CEO of Integrated Medical Center in Jupiter, Florida.
Once you leave the cold and start heating up again, your blood vessels expand (also known as vasodilation), according to a study published in August 2018 in the Journal of Athletic Training. As the blood vessels open up, oxygen- and nutrient-rich blood flows back to your tissues, helping flush out inflammation, Dr. Larivee explains.
Inflammation is at the root of many health complaints, from muscle soreness to arthritis to Alzheimer’s, notes a paper published in December 2019 in Nature Medicine. As such, proposed inflammation-lowering therapies like cryotherapy may be beneficial for some people.
In addition, scientists speculate that cryotherapy may create an analgesic, or pain-relieving, effect by blunting nerve transmission (when a nerve fires a signal to the brain) in pain cells, per a review published in December 2020 in Pain and Therapy. This may suggest that cryotherapy could be an effective therapy for pain conditions, similar to how placing an ice pack on an injured area may help temporarily relieve pain, though more research is needed to confirm this.
Some forms of cryotherapy — namely, cryoablation or cryosurgery (a surgical procedure using extreme cold) — are used medically by surgeons and other certified healthcare providers for specific procedures to address certain conditions.
For example, a dermatologist may use cryoablation to treat abnormal tissue, and some surgeons may use this technique to destroy certain cancers. It’s important to note that cryoablation is a different form of cryotherapy than the healing, supportive approaches focused on in this article.
However, most of the nonmedical-grade cryotherapy methods and devices that you may have seen online or at wellness centers aren’t regulated. As the FDA notes, WBC hasn’t been approved by the FDA to treat any specific medical conditions, “but there are a lot of claims around potential impacts on disease, so there needs to be some caution there,” Dr. Arent says.
In addition, technicians don’t need to be highly trained to run one of the machines. “There’s no specific license needed to do this job,” Arent says. “So take the appropriate precautions and look for a reputable facility.”
Cryotherapy comes in many forms.
WBC involves sitting or standing in a small, enclosed chamber (also known as a cryochamber) that’s been cooled with liquid nitrogen. The entire body, including the head, is exposed to the frigid temperature, which typically ranges from minus 200 to minus 300 degrees F, per the FDA. Because the air is so cold, the exposure time is short, typically between two to four minutes.
PBC is similar to WBC, except that you stand in a one-person-sized chamber that’s open at the top. This way, your torso and legs are enclosed in the freezing chamber, but your head is above at room temperature, notes the FDA.
Cold-water immersion involves submerging yourself, excluding your head and neck, in water at temperatures cooler than 59 degrees F, per a review. This therapeutic technique is often used to manage muscle soreness after exercise.
Ice application is one of the first steps in treating acute injuries, such as strains, sprains, and fractures. Using ice packs, ice baths, or ice massage helps decrease pain, swelling, and inflammation in the injured area, according to the American Academy of Pediatrics.
Also known as cryosurgery, this is a minimally invasive method that’s used to treat skin conditions (such as warts and skin tags) and some cancers (including prostate, cervical, and liver cancer), notes the Cleveland Clinic. To do it, a doctor applies extreme cold to freeze and remove abnormal tissue; this medical or surgical procedure is performed only in clinics or surgical centers by licensed healthcare professionals.
Cryotherapy has many reported uses, yet overall there is limited published conclusive research on its use as a complementary therapy. Here are some of the areas where researchers are finding some theoretical benefits.
One of the more popular uses for cryotherapy is for recovery after exercise, and research on athletes and high-intensity exercise subjects suggests that there may be something to this.
In a study published in October 2022 in The Journal of Strength and Conditioning Research, 12 middle- and long-distance runners in China were treated with different cryotherapy methods after exercise. The findings suggest that WBC may reduce muscle damage and inflammation better than other methods of recovery. However, the study was small, so further research is needed to fully understand the relationship between cold therapy and athletics.
Still, other small studies found that WBC decreased muscle pain and inflammation and boosted post-exercise recovery, according to a research paper published in Frontiers in Physiology.
Cryotherapy’s numbing and inflammation-lowering effects may benefit people with chronic pain.
The authors of the 2020 review in Pain and Therapy postulated that cryotherapy could be an easy, low-risk option for managing chronic pain associated with diseases like rheumatoid arthritis and ankylosing spondylitis (an inflammatory disease of the spine). WBC and ice application both provided pain relief for many of the patients included in the studies. However, research on the long-term effects of cryotherapy on chronic pain is lacking, as are standardized protocols.
