Effects of cryotherapy methods on circulatory, metabolic, inflammatory and neural properties: a systematic review

Abstract

Introduction: The cooling therapy (cryotherapy) is commonly used in clinical environmental for the injuries treatment according to its beneficial effects on pain, local inflammation and the recovery time of patients. However, there is no consensus in the literature about the effects of cryotherapy in the physiological reactions of affected tissues after an injury. Objective: To realize a systematic review to analyze the cryotherapy effects on circulatory, metabolic, inflammatory and neural parameters. Materials and methods: A search was performed in PubMed, SciELO, PEDro and Scopus databases following the eligibility criteria. Included studies were methodologically assessed by PEDro scale. Results: 13 original studies were selected and presented high methodological quality. Discussion: The cryotherapy promotes a significant decrease in blood flow, in venous capillary pressure, oxygen saturation and hemoglobin (only for superficial tissues) and nerve conduction velocity. However, the effect of cryotherapy on the concentration of inflammatory substances induced by exercise, as the creatine kinase enzyme and myoglobin, remains unclear. Conclusion: The physiological reactions to the cryotherapy application are favorable to the use of this therapeutic tool in inflammatory treatment and pain decrease, and demonstrate its importance in the neuromuscular system injuries rehabilitation.

The effect of cryotherapy application before versus after subcutaneous anticoagulant injection on pain intensity and hematoma formation: A quasi-experimental design

“…The cold application has a local anesthetic effect that may suppress the injection pain. This finding is congruent with those of previous studies [4,9,12,14,20], which examined the effects of ice application on pain, and concluded that ice had a significant effect in reducing pain intensity.…”

“…The researchers attribute this finding to the physiological effects of ice, which include increased vasoconstriction at the injection site; these physiological changes may contribute to decrease the occurrence and size of hematoma. As previous studies show the ice pack application also reduces the initial inflammatory response at the injection site, thus minimizing the barriers to healing and facilitating tissue repair [8,9]. Consequently, these results support the fourth and fifth research hypotheses.…”

“…Cryotherapy aims to reduce inflammation, decrease spasm and pain and stimulate blood vessel constriction (vasoconstriction), so it can increase the survival of cells. It is currently debated whether applying cryotherapy at the injection site is effective in decreasing pain intensity and hematoma size [5,8,9]. Cold has a physiological effect that can avoid SCAI related complications by increasing vasoconstriction at the injection site and the inflammatory process.…”

“…Cold also prevents the intensity of pain through its effect on sensory nociceptors by decreasing the conduction time and the synaptic activity in peripheral nerves. When heat in the nerves is reduced, a decrease in the sensory and motor conduction velocities is observed; thus, the intensity of pain is prevented [3,9,10].…”

Effectiveness of cooling therapy (cryotherapy) on leg pain and self-efficacy in patients with chronic venous disease: A randomized controlled trial

“…Pain is defined as a “complex constellation of unpleasant sensory, emotional and cognitive experiences provoked by real or perceived tissue damage and manifested by certain pathophysiological, autonomic, psychological and behavioral reactions.” (Terman and Bonica, 2003). CVeD evokes tissue damage from an influx of inflammatory chemical mediators that attract more circulating inflammatory cells which increase the production of free radicals and damage the cellular membrane resulting in increased tissue injury (Freire, et al, 2016). This inflammatory process disrupts the peripheral nervous system, specifically the nociceptive pain pathway in the skin that is responsible for thermosensation.…”