How does whole-body cryotherapy affect immune parameters in rheumatoid arthritis patients. What are the clinical benefits of cryotherapy for rheumatoid arthritis symptoms and disease activity. Is whole-body cryotherapy a safe and effective complementary treatment for rheumatoid arthritis.

Understanding Whole-Body Cryotherapy in Rheumatoid Arthritis Treatment

Whole-body cryotherapy (WBC) is an emerging complementary treatment option for patients with rheumatoid arthritis (RA). This therapeutic approach involves exposing the entire body to extremely cold temperatures, typically between -110°C and -140°C, for a short duration of 2-3 minutes. The potential benefits of WBC for RA patients have garnered increasing interest in recent years, prompting researchers to investigate its effects on immune parameters and clinical outcomes.

How does whole-body cryotherapy work?

WBC is believed to work by triggering a series of physiological responses in the body. The extreme cold exposure causes blood vessels to constrict, redirecting blood flow to vital organs. Upon rewarming, blood vessels dilate, promoting enhanced circulation throughout the body. This process is thought to reduce inflammation, alleviate pain, and potentially modulate immune function.

The Impact of Cryotherapy on Immune Parameters in RA Patients

A key focus of recent research has been to understand how WBC affects immune parameters in RA patients. The immune system plays a central role in the pathogenesis of RA, with various inflammatory mediators contributing to joint damage and systemic inflammation.

Which immune markers are affected by whole-body cryotherapy?

Studies have shown that WBC can influence several immune markers relevant to RA. These include:

• Pro-inflammatory cytokines (e.g., TNF-α, IL-6)
• Anti-inflammatory cytokines (e.g., IL-10)
• Acute phase reactants (e.g., C-reactive protein)
• Regulatory T cells
• Oxidative stress markers

The modulation of these immune parameters may contribute to the potential therapeutic effects of WBC in RA patients.

Clinical Benefits of Whole-Body Cryotherapy for RA Symptoms

Beyond its effects on immune markers, WBC has demonstrated several clinical benefits for RA patients. These improvements in symptoms and disease activity measures have been documented in various studies.

Can whole-body cryotherapy reduce pain in RA patients?

Pain reduction is one of the most consistently reported benefits of WBC in RA patients. The analgesic effect is thought to be mediated through several mechanisms, including:

1. Decreased nerve conduction velocity
2. Release of endorphins
3. Reduction of inflammatory mediators
4. Muscle relaxation

Many RA patients report significant improvements in pain levels following a series of WBC sessions, with effects often lasting for several weeks after treatment.

Effects of Cryotherapy on Joint Function and Mobility

Improved joint function and mobility are crucial goals in RA management. WBC has shown promise in addressing these aspects of the disease.

How does cryotherapy impact joint stiffness and range of motion?

WBC can help reduce joint stiffness and improve range of motion in RA patients through several mechanisms:

• Decreased inflammation in affected joints
• Reduced muscle tension
• Improved blood flow to joints upon rewarming
• Temporary analgesic effect allowing for increased movement

These effects can contribute to improved functional capacity and quality of life for RA patients undergoing WBC treatment.

Assessing Disease Activity and Inflammation Markers After Cryotherapy

Objective measures of disease activity and inflammation are essential for evaluating the efficacy of any RA treatment. Research has explored how WBC impacts these important clinical parameters.

Do inflammatory markers decrease following whole-body cryotherapy?

Several studies have reported reductions in inflammatory markers following WBC treatment in RA patients. These include:

• Decreased C-reactive protein (CRP) levels
• Lowered erythrocyte sedimentation rate (ESR)
• Reduced levels of pro-inflammatory cytokines

These changes in inflammatory markers suggest that WBC may have a systemic anti-inflammatory effect, potentially contributing to its therapeutic benefits in RA.

Safety Considerations and Potential Side Effects of Cryotherapy

As with any medical intervention, it is crucial to consider the safety profile and potential side effects of WBC when evaluating its use in RA patients.

Is whole-body cryotherapy safe for all RA patients?

While WBC is generally considered safe for most RA patients, certain precautions and contraindications should be noted:

• Patients with severe cardiovascular conditions should avoid WBC
• Those with uncontrolled hypertension may be at increased risk
• Individuals with Raynaud’s syndrome should use caution
• Pregnant women are typically advised against WBC

It is essential for patients to consult with their rheumatologist before initiating WBC treatment to ensure it is appropriate for their individual case.

