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OBJECTIVESHistoryCharacteristicsMethods of CryotherapyEvidence Based ResearchReview QuestionsReferences
HISTORYThe Egyptians used cold to treat injuries and inflammation as
early as 2500 BC. Ancient Greeks and Romans used cold applications of snow
and natural ice to treat a variety of medical problems. Many books and articles were written about
cryotherapy in the early 19th century. By 1835 the application of cold compresses to inflammed wounds was a common treatment option. The first commercially viable ice machine was patent- -ed in 1850 by a Florida physicianBetween 1845 and 1851, Dr. James Arnott of Brighton, England described the benefits of local cold application in
the treatment of numerous conditions, including headaches and neuralgia.
HISTORYBy 1881, cold compresses were a recognized addition to
treatment after surgery. But in the 1930s, the common treatment for acute injuries
was hot compresses combined with soap suds or epsom salts. Medicine books began advocating cold treatments again for
acute injuries by the 1940s. In the early 1960s, athletic trainers were arguing the benefits
of heat vs. cold applications for initial treatments of athletic injuries.
Cold was almost used universally by sports medicine practitioners for immediate care by the 1970s.
Beginning in the 1980s through the 21st century, great efforts have been made to expand the theoretical basis for the use of cold applications in acute injury management.
WhirlpoolMethods of applicationIndicationsContraindicationsPrecautionsRecommendations for useProper use of agent
ICE MASSAGEMethods of applicationIndicationsContraindicationsPrecautionsRecommendations for useProper use of agent
Cold Compression TherapyMethods of applicationIndicationsContraindicationsPrecautionsRecommendations for useProper use of agent
METHODS OF APPLICATIONApplied 24 to 72 hours after acute injury of
surgery.Cuffs come for specific areas of the body, i.e.
shoulder, ankle, and kneeProvides a cooling effect with compression
and elevation for post surgery patients.
CONTRAINDICATIONSCardiac or Respiratory ProblemsUncovered Open WoundsCirculatory InsufficiencyCold Allergy or HypersensitivityAnesthetized Skin
PRECAUTIONSAvoid applying too much pressureAvoid applying over large superficial nerves,
could cause cold induced neuropathy
RECOMMENDATIONS FOR USERecommended for postsurgical patients for
home use.Can be used for 24 to 72 hours post surgery.
ICE PacksMethods of applicationIndicationsContraindicationsPrecautionsRecommendations for useProper use of agent
METHODS OF APPLICATION• Apply to affected area
• 15 to 20 minutes at a time several times a day
• Prolonged ice application beyond 1 to 2 days has been shown to impair healing.
INDICATIONSUse of an ice pack is in the acute phase of a
soft tissue injury.Cooling will help prevent swelling.Ice packs are also useful to minimize or
prevent increased inflammation or pain.The depth of anesthesia with an ice pack is
generally considerably less than with an ice massage.
CONTRAINDICATIONSSevere reactions to cold are rare and are related
to hypersensitivity reactions.Cold is contraindicated for patients who have
developed hypertension during cold treatment or have a cold allergy (hives, joint pain) or cryoglobulinemia.
Cold should not be applied to areas of reduced skin sensitivity, or in patients who have Raynaud’s syndrome or sickle cell anemia.
Cold can further impair local blood flow in people who have peripheral vascular disease.
PRECAUTIONS• Prolonged exposure will lead to freezing of tissue.
• A number of cases of peripheral nerve injury from cryotherapy have been reported.
• Injury sites have included the peroneal, lateral femoral cutaneous, and supraclavicular nerves
RECOMMENDATIONS FOR USEDecreases or reduces swellingDecreases inflamationDecreases muscle spasmDecreases painDecreases vasoconstrictionDecreases secondary tissue damage
PROPER USE OF AGENTWhen applying an ice pack, never do so
directly onto the skin unless you are using crushed ice.
15-20min intervals several times a dayDuring the first 24 to 72 hours after an injury
be sure to avoid any form of heat at the injury site, avoid movement and do not massage the injured area as these will increase the bleeding, swelling, and pain.