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

Abstract

Cold therapy has been used regularly as an immediate treatment to induce analgesia following acute soft-tissue injuries, however, a prolonged ice application has proved to delay the start of the healing and lengthen the recovery process. Hyperbaric gaseous cryotherapy, also known as neurocryostimulation, has shown the ability to overcome most of the limitations of traditional cold therapy, and meanwhile promotes the analgesic and anti-inflammatory effects well, but the current existing studies have shown conflicting results on its effects. Traditional cold therapy still has beneficial effect especially when injuries are severe and swelling is the limiting factor for recovery after soft-tissue injuries, and therefore no need to be entirely put out to pasture in the rehabilitation practice. Strong randomized controlled trials with good methodological quality are still needed in the future to evaluate the effects of different cryotherapy modalities.

Keywords: Cryotherapy; Hyperbaric gaseous cryotherapy; Neurocryostimulation; Cold therapy; Soft tissue injury

Core Tip: Traditional cold therapy (e.g., topically icing the injured area) may not be helpful but rather act as a barrier to recovery process. A prolonged period of cold on the skin was reported to lead to a reduction of the blood flow, resulting in tissue death or even permanent nerve damage. Hyperbaric gaseous cryotherapy, also known as neurocryostimulation, has shown the ability to induce greater analgesic, anti-inflammatory, vasomotor, and muscle relaxing effects than other traditional cold application, thus quickening recovery and heal following soft tissue injuries. More high quality level evidence is still needed to confirm the efficacy of hyperbaric gaseous cryotherapy about its clinical effects for soft-tissue injuries in the future, in order to find the optimal way to use it.