Integrating Cryotherapy into Comprehensive RA Management

While WBC shows promise as a complementary therapy for RA, it is important to consider how it fits into a comprehensive management plan for the disease.

How can cryotherapy complement traditional RA treatments?

WBC may be used in conjunction with standard RA treatments to enhance overall outcomes. Potential benefits of integrating WBC include:

• Reduced reliance on pain medications
• Improved response to physical therapy and exercise
• Enhanced quality of life and functional capacity
• Potential synergistic effects with disease-modifying antirheumatic drugs (DMARDs)

It is crucial for patients and healthcare providers to view WBC as a complementary approach rather than a replacement for evidence-based pharmacological and non-pharmacological interventions.

Future Directions in Cryotherapy Research for Rheumatoid Arthritis

While current evidence supports the potential benefits of WBC in RA, further research is needed to fully elucidate its mechanisms of action and optimize its use in clinical practice.

What are the key areas for future cryotherapy research in RA?

Future studies should focus on:

1. Long-term efficacy and safety of WBC in RA patients
2. Optimal treatment protocols (frequency, duration, temperature)
3. Identifying patient subgroups most likely to benefit from WBC
4. Investigating the molecular mechanisms underlying WBC’s effects on immune function
5. Exploring potential synergies between WBC and other RA treatments

By addressing these research gaps, clinicians and patients will be better equipped to make informed decisions about incorporating WBC into RA management strategies.

In conclusion, whole-body cryotherapy represents a promising complementary approach for managing rheumatoid arthritis symptoms and potentially modulating immune function. While current evidence suggests benefits in terms of pain reduction, improved joint function, and decreased inflammation, further research is needed to fully establish its role in comprehensive RA care. As with any emerging therapy, patients should consult with their healthcare providers to determine if WBC is an appropriate addition to their individual treatment plan.

Whole-body cryotherapy for the treatment of rheumatoid arthritis: a monocentric, single-blinded, randomised controlled trial

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Randomized Controlled Trial

. 2022 Nov;40(11):2133-2140.

doi: 10.55563/clinexprheumatol/lrff6k.

Epub 2022 Mar 1.

Philipp Klemm 
¹
, Jutta Hoffmann 
²
, Thomas Asendorf 
³
, Iris Aykara 
²
, Klaus Frommer 
²
, Gabriel Dischereit 
⁴
, Ulf Müller-Ladner 
²
, Elena Neumann 
²
, Uwe Lange 
²

Affiliations

Affiliations

• ¹ Department of Rheumatology, Clinical Immunology, Osteology and Physical Medicine, Campus Kerckhoff, Justus-Liebig-University Gießen, Bad Nauheim, Germany. [email protected].
• ² Department of Rheumatology, Clinical Immunology, Osteology and Physical Medicine, Campus Kerckhoff, Justus-Liebig-University Gießen, Bad Nauheim, Germany.
• ³ Department of Medical Statistics, University Medical Center Göttingen, Germany.
• ⁴ Rheumatologische Schwerpunktpraxis Marburg, Germany.

• PMID:

  35238767

• DOI:

  10.55563/clinexprheumatol/lrff6k

Free article

Randomized Controlled Trial

Philipp Klemm et al.

Clin Exp Rheumatol.

2022 Nov.

Free article

. 2022 Nov;40(11):2133-2140.

doi: 10.55563/clinexprheumatol/lrff6k.

Epub 2022 Mar 1.

Authors

Philipp Klemm 
¹
, Jutta Hoffmann 
²
, Thomas Asendorf 
³
, Iris Aykara 
²
, Klaus Frommer 
²
, Gabriel Dischereit 
⁴
, Ulf Müller-Ladner 
²
, Elena Neumann 
²
, Uwe Lange 
²

Affiliations

• ¹ Department of Rheumatology, Clinical Immunology, Osteology and Physical Medicine, Campus Kerckhoff, Justus-Liebig-University Gießen, Bad Nauheim, Germany. [email protected].
• ² Department of Rheumatology, Clinical Immunology, Osteology and Physical Medicine, Campus Kerckhoff, Justus-Liebig-University Gießen, Bad Nauheim, Germany.
• ³ Department of Medical Statistics, University Medical Center Göttingen, Germany.
• ⁴ Rheumatologische Schwerpunktpraxis Marburg, Germany.

