Cryotherapy

Cold Packs

A cold pack is a superficial physical agent that reduces tissue temperature by means of conduction. Cold packs are typically composed of an outer vinyl pouch filled with a silica gel mixture that is kept between 0 C and 5 C. This method is used to achieve constriction of the blood vessels, decrease tissue metabolism, decrease pain threshold, reduce muscle spasm, temporarily decrease spasticity, and decrease tissue elasticity.

A protective layer should be placed between the cold pack and the skin. The layer can be either dry or damp. Place the pack on the area to be treated, and secure it well. The skin should be checked after 10 to 15 minutes for any signs of adverse effects, such as a rash or bluish/whitish coloring of the skin. Following 20 minutes of cold, the skin may be red or dark pink. Application of the cold pack may be repeated every 1 to 2 hours to control pain and inflammation.

Ice Massage

Ice massage is a convenient and easy example of cryotherapy. An ice cup (a paper cup filled with water that has been frozen) is used for the massage. Move the ice over the area to be massaged in small, overlapping circles. Ice massage can be done for 3 to 5 minutes or until numbness is experienced. The treatment area should be inspected for any signs of adverse reactions.

Contrast Bath

A contrast bath is a method applied by alternately immersing an area in warm or hot water, followed [Page 342]by cool or cold water. This method is used to increase superficial circulation, decrease pain, reduce muscle spasm, relieve joint pain and stiffness, decrease swelling, and increase tissue metabolism. Due to the circulatory effect of alternating opening and closing of the blood vessels, a pumping effect is achieved. Contrast bath is often used for edema and inflammation control. Indications for contrast bath are sprains, strains, tendinitis, and hypersensitivity. Contraindications are recent skin grafts, infection, bleeding, or decreased thermal sensation.

Two containers of water are placed adjacent to each other, one filled with warm water (3844 C) and the other filled with cool water (1018 C). The area to be treated is placed in the warm water first for 3 to 4 minutes. Then the area is immediately placed into the cool water for 1 minute. This sequence is repeated for up to 30 minutes. Recommendations for ending with cold or hot may be found equally in the literature, but there is no conclusive evidence to support either hot or cold as having superior effectiveness.

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