Cryotherapy, or cold therapy, involves using cold temperatures to treat pathological conditions. It works by affecting haemodynamics, neuromuscular functions, and metabolism. Common cryotherapy methods include ice packs, ice massage, cold compression units, ice towels, immersion in an ice water bath, and vapocoolant sprays. Cryotherapy provides benefits such as reducing edema, controlling pain, decreasing spasticity, and facilitating muscle contraction. However, it can cause harm in patients with conditions like peripheral vascular disease, Raynaud's disease, cold urticaria, or cryoglobulinemia.

1. PRATIGYA DEUJA

2.  It is the treatment of pathological conditions by the
use of low temperature agents such as ice, frozen
gels and vapocoolant sprays.
 It exert it’s therapeutic effect by influencing
haemodynamic, neuromuscular and metabolic
effects.

3. 1) Ice pack : The commercially available pack consists
of a gel made from silica or a mixture of saline and
gelatin, which is covered by a vinyl covering. The
temperature of cold pack is maintained by storing it
in freezer at -5°C and allowing it to be cooled for 30
minutes between uses and 2 hours initially.
→ The pack should be wrapped in a towel and
applied to a body parts. Therefore, we use oil in the
body parts in order to prevent it from ice burn.

4. 2) Ice massage : It is a most common method where
ice cubes are gently applied to the body parts and
water drawing due to melt of ice is removed by
towels. We used this in trigger point, small area of
inflammation & pressure sore.

5. 3) Cold Compression Units : These are the devices that
alternately pump cold water or a temperature of
10°-20° and air into a sleeve that is wrapped around
a patient limb. Compression is also applied by
intermittent inflation of a sleeve with air.
It is mainly used after surgery for controls of post-
operative inflammation and edema, it is applied for
15 minutes in every 2 hours.

6. 4) Ice Towels : This method is done in large areas. The
ice is kept in a towel and applied to the body parts.
It is usually given for 20 minutes.
5) Immersion : In this technique, the part mainly distal
going to be treated is directly placed in a container
for 10 minutes which contains 50% of ice & 50% of
water.

7. 6) Vapocoolant sprays : Done for sports injury to
stretch the tight muscles. A technique where a
volatile substance such as ethylchloride or
flurorimethane etc. are sprayed directly on to the
area to be treated.

8. 1) Haemodynamic Effects :
Cold →Vasoconstriction followed by Vasodilation
( Lewis hunting reaction)
2) Decrease Nerve Conduction :
Decrease velocity of conduction in both sensory as
well as motor nerves and has a greater effect on
myelinated and small diameter fibers i.e. conduction
velocity decreases.

9. 3) Increase in Pain Threshold :
Pain decreases due to increase in pain threshold,
which occur due to counter irritation via pain gate
mechanism and reduction of muscle spasm and
sensory nerve conduction velocity.
4) Alteration of Muscle Strength
5) Facilitation of Muscle Contraction :
By exciting alpha motor neuron.

10. 6) Decrease Spasticity
7) Metabolic Effects :
Cold leads to abnormal increase in the demand for
the metabolic reaction.

11. 1) Control of edema
2) Pain control
3) Spasticity reduction
4) Facilitation of muscular contraction
5) Symptom management in multiple sclerosis
6) Acute inflammation

12. 1) Peripheral Vascular Disease :
Conditions like arteriosclerosis & other peripheral
vascular disorders, where there is impairment of
circulation over a particular area, the cryotherapy is
contraindicated because it may cause vaso-
constriction which increase blood viscosity and
decrease circulation.

13. 2) Vasopastic disorders :
E.g: Raynaud’s disease
3) Cold urticaria :
Due to release of histamine the patient suffering
from urticaria develops itching & erythema.

14. 4) Cryoglobulinemia :
Precipitation of abnormal blood production which
may block blood vessel.
5) Over Regenerating Peripheral Nerve

15.  Open wound
 Hypersensitive patient
 Cardiac disease
 Defective skin sensation
 Skin hypersensitivity
 Adverse psychological factors