• PMID:

  35238767

• DOI:

  10.55563/clinexprheumatol/lrff6k

Abstract

Objectives:

To evaluate effects of whole-body cryotherapy (WBC) in rheumatoid arthritis (RA).

Methods:

Patients with active RA undergoing a 16-day multimodal rheumatologic complex treatment were randomly assigned to either WBC (6 applications in 14 days at -130°C for 3 min) or no treatment. The primary outcome was the difference between groups in pain on a numerical rating scale after intervention. Secondary outcomes assessed effects on i) disease activity, ii) functional capacity, iii) cytokine levels, and iv) use of analgesics.

Results:

A total of 56 RA patients completed the trial (intervention group [IG]: 31 patients, control group [CG]: 25 patients). The mean change (± standard error) in pain after intervention was -2 in the IG (95% confidence interval [CI] -2.75 to -1.31, p<0.001) and -0.88 (95% CI -1.43 to -0.33, p=0.003) in the CG, with a baseline-adjusted between-group difference of -1.31 ± 0.4 (95% CI -2.1 to -0.53; p=0. 002). Pain at the 12-week follow-up visit remained significantly below baseline values in the IG. Disease activity and functional capacity showed statistically and clinically meaningful improvement after intervention but were not significant at the 12-week follow up. TNF and IL-6 levels changed significantly in the IG. Eighteen of 31 (58%) patients of the IG reduced or discontinued analgesics at the 12-week follow-up. No WBC-related side effects were reported.

Conclusions:

WBC in RA reduces pain and disease activity significantly and in a clinically meaningful manner, resulting in a reduction of analgesics. These effects are potentially based on a change in cytokine levels.

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Does Cryotherapy Help Treat Rheumatoid Arthritis Pain?

Some spas tout whole-body cryotherapy as a way of reducing RA inflammation and pain. Does the deep-freeze treatment work?

By Meryl Davids LandauMedically Reviewed by Alexa Meara, MD

Reviewed: September 9, 2021

Medically Reviewed

Get the facts before you try whole-body cryotherapy (WBC) for rheumatoid arthritis pain.Adobe Stock

It almost sounds too good to be true. Specialized spas are touting whole-body cryotherapy (WBC) as a way of reducing rheumatoid arthritis (RA) symptoms of inflammation, swelling, and pain.

On its surface, it sounds logical. After all, cold therapy, typically in the form of ice packs, is often recommended to bring relief to achy joints.

But cryotherapy isn’t just cold. It is way below freezing. The temperature where water freezes is 32 degrees Fahrenheit (0 degrees Celsius). Whole-body cryotherapy temporarily exposes skin to temperatures as low as minus 200 degrees Fahrenheit.

RELATED: 10 Foods to Help Fight RA Inflammation

Little Evidence Supports Whole-Body Cryotherapy

Although athletes and celebrities have touted whole-body cryotherapy as helping their health and feelings of well-being, there’s little documentation of extreme cold having tangible effects, or whether there are side effects from use of this treatment long-term.

Many spas tout the ability of cryotherapy to help muscles recover from injury or overuse. But as scientists at Lenox Hill Hospital in New York City noted in a review published in August 2021 in the European Journal of Applied Physiology, “Cryotherapy-induced reductions in metabolism, inflammation, and tissue damage have been demonstrated in animal models of muscle injury; however, comparable evidence in humans is lacking.”

One study that looked at the effect of cryotherapy on people with rheumatoid arthritis didn’t find it beneficial. Sixty people were randomized either to WBC at minus 166 degrees F, or minus 66 degrees, or cryotherapy in just one localized area. Each treatment was given three times a day for a week, with rheumatologists subsequently measuring antioxidant capacity in the blood. Those having the coldest treatment did receive a short-term boost in this capacity, but none of the other groups did, and the effects didn’t last the week. “The cold treatments did not cause a significant oxidative stress or adaptation during one week, the study authors conclude in the September 2017 issue of Rheumatology International.

