From the Guidelines
After cryotherapy, it is crucial to keep the treated area clean and dry for 24 hours, then gently wash with mild soap and water, as improper care can lead to complications such as infection, which can increase morbidity and mortality, and negatively impact quality of life 1.
Post-Cryotherapy Care
To promote healing and minimize potential side effects, the following steps should be taken:
- Keep the treated area clean and dry for 24 hours to prevent infection, which is essential for reducing morbidity and mortality, and improving quality of life 1.
- Gently wash the area with mild soap and water after 24 hours, taking care not to irritate the skin, as this can lead to complications such as scarring, which can negatively impact quality of life.
- Apply petroleum jelly (like Vaseline) to the area 2-3 times daily until healing is complete, which can help to reduce the risk of scarring and promote healing, thereby improving quality of life.
- Protect the area from sun exposure with clothing or SPF 30+ sunscreen once healed, as sun exposure can cause further damage to the skin and increase the risk of complications, which can negatively impact quality of life.
- Take acetaminophen (Tylenol) as directed for any discomfort, but avoid aspirin or ibuprofen, which may increase bleeding risk, and can negatively impact morbidity and mortality.
Monitoring for Complications
It is essential to watch for signs of infection, such as:
- Increasing pain
- Warmth
- Spreading redness
- Pus
- Fever These signs require immediate medical attention, as untreated infections can lead to serious complications, including increased morbidity and mortality, and negatively impact quality of life 1.
Resuming Normal Activities
Most patients can resume normal activities immediately, but it is recommended to avoid strenuous exercise for 24-48 hours if the treated area is large or on a joint, as this can help to reduce the risk of complications and promote healing, thereby improving quality of life. The treated area may appear lighter than surrounding skin after healing, as cryotherapy destroys pigment-producing cells along with the targeted tissue, which can negatively impact quality of life. However, this is a common side effect and typically resolves on its own, and does not significantly impact morbidity and mortality.
From the Research
Cryotherapy After Care
- Cryotherapy is utilized as a physical intervention in the treatment of injury and exercise recovery, with benefits including reduced pain and inflammation 2.
- The effectiveness of cryotherapy as a recovery modality is dependent upon its ability to maintain a reduction in muscle temperature and on the timing of treatment with respect to when the injury occurred, or the exercise ceased 2.
- Cryotherapy should be applied in abundance within the first few hours of structural damage to limit the proliferation of secondary tissue damage 2.
- Cryotherapy diminishes the inflammatory reaction to trauma and reduces edema, hematoma formation and pain, making it a useful tool in the rehabilitation period 3.
- Cold application enables the patient to develop strength and mobility in an injured area, with minimal inflammation and discomfort, while heat should be reserved for improving mobility and absorbing hematomas after all inflammation has subsided 3.
Chronic Pain Management
- Cryotherapy has been used to reduce chronic pain due to its ease of use, affordability, and simplicity, and can be applied either locally or non-locally depending on the location of the pain 4.
- Both local and non-local cryotherapy applications show promise in reducing chronic pain associated with various chronic diseases, including those of rheumatic and degenerative origin 4.
- Cryotherapy appears to be a safe therapy in carefully selected patients, with only minimal adverse effects reported in the literature, and can be a low-risk and easy treatment option to add in the management of chronic pain 4.
Orthopaedic Application
- Cryotherapy is commonly used in postoperative care for both arthroscopic and open orthopaedic procedures, and is associated with an analgesic effect caused by microvasculature alterations that decrease the production of inflammatory mediators 5.
- Postoperative cryotherapy using bagged ice, ice packs, or continuous cryotherapy devices reduced visual analog scale pain scores and analgesic consumption in approximately half of research studies 5.
- Continuous cryotherapy devices demonstrated the best outcome in orthopaedic patients after knee arthroscopy procedures, compared with all other procedures and body locations, in terms of showing a significant reduction in pain, swelling, and analgesic consumption and increase in range of motion 5.
Safety and Efficacy
- Complications from cryotherapy, including skin irritation, frostbite, perniosis, and peripheral nerve injuries, can be avoided through patient education and reducing the duration of application 5.
- Cryotherapy appears to be an efficient treatment in pain management correlated with a relatively few numbers of side effects, and can provide a reduction in pain for up to several months, a decrease of opioid consumption and an improvement in physical activity 6.