Cryotherapy may help soothe skin conditions for some people.
Research suggests that WBC may help lower inflammation and relieve itching in people with atopic dermatitis (eczema), a chronic skin condition that causes dry, itchy, and inflamed skin. However, the study sample was too small to determine whether WBC is an effective treatment for atopic dermatitis. What’s more, the American Academy of Dermatology Association doesn’t recommend using WBC as a skin treatment at this time.
More research is needed to confirm this possible benefit.
In addition to measuring post-exercise muscle recovery, the authors of the study in The Journal of Strength and Conditioning Research also gathered information about how well runners slept after receiving cryotherapy. They found that runners reported better sleep quality after WBC than other forms of cryotherapy.
And a study published in July 2019 in the European Journal of Sport Science reveals that active men who received WBC after an evening workout tossed and turned less during the night and reported significantly better sleep than those who didn’t.
Through a specific cryotherapy method known as cryoablation, which is performed surgically, healthcare providers can use extreme cold (liquid nitrogen) to freeze tumor cells on the surface or inside the body, according to the Cleveland Clinic. A doctor inserts an instrument called a cryoprobe through a small incision in the skin and applies the cold with a spraying device. The extreme cold freezes the targeted tissue, causing tumor cells to die. Cryoablation is often used for bone tumors, prostate cancer, and liver cancer, according to a research article.
Cryotherapy is also a common procedure for treating skin lesions. These lesions can be benign (not cancerous), precancerous, or superficially cancerous (skin cancer that’s on the surface of your skin), according to Memorial Sloan Kettering Cancer Center. The frozen skin blisters and peels off, which allows healthy new skin to grow in its place, notes the Cleveland Clinic.
The primary risks involved with any form of cryotherapy include frostbite, rash, eye injury, and hypothermia (a significant and potentially dangerous drop in body temperature that’s commonly caused by prolonged exposure to cold, per the Mayo Clinic.
WBC and PBC are especially risky, due to the extreme temps used in these methods. The FDA also warns that using liquid nitrogen to cool an enclosed space — as in WBC — lowers the amount of oxygen available, which can lead to hypoxia (insufficient oxygen) and loss of consciousness.
Exposure to cold can also be dangerous for people with heart, nerve, and circulatory conditions.
Research suggests that certain types of cryotherapy may help with muscle recovery, joint pain, chronic skin conditions, and sleep. It may be worth checking with your primary care physician about using cryotherapy for these purposes.
However, some groups may want to avoid cryotherapy.
Cryotherapy is dangerous for people with high blood pressure (hypertension) and any type of heart disease. “You should never put those individuals in a cryochamber,” Larivee says. Sudden exposure to extreme cold is a shock to the system — the heart in particular.
People with nerve damage should also steer clear of WBC, PBC, and cold-water immersion. For example, people with nerve damage from diabetes (known as diabetic neuropathy) often lose sensation in their hands and feet, which can increase the risk of frostbite in cryochambers. “Your feet are at the bottom of the cryochamber, and if you can’t feel the cold through your protective footwear, you can’t know if it’s getting too cold,” Larivee says.
In addition, Larivee doesn’t recommend cryotherapy for pregnant people or those who are hypersensitive to cold.
Meanwhile, older adults and others with poor circulation don’t necessarily need to avoid cryotherapy, but they should approach it with caution and consult with their doctor. Often, Larivee will simply shorten the length of time that the patient is inside the cryochamber and monitor how they respond.
Where you go for cryotherapy depends on the type of cryotherapy you’re interested in.
Cryoablation is a medical procedure and can only be done in a conventional healthcare setting. This treatment is FDA approved and often covered by Medicare and most private insurance companies. However, check with your insurance company to be sure.
WBC, PBC, cold-water immersion, and other forms of cryotherapy are offered at many wellness centers, medical and physical therapy clinics, and fitness centers, but they are not typically covered by insurance. Take caution when finding a location if you’re not getting WBC or PBC from a medical facility, as licensing and permitting to run a cryotherapy chamber is not yet established or regulated at the federal level.
If you’re under medical care or recovering from an injury, your healthcare provider or integrative health practitioner may incorporate WBC, PBC, or cold-water immersion into your care plan. Similarly, if you’re working with a personal trainer or physical therapist, they may suggest using on-site cryotherapy to speed recovery.
If you’re interested in trying cryotherapy on your own, you can take an ice bath at home or seek cryotherapy services. In fact, many businesses offer nothing but whole- and partial-body cryotherapy.