RELATED: How Massage Therapy Helps Ease Rheumatoid Arthritis Pain

More positive results were found in a small Polish study for another inflammatory autoimmune condition, ankylosing spondylitis (AS), published in October 2018 in Oxidative Medicine and Cellular Longevity. Here too, just over 60 people were randomized to the two WBC temperature treatments, and there was also a control group receiving no cryotherapy treatment. After eight days of the intervention, those in the group experiencing the coldest cryotherapy reported a subjective decrease in disease activity at rates statistically higher than the others.

The FDA Hasn’t Given Its Approval

The last time the U.S. Food and Drug Administration (FDA) weighed in on cryotherapy was in 2016 when the agency issued a statement that although some spas suggest they have gotten the agency’s nod, “In fact, not a single WBC device has been cleared or approved by the agency in support of these claims. ”

The statement quoted an FDA official on the lack of strong science: “Given a growing interest from consumers in whole body cryotherapy, the FDA has informally reviewed the medical literature available on this subject. … We found very little evidence about its safety or effectiveness in treating the conditions for which it is being promoted.”

When asked what happens physiologically — to your heart, blood pressure, and other bodily functions — when exposed to such extreme cold, an FDA scientific reviewer responded, “We simply don’t know.”

Cryotherapy Treatment Takes Place in a Small Tank

In a cryotherapy spa, you wear minimal clothes and are exposed to the cold by standing solo in a tank that covers everything but your head. Or, in some places, you enter a specialized room with several other people. A substance such as liquid nitrogen is pumped in, but since it turns to gas when it is frozen, you don’t actually feel it.

What you do feel, according to people who have tried it, is a sensation of a blast of cold air, then the chattering of your teeth as if you were outside on a frigid day, to several seconds more when your body starts to feel like an icicle.

There’s Probably Little to No Downside — Except That WBC Treatment Is Not Cheap

Daniel Muller, MD, a rheumatologist at UCHealth in Fort Collins, Colorado, and a coauthor of the book Integrative Rheumatology, says it’s unlikely that severe negative effects would result in people with RA from the few minutes of exposure.

For most people, he says, the biggest risk is likely to your wallet, since most cryotherapy treatment centers recommend you go several times a week for an extended period of time, and the payments will add up fast.

People with severe Raynaud’s syndrome, a comorbid condition to rheumatoid arthritis, in which small blood vessels in the fingers or toes constrict when exposed to cold, should probably stay away, Dr. Muller advises.

If You Want to Try Cryotherapy, Look for a Reputable Place

If you do decide to try it, look for a cryotherapy spa with a lot of positive reviews on ratings sites. You might also ask about the medical training of the owner of the spa. Because no credentialing is currently required, owners can range from someone with a formal medical degree (the ideal) to someone with absolutely no medical knowledge.

There are dangers to going to a place that doesn’t take safety seriously. In 2015, a young woman who worked at a cryotherapy spa in Las Vegas died after going into the whole-body cryotherapy chamber after-hours. She suffocated, although exactly how that happened is a mystery, since she was alone. The state of Nevada promptly shut down that spa.

Whole-Body Cryotherapy Risks and Potential Problems

In its statement the FDA cites potential hazards from the treatment, including:

• Frostbite
• Burns
• Eye injury
• Oxygen deficiency
• Asphyxiation

Talk to Your Doctor Before Trying Cryotherapy

It’s always a good idea to discuss therapies like WBC with your doctor before you try it. And as with all complementary approaches, it should never be done in place of treatment options with established records of safety and effectiveness.

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Cryotherapy for arthritis. The real story – Cryotherapy

Cryotherapy for arthritis. The real story

In any business, the most valuable is the personal experience “passed through oneself”. In the field of joint disease treatment, I was “lucky”: 7 years ago I experienced and successfully overcame an attack of knee arthritis. It is especially valuable that I experienced all the stages and features of the treatment by the method of general cryotherapy and I can describe my feelings to the nearest day.

