Is it time to put traditional cold therapy in rehabilitation of soft-tissue injuries out to pasture?

Table 1 Comparison between application of gaseous cryotherapy and traditional cold therapy

	Hyperbaric gaseous cryotherapy	Traditional cold therapy
Cooling modality	Projection of CO2 microcrystals under high pressure (75 bar) and low temperature (78 ℃)	Simply locate ice or a cold gel pack on the top of injured skin
Lowest temperature can be reached	Below 2 ℃[27]	Hard to drop below 13.6 ℃[21,27]
Time to achieve enough low temperatures to produce local analgesia	20-45 s[27,34-35]	15-30 min[27,34]
Time to recover the normal skin temperature	5 min[27]	60 min[3-5]
Amount of heat absorption	Greater and more rapid[34]	Lesser and more slowly[34]
Cutaneous vasoconstriction area	Systemic[27]	Localized only to the cooled area[27]
Physiological response after application	Thermal shock - a swift systemic response resulting in cutaneous vasoconstriction[27,34-36]; profound vasomotor effects[34]; modulates inflammation and release cytokines; sooner metabolic rate[27,34-35]	Prolonged application may happen, which would cause neuromuscular impairments, frostbite and nerve injuries[19,27]; prevent the release of IGF-1[5,6]; slower metabolic rate[34-35]
Clinical treatment effect of application	Controversial results[34-36] across different studies when comparing the two

IGF: Insulin-like growth factor.