Your path to cryotherapy should begin with a conversation with your healthcare provider, especially if you’re interested in using cryotherapy for a chronic condition or disease.
If you’re not getting WBC or PBC as part of a treatment plan created by your doctor or physical therapist, use caution when selecting a cryotherapy location. Research the businesses in your area and beware of red flags. “I would stay away from places that overstate the evidence for cryotherapy or say that cryotherapy cures diseases,” Arent says, suggesting health clinics and wellness facilities that are run by medical professionals. And be sure to include your primary care physician in the conversation before you add cryotherapy to your wellness routine.
Both cryotherapy and cold-water immersion are methods of cold therapy, in general. However, cryotherapy chambers use chilled air and do not use water, whereas cold-water immersion employs ice baths, cold-pool plunges, and even cold showers to achieve similar potential therapeutic effects.
If you are interested in trying cold therapy but don’t yet feel ready for cryotherapy, you may consider starting with cold-water therapy. Perhaps test a cold shower after a workout or spend time in a cool pool.
If you want to test how cryotherapy feels, you can also request a shorter WBC or PBC session — instead of two to four minutes, consider trying 90 seconds, Larivee says. However, be sure to talk to your healthcare provider about which option is most appropriate for your wellness needs.
While your experience with cryotherapy will depend on the type you’re using, most people have questions about what to expect from WBC and PBC.
Quality clinics will review your medical history before you enter the chamber, “because there are contraindications,” Larivee says. They will also go over any precautions you need to know to stay safe during your session. This includes wearing proper attire, such as protective socks, shoes, and gloves, and — in many cases — minimal clothing. The facilities will provide the protective gear.
You should also ensure that your skin is dry before your session starts, as wet or sweaty skin can cause a skin reaction, Larivee says.
Once you’re ready, you’ll enter the cryochamber, and a technician will operate the machine. If you’re doing WBC, you’ll sit or stand in an enclosed space. If you’re doing PBC, you’ll stand in an individual-sized chamber with your head and neck exposed. Sessions typically last two to four minutes, but your first session may be shorter.
“We tell people to just walk in and enjoy it,” Larivee says. “We understand that it’s nerve-racking for first-time clients, especially those who hate the cold, but we recommend keeping an open mind.”
In fact, people often report that the WBC and PBC are exhilarating. Typically, users leave the chamber feeling energized, loose, and in less pain.
“People notice a difference after one session, but the more you do it, the more the effects accumulate,” Larivee says.
Unfortunately, there aren’t any guidelines as to how often to use WBC and PBC. The number and frequency of your sessions may depend on your goal and any chronic conditions. “If you do [WBC or PBC] one time after exercising, you’ll notice a change in terms of your recovery the next day,” Larivee says, adding that it typically takes 10 to 20 sessions to see a change in blood chemistry — specifically, changes in common markers of inflammation.
After your session, let your body warm up naturally. “Don’t go sit in the car with the seat warmers,” Larivee says.
Similarly, don’t hang around outdoors if you live in a chilly climate, he adds.
CryoAction
CryoAction is a provider of whole-body cryotherapy equipment, with a client list that includes sports franchises, spa and wellness centers, gyms, and boutique cryotherapy businesses. Its blog offers informative articles that answer common questions about cryotherapy, such as how often to do it, what benefits it might offer, and where to get it.
USCryotherapy
USCryotherapy is a chain that operates in eight states, including Michigan, Minnesota, New Mexico, and Texas. While Everyday Health does not in any way endorse its facilities or technicians, it offers WBC and partial cryotherapy, and it may be a starting point to find a cryochamber near you, after you have discussed cryotherapy with your healthcare provider.
What Doesn’t Kill Us
You’ll learn about more than just cold therapy in What Doesn’t Kill Us. Investigative journalist and anthropologist Scott Carney examines how embracing freezing water, extreme altitude, and other environmental challenges can make us stronger.
Wim Hof Method
Created by Dutch extreme athlete Wim Hof (aka, “The Iceman”), the Wim Hof method combines breathing, cold-water therapy, and a commitment to reconnect with yourself and the world around you. This specific approach to cold-water therapy differs from cryotherapy, but it is inline with a similar therapeutic approaches to possible healing. The potential benefits may include increased energy, better sleep, reduced stress, and a stronger immune system. If you’re interested in learning more, the Wim Hof website provides a blog and a newsletter. Ready to go deeper? Take an online course, download the app, or read Hof’s book.
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