The latest physical therapy craze is Whole Body Cryotherapy (WBC), which means exposing the entire body to subzero temperatures. Usually this is done by standing in a freezing room cooled by liquid nitrogen. The claim is that WBC can decrease pain and inflammation, help people lose weight and enhance circulation, among other medical benefits.
Let me first say that any treatment claimed to be effective for totally unrelated medical problems is usually too good to be true. I am a bit saddened by the fact that the fountain of youth is apparently strewn with bodies of the hopeful.
Cryotherapy is getting more common in cities like Las Vegas and Los Angeles. The “clinic” for this treatment is a strip-mall location with a very small room or partial containment machine (open at the top) that can be cooled to extremely low temperatures. You are in the room or machine for two to four minutes. The medical supervision is pretty much non-existent. The charge per session is $75 to $100.
Why do people do this? In search of the eternal quest for youth, vigor and beauty. And … there have been deaths.
It is strange that people will spend money on this physical unpleasantness, but cannot find the time, energy or inclination to exercise. Sweating is a sure bet; freezing is a reach.
The science behind WBC is anything but convincing. Here are a few physical facts to help us evaluate the “treatment.” Air is a poor heat conductor. That is why a thermos has air between the layers and polar fleece keeps you warm. Because of this, you do not lose a great deal of heat in a machine or room that is negative 200 degrees Fahrenheit, over two to four minutes. Liquid, on the other hand, is an excellent heat conductor. Spend any time (seconds) in liquid at that temperature and you will have total body third-degree frost bite and cardiovascular collapse (death). So the cold treatment is pretty superficial.
Cold therapy has long been a staple of care for acute orthopedic injuries. In trauma, there is tissue tearing and bleeding from tiny blood vessels. Applying ice slows down the circulation and helps the ruptured blood vessels clot. That is why you start with ice on an injury. Classically, moist heat is applied after the first 24 hours because the bleeding has stopped, and increasing blood flow will help healing. Many therapists also believe ice decreases inflammation and swelling.
But this does not translate to treatment of the whole body. Icing an ankle will cause measurable temperature change all the way down to bone. Direct contact is a good heat conductor. When you are in a very cold room with cold, still air for a couple of minutes, the temperature beneath the skin does not change very much. The cold, like so many other things, is only skin deep. So WBC lacks the depth or duration to treat injuries, whether they are focal or generalized muscle soreness.
As to claims of weight loss, shivering does burn calories, which is the point. But you shiver for only a few minutes and that is not long enough to significantly change your weight. Perhaps you should consider making several scuba dives off the California coast. A swim in 57-degree water, even with a wet suit, produces more constant shivering and a core body temperature drop.
For the claim that WBC can slow the aging process and provide cosmetic benefits, little data backs this up. But here’s the common sense argument: Applying a cold compress to swollen eyes has measurable transient benefit to swelling, according to the former longtime editor of Vogue – hardly a medical authority. She was partial to cold, sliced cucumber, which not only fits nicely over the eyes, but makes a colorful photograph. The local cold firms the loose skin, reducing the appearance of swelling. This is due to vasoconstriction, or decreased circulation in the smallest of blood vessels.
Now, does this work on a more generalized whole body scale? The dermatologists tell us WBC does not improve the appearance of our skin.
WBC is destined to join other similar medical curiosities like “high colonics” and “inversion tables.” Your money is better spent on red wine, a gym membership and meditation – which all have proven benefit to help you age gracefully.
Donald Bucklin, MD (Dr. B) is a Regional Medical Director for U.S. HealthWorks and has been practicing clinical occupational medicine for more than 25 years. Dr. B. works in our Scottsdale, Arizona clinic.