What is Whole Body Cryotherapy Used For?
Whole-body cryotherapy (WBC) is primarily used as an adjuvant therapy for chronic inflammatory conditions, exercise recovery, and chronic pain syndromes, though the evidence quality remains very low and safety surveillance is inadequate. 1, 2
Primary Clinical Applications
Chronic Inflammatory Conditions
- WBC demonstrates potent anti-inflammatory effects and may serve as adjuvant therapy for systemic inflammatory conditions including rheumatoid arthritis and chronic inflammation associated with obesity. 2
- The mechanism involves controlled exposure of the whole body to extreme cold (below -100°C) for 2-4 minutes in a specialized chamber, which influences inflammatory events at cellular and physiological levels. 1
Chronic Pain Management
- Fibromyalgia patients show significantly improved health-related quality of life following WBC treatment, with effects lasting at least one month. 3
- WBC provides chronic pain relief for patients with fibromyalgia, rheumatism, and arthritis through its anti-inflammatory mechanisms. 1
- One randomized trial demonstrated that 10 sessions of WBC over 8 days resulted in improved perceived health and quality of life in fibromyalgia patients compared to usual care alone. 3
Exercise Recovery
- For muscle soreness after exercise, the evidence is insufficient and of very low quality to recommend WBC over passive rest. 4
- A Cochrane systematic review found very low quality evidence for reduced muscle soreness at 1 hour post-exercise, but confidence intervals included no benefit or even harm at 24,48, and 72 hours. 4
- Traditional cryotherapy application must be repeated to maintain therapeutic benefit, as single applications provide inadequate duration of cooling. 5
- WBC should only be considered when rapid recovery is required between exercise bouts, not after routine training, as chronic use during resistance training may blunt anabolic training effects. 5
Neuropsychiatric and Cognitive Applications
- WBC may benefit mental health conditions including depression and anxiety disorders, potentially through increased circulating BDNF levels. 1
- Preliminary evidence suggests potential applications in chronic brain disorders including mild cognitive impairment, general anxiety disorder, and neuroinflammation reduction in multiple sclerosis. 2
- These neuropsychiatric applications require further randomized controlled trials with adequate sample size and longer follow-up periods. 2
Other Potential Applications
- WBC may improve sleep quality and provide faster neuromuscular recovery after high-intensity exercise. 1
- Multi-systemic disorders involving chronic inflammation, such as myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), represent potential targets for WBC therapy. 2
Critical Safety Considerations
Adverse Events and Monitoring
- Safety concerns have been raised by public health authorities (FDA, INSERM) based on adverse event reports, though many involved partial-body cryotherapy (PBC) rather than true whole-body cryotherapy. 1
- A scoping review identified only 16 documented adverse events across 5 case reports and 2 RCTs, suggesting WBC-related safety risks are within acceptable limits when proper protocols are followed. 1
- None of the included trials reported active surveillance of predefined adverse events, representing a critical gap given the exposure to extreme temperatures. 4
Important Distinctions
- True whole-body cryotherapy differs fundamentally from partial-body cryotherapy (PBC), where only the body except the head is exposed to vaporized liquid nitrogen in a narrow bathtub. 1
- These two approaches are often erroneously conflated but have different safety profiles and mechanisms. 1
Evidence Quality and Limitations
Current Evidence Base
- The quality of studies on WBC in clinical settings is generally very low, with all four trials in the Cochrane review having design features carrying high risk of bias. 4, 2
- Research is limited by small sample sizes (typically <30 participants), predominantly young adult males, heterogeneous protocols, and inadequate follow-up duration. 4
- There is no evidence on the use of WBC in females or elite athletes. 4
Research Gaps
- Randomized controlled trials with adequate sample size and longer follow-up periods are urgently needed. 2
- Further studies must examine the mechanisms underlying clinical efficacy and provide detailed reporting of adverse events. 2, 4
- The effectiveness depends critically on maintaining reduced muscle temperature and timing of treatment relative to injury or exercise cessation. 5