From the Guidelines
Cold plunges, specifically cold-water immersion, have been shown to be highly effective in rapidly reducing core body temperature, which is crucial in treating heat stroke and exertional hyperthermia, with the most recent and highest quality study suggesting its use as the preferred modality for cooling 1.
Benefits of Cold Plunges
- Rapid cooling: Cold-water immersion is the most effective method for rapidly reducing core body temperature, with a cooling rate of 0.07-0.14°C/min 1.
- Improved survival: Rapid cooling with cold-water immersion has been shown to improve survival rates and reduce morbidity in patients with heat stroke 1.
- Reduced organ dysfunction: Cold-water immersion has been shown to reduce organ dysfunction and improve outcomes in patients with heat stroke 1.
Implementation
- Start with brief exposures: Begin with brief exposures to cold water, such as 30-60 seconds, and gradually increase the duration as tolerance builds 1.
- Monitor temperature: Continuously monitor core body temperature during cold-water immersion to ensure safe and effective cooling 1.
- Avoid certain conditions: Avoid cold plunges if you have cardiovascular conditions, Raynaud's disease, or are pregnant, as they may pose a risk to your health [@Example@].
Evidence
- The most recent and highest quality study, published in 2025, recommends cold-water immersion as the preferred modality for cooling in patients with heat stroke 1.
- Other studies have shown that cold-water immersion is effective in reducing core body temperature and improving outcomes in patients with exertional hyperthermia and heat stroke 1.
From the Research
Benefits of Cold Plunges
- Cold water immersion has been shown to induce vasoconstriction, followed by vasodilation in some individuals, which may have beneficial effects on cardiovascular health 2.
- A study on patients with Raynaud's disease found that induced vasodilation through cold water immersion increased digital temperature, suggesting a potential benefit for this condition 3.
- Cold-induced vasodilation (CIVD) has been observed in both men and women during cold-water immersion, with women experiencing elevated cardiovascular strain and higher frequency of CIVD reactions 4.
- A systematic review and meta-analysis found that cold exposure, including cold water immersion, increased heart rate variability (HRV) indices, reduced heart rate, and slightly increased mean blood pressure, suggesting enhanced parasympathetic nervous activity 5.
Limitations and Considerations
- The current evidence on the benefits of cold plunges is largely based on studies with small sample sizes and limited populations, and more research is needed to fully understand its effects 2, 3, 4, 5.
- Clinical reasoning and individualized decision-making are essential when considering the use of cold plunges as a therapeutic intervention, as the response to cold exposure can vary greatly between individuals 6.