Cryotherapy involves the use of extreme cold temperatures to relieve pain and promote general wellness. Proponents of cryotherapy claim that it can help improve symptoms of a variety of chronic pain conditions, including rheumatoid arthritis (RA).

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The use of cryotherapy has become increasingly popular in recent years thanks to outspoken support from celebrities and professional athletes alike.

In this article, we discuss in detail what cryotherapy is and the current evidence regarding its use in relief of RA pain.

Cryotherapy involves the use of extreme cold temperatures to cool the body.

Broadly speaking, there are two main types of cryotherapy: local cryotherapy and whole-body cryotherapy.

Local cryotherapy involves the direct application of cold to an affected body part. This commonly involves the use of ice or gel packs, ice baths or massages, or specialized wraps.

Whole-body cryotherapy cools the entire body, with the goal of providing widespread pain relief. A person can undergo whole-body cryotherapy by sitting in cold water on their own in a personal chamber. Health experts call this cold water immersion therapy. It is also possible to sit alone or in a group in a small chamber that is supercooled using nitrogen, oxygen, or both.

In whole-body cryotherapy, the body is cooled to an ultra-low temperature, typically ranging from -200oF to -300oF. Time a person spends at these super cold temperatures is short, usually on the order of 2–4 minutes.

The idea of cryotherapy is not new. Already in ancient Greece, medical experts described the use of cold therapy to help relieve pain.

Scientists do not know exactly how cryotherapy relieves pain. They think, however, it is at least partly related to reductions in:

  • inflammation and swelling
  • transmission of pain signals in the nerves
  • oxidative stress

Inflammation and oxidative stress can be damaging to surrounding tissues and have been implicated in a variety of aspects of human health, including RA.

RA is an autoimmune condition that results from misdirection of the immune system and destroys the body’s own tissues. Immune cells mistakenly identify the joints and surrounding areas as invaders and release inflammatory factors and oxidative molecules as an ill-informed defense mechanism.

This results in damage to the tissues of the joints and causes the characteristic features of RA, including:

  • pain
  • swelling
  • stiffness and loss of function

A 2020 review of the research on cryotherapy for chronic pain found that several older studies recorded a reduction in pain and an increased range of motion in individuals with RA after the use of local cryotherapy.

The authors of a 2021 study found that both cold air therapy and ice massage resulted in immediate pain relief that lasted for at least 60 minutes. Also, local cryotherapy temporarily improved handgrip strength. Benefits of treatment were similar regardless of the type of therapy used.

In general, the benefits of whole-body cryotherapy are not well established. Moreover, the Food and Drug Administration (FDA) emphasizes that these procedures have not been medically validated to fully understand the benefits and risks of treatment.

Studies on the use of whole-body cryotherapy for RA are limited. However, a 2019 study found that there was no improvement in measures of inflammation, pain, or functionality with whole-body cryotherapy, compared with conventional physical and kinesitherapy alone.

In general, health experts consider both local and whole-body cryotherapy safe, but there are some risks a person should be aware of.

For example, without proper care, the use of extreme cold temperatures can cause frostbite or even skin burns.

Cryotherapy is also not suitable for people with certain vascular or blood conditions, as cold temperatures can affect blood flow. This includes individuals with poor circulation or uncontrolled high blood pressure.

Healthcare professionals do not recommend whole-body cryotherapy in particular for people with:

  • major heart or lung disease
  • allergy symptoms, such as asthma, that are triggered by cold
  • problems with the nerves in the legs or feet

The cost of this type of therapy may also be a downside for some. Individual whole-body cryotherapy sessions typically run anywhere from $20 to $80.

A full course of cryotherapy treatment can end up costing several hundred dollars, and most health insurance plans do not cover whole-body cryotherapy.

People have used cryotherapy and cold therapy for centuries to help manage pain.

Research has shown that local cryotherapy reduces inflammation and pain and improves range of motion. It may also be a promising addition to current therapy for people with RA.

Currently, it is unclear what benefits whole-body cryotherapy may have. People interested in trying it out should consult a healthcare professional about possible risks and benefits based on their current health status.