Arthritis: treatment, remission, relapses

To my shame, faced with the disease personally, I did not immediately use cryotherapy. At first there was an appeal to traditional, drug therapy. At the specialist, my suspicions about the causes of knee pain were confirmed. The diagnosis is arthritis. Strict dietary recommendations were immediately formulated, a course of several drugs was prescribed, and an “optimistic” statement was made: “Now you are our regular patient.” It was this statement, with its hopelessness, that made me remember that cryotherapy, to which so much effort and time has been given, was invented just for the treatment of rheumatoid arthritis.

Therefore, before “surrendering” to rheumatologists, I decided to take advantage of the unique possibilities of the cryosauna. And… everything worked out! Two 3-minute sessions allowed me to move freely throughout the day. To speed up the treatment, I bought an exercise bike and “pedaled” daily for up to 1.5 hours. On vacation, he swam to “frenzy”, and the disease receded. First, the night pains disappeared, then the swelling of the knee, and a month later the problem became an unpleasant memory. To enhance the effect, I followed the recommendations of rheumatologists and removed the tonsils.

Result – 7 years of normal life without doctors, pills, diets and other restrictions. True, at first the fright from the disease was strong, so I sacredly observed the training regimen of 0.5 hours of an exercise bike every day. Years later, the troubles were forgotten. Laziness gradually took its toll, the exercise bike was covered with dust …. And I got what “friendly” rheumatologists predicted for me from the first days – a relapse of the disease. A combination of circumstances: a cold January, skiing, neglecting cycling did their job. The knee was swollen again, stopped bending and almost constantly hurt. I had to start all over again, since I already have experience. Again an intensive course, 2 times a day with a maximum duration of procedures, therapy, exercise bike and increased joint activity. And within 2 weeks, things were looking up. The pain went away, the swelling subsided again, the ability to move and live without looking back returned. A new positive experience has appeared – to supplement cryotherapy with traditional methods. In particular, it is very good to apply a warming ointment on the knee after the procedure and wrap the composition in a warming kneecap. The active substances of the warming ointment, combined with the effect of general cryotherapy, significantly accelerate the suppression of edema and the restoration of mobility. It is useful to work out on an exercise bike immediately after applying a warming bandage. The movement is intense, and the load on the inflamed joint is small. But it is better to refuse walking and running for the duration of treatment. When the pain began to recede, I rashly played tennis for 1 hour and immediately realized that it was a mistake.

Summing up personal observations, I can give some advice to those who face the problem of arthritis:

1. Try to organize your treatment according to an intensive scheme, i. take at least two treatments daily. Three sessions are ideal: early morning, mid-afternoon and evening. This is the classic treatment regimen according to Yamauchi T. , it provides complete relief from pain and significantly reduces the duration of treatment.
2. Be sure to supplement cryotherapy sessions with light gymnastic exercises for the diseased joint, as well as the application of warming ointments. These additional measures will help to focus the “attention” of the immune system on the “problem” joints.
3. After the attack has passed, keep the increased activity of the joint for at least a month. And then periodically conduct preventive training.
4. Strive to stay in the cryosauna as long as possible, as the maximum effect is achieved in the last seconds of the session.

Unfortunately, cryotherapy is still not popular with rheumatologists.

However, knowing the mechanism of action of cryotherapy, you can treat yourself.

Theoretical basis for the treatment of rheumatoid arthritis

Rheumatoid arthritis is a chronic autoimmune systemic inflammatory disease of the connective tissue with a predominant lesion of the joints, similar to erosive-destructive progressive polyarthritis. The disease affects 0.5-1% of the population. Around 58 million people worldwide suffer from rheumatoid arthritis.

Behind the dry lines of a quote from a medical reference book, there is a sad story of many people’s illnesses. With a modern lifestyle with insufficient physical activity and the same type of movements during work, not everyone succeeds in maintaining healthy joints. The result is sad – rheumatoid arthritis is a disease that knows no age or racial boundaries. A disease with which people live, or rather survive for decades.

In patients with rheumatoid arthritis, joint mobility is sharply reduced. Patients lose the ability to perform habitual actions, they are tormented by pain and awareness of their own weakness. If the disease is not stopped in time, in five years a person may end up in a wheelchair. And that is not all. In addition to the joints, rheumatoid arthritis extends its influence to the internal organs. Complications of the disease can be rheumatic lesions of the heart, lungs, liver, kidneys, blood vessels and intestines.

