Physiological Effects
- Decrease metabolic rate (reduces tissue damage from secondary hypoxia and enzyme activity)
- Vasoconstriction and decreased blood flow
- Increased blood viscosity
- Stimulation of sensory nerves
- Reduced nerve conduction velocity
Cryotherapy
To progressively decrease the subcutaneous temperature through local body cooling via the application of substance that results in transfer of heat away from the tissue
Therapeutic Effects?
- Pain Relief
- Reduce inflammation and swelling
- Limits secondary tissue damage due to hypoxia
- Reduced muscle spasm due to reduced pain
- Increase range of motion due to reduction in swelling
Contraindications/ precautions
- Circulatory insufficiency
- Existing conditions that could be exacerbated:
Areas recently treated with radiotherapy
Haemorrhagic disorders
Severe organ states e.g. cardiac failure
Skin conditions, open wounds, etc. - Sensory loss
- Unable to communicate
- Hypersensitive patients (precaution)
- Angina (can be aggravated by cooling)
Ice Burns
Mild: Characterised by erythema and skin tenderness a few hours after treatment.
Severe: Bruising and damage to neural tissue that can last for > 3 weeks.
Ice Reaction Test
Test by either performing an ice cube massage for a minimum of 30 seconds OR
Apply an ice pack and examine local response under the pack after 5 minutes
Contraindication: excessive redness, swollen mark or a systemic reaction, including increased blood pressure or heart rate.
Application: Immersion
- Temperature is controlled by varying the proportions of ice-to-water
- Water of 16-18°C can usually be tolerated for 15-20 minutes
Lower temperatures (i.e. 5°C) require intermittent immersion usually around 1 minute
Commercial cold packs/ ice packs Application
Need to be wrapped in a towel prior to application
Ice Towels Application
Towels placed in a mixture of water/ice then wrung out. Repeated applications every 2-3 mins
Cryocuffs Application
Ice/water mixture applied to the body via a sleeve that introduces simultaneous compression
Ice massage Application
Ice is frozen into a cup for massage over a local area. Ice is kept moving over the body part
Monitoring
Observe skin and ask patient regarding the temperature
* Be careful of superficial nerves
* Check for adverse reactions
At the start of Rx
After 5 minutes; then regularly
After Rx
* Adverse reactions include:
Excessive redness
swollen mark
systemic reaction (including increased blood pressure/ heart rate)
* Document and refer for medical Rx if required
