4.4 Review

Use of Cryotherapy for Managing Chronic Pain: An Evidence-Based Narrative

Journal

PAIN AND THERAPY
Volume 10, Issue 1, Pages 81-100

Publisher

SPRINGER INT PUBL AG
DOI: 10.1007/s40122-020-00225-w

Keywords

Chronic pain; Cold application; Cold therapy; Cryotherapy; Pain

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Cryotherapy has been used for many years to reduce chronic pain due to its ease of use, affordability, and simplicity. Both local and non-local applications show promise in reducing chronic pain associated with various chronic diseases. However, limitations in standardized studies, differences between studies, and lack of control groups make meta-analysis difficult, and further research is needed to fully support the use of cryotherapy in chronic pain management.
Background Cryotherapy has been used to reduce chronic pain for many years due in part to its ease of use, affordability, and simplicity. It can be applied either locally (e.g., ice packs) or non-locally (e.g., partial and whole-body cryotherapy) depending on the location of the pain. Objectives To determine the overall effectiveness of cryotherapy at reducing chronic pain by characterizing the currently available evidence supporting the use and effects of cryotherapy on chronic pain associated with chronic diseases. Study Design A narrative review of original research studies assessing the