Medical books and the Internet sympathetically report that, unfortunately, scientists have not yet invented magic pills that rid patients of rheumatoid arthritis quickly and permanently. However, it is possible and necessary to treat the disease … At the same time, it is directly stated that modern remedies for rheumatoid arthritis only slow down the development of the disease, relieve unpleasant symptoms and prevent the occurrence of complications.

Anti-inflammatory drugs relieve inflammation, reduce pain.

Antirheumatic drugs are used during an exacerbation. It must be borne in mind that all these drugs will have to be taken for a very, very long time, perhaps even for the rest of your life. In addition, they often cause adverse reactions, so it is advisable to take them only under the supervision of a doctor. Here’s a prospect…

Reporting this gloomy information, specialists prepare the patient for long years of treatment and even surgery. At the same time, nowhere can you find at least a mention that an alternative to traditional palliative care has existed for 30 years. ..

Even 30 years ago in Japan, doctor T. Yamauchi used a fundamentally new method – cryotherapy – to treat patients with rheumatoid arthritis. If before that, diseased joints were warmed, and it was believed that physical activity was contraindicated for such patients, then in a Japanese clinic they were blown with cryogenic gas at a temperature of -180 ° C. Moreover, starting with individual joints, they quickly became convinced that it is even more effective to cool the entire surface of the skin. Apparatuses in which people were treated with cold were called cryosaunas. 25 years ago, the magical effect of cryotherapy was discovered in Europe. 10 years ago at 1998, the first patients underwent trial procedures in the domestic cryosauna of hospital No. 32 in St. Petersburg.

In May 2008, 10 years have passed since the beginning of the clinical use of general cryotherapy in Russia. I recall the anxiety with which we started the first sessions of cryotherapy. Reality exceeded our expectations… Patients with rheumatoid arthritis, mostly elderly people, simply flourished before our eyes. And this is after 10-20 years of unsuccessful treatment! After the cryosauna session, the patients got up from the wheelchair and moved freely for 6-8 hours. With each procedure, the condition improved. I especially remember sick B., a woman who at that time headed the society of patients with rheumatoid arthritis. She ended up in hospital No. 32 by a lucky chance and just came back to life right in front of our eyes. Everything seemed to be decided: not only the Japanese and Western Europeans, but also our citizens will finally receive the long-awaited help in the unequal struggle with the insidious disease… But the method remained unclaimed by rheumatologists. Today, cryotherapy is used very widely: it is used to treat psoriasis, bronchial asthma, burns, fractures, etc. and so on. And only in rheumatology – the area for which this method was created, cryosauna remains unclaimed. Of the 200 domestic cryosaunas, not one got into specialized rheumatological centers.

The physiological, effective method is simply not noticed, and patients are reassured by reasoning about the lack of adequate therapy. Meanwhile, the effectiveness of cryotherapy in the treatment of rheumatoid arthritis, proven by practice, follows from the definition of the disease. We know that rheumatoid arthritis is a chronic autoimmune disease and cryotherapy is the best known remedy for immune problems. Everything is so obvious that there is nothing to argue about. But the conspiracy of silence continues…

Professor of the Department of Cryogenic Engineering, St. Petersburg State University of Low Temperature and Food Technologies Baranov A.Yu. March 2010

Cryotherapy – Treatment – Sanatorium-dispensary – Medical unit “Shakhtar”

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Cryotherapy is a cold treatment. Krio (Greek kryos cold, frost).

Cryotherapy – cold treatment; physiotherapeutic procedure, the action of which is based on the response of the body to hypothermia of the outer (receptor) layer of the skin. General cryotherapy (cryosauna) irritates the entire receptor field of the skin, affects the central nervous system and causes a number of positive changes in the immune, endocrine, circulatory and other systems of the body.

Cryosauna has analgesic, anti-inflammatory, anti-edema and antispasmodic effects, promotes blood saturation with active biological components – endorphins. Cryosauna has a hardening effect (1 course cryotherapy equals 3-4 years of hardening)

The duration of the procedure is 60-180 sec. Therapeutic results even from the first 2-3 procedures are felt immediately – the cessation of pain in the joints, spine, improved sleep, improved mood, etc. The healing course is 5-10 sessions within 2-3 weeks, the procedure time can vary from 1 to 3 minutes.