Tanja Reutelingsperger
This time of year, the temperature drops below zero and together with the bleak wind this results in a freezing cold winter. However, these temperatures are nothing compared to the temperatures people are voluntarily exposing themselves to in whole body cryotherapy (WBC). They even pay big bucks for three minutes in -110 degrees of Celsius in wellness centers. Is this something we should all try or should we leave these crazy colds up to Wim Hof, the Iceman?
Whole body cryotherapy, one could call it an inverted sauna treatment, is increasing in popularity. For several years now, whole body cryotherapy is being used as a treatment in sports medicine for, amongst others, recovery of exercise-induced muscle damage. WBC has shown to decrease creatine kinase activity by 40% in rugby players after five daily session of WBC. Moreover, it lowers the VAS score in physically active men after exercise compared to controls [1, 2]. Studies also show that WBC lowers disease activity and markers of inflammation and oxidative stress in patients with inflammatory diseases such as ankylosing spondylitis [3, 4]. Furthermore, potential beneficial effects in patients with depression, tinnitus and fibromyalgia are mentioned [5, 6, 7].
However, a recent study could not reproduce the reducing effect of WBC on several inflammatory, hormonal or muscle damage biomarkers [8]. Also, a Cochrane review in 2016 pooled the results of four previous studies, with a total of 64 study subjects, and could not support the findings that WBC improves recovery or decreases muscle soreness after a workout [9].
But there is no harm in trying right? Well…, there could be. Of course, people with certain medical conditions as unstable angina pectoris, Raynaud disease or hypothyroidism are, because of their known responses to cold, not allowed entry to a cryotherapy cabine. But several adverse events have also been reported in healthy people ranging from cutaneous eruptions to transient global amnesia [10, 11]. The nitrogen vapors in the closed rooms can even result in loss of consciousness by depriving your brain of oxygen. Moreover, there is a lack of well-conducted studies on the possible adverse events of WBC. This is why the U.S. Food and Drug Administration (FDA) has not approved or cleared WBC devices for medical treatment [12].
So, you probably might want to discuss starting WBC with your general physician before making an appointment. Or just use the miniature version of cryotherapy to treat your muscle soreness; the good old bag of frozen peas!
[1] Banfi, G., et al. Effects of the whole-body cryotherapy on NTproBNP, hsCRP and troponin I in athletes. J Sci Med Sport 12, 609-610 (2009).
[2] Hausswirth, C., et al. Effects of whole-body cryotherapy vs. far-infrared vs. passive modalities on recovery from exercise-induced muscle damage in highly-trained runners. PloS one 6, e27749 (2011).
[3] Straburzynska-Lupa, A., et al. The Effect of Whole-Body Cryotherapy at Different Temperatures on Proinflammatory Cytokines, Oxidative Stress Parameters, and Disease Activity in Patients with Ankylosing Spondylitis. Oxidative medicine and cellular longevity 2018, 2157496 (2018).
[4] Stanek, A., et al. Whole-Body Cryotherapy Decreases the Levels of Inflammatory, Oxidative Stress, and Atherosclerosis Plaque Markers in Male Patients with Active-Phase Ankylosing Spondylitis in the Absence of Classical Cardiovascular Risk Factors. Mediators of inflammation 2018, 8592532 (2018).
[5] Rymaszewska, J., et al. Whole-body cryotherapy as adjunct treatment of depressive and anxiety disorders. Archivum immunologiae et therapiae experimentalis 56, 63-68 (2008).
[6] Kaminska-Staruch, A. & Olszewski, J. [Evaluation of effectiveness of whole-body cryotherapy in patients with tinnitus]. Otolaryngologia polska = The Polish otolaryngology 61, 801-804 (2007).
[7] Rivera, J., et al. The effect of cryotherapy on fibromyalgia: a randomised clinical trial carried out in a cryosauna cabin. Rheumatology international 38, 2243-2250 (2018).
[8] Krueger, M., et al. Whole-body cryotherapy (-110 degrees C) following high-intensity intermittent exercise does not alter hormonal, inflammatory or muscle damage biomarkers in trained males. Cytokine (2018).
[9] Costello, J.T., et al. Cochrane review: Whole-body cryotherapy (extreme cold air exposure) for preventing and treating muscle soreness after exercise in adults. Journal of evidence-based medicine (2016).
[10] Greenwald, E., et al. Cold panniculitis: Adverse cutaneous effect of whole-body cryotherapy. JAAD case reports 4, 344-345 (2018).
[11] Carrard, J., et al. Transient global amnesia following a whole-body cryotherapy session. BMJ case reports 2017(2017).
[12] FDA. Whole body cryotherapy (wbc): A “cool” trend that lacks evidence, poses risks, U.S. Food and Drug Administration, 2016, https://www.fda.gov/ForConsumers/ConsumerUpdates/ucm508739.htm, (Last accessed at November 30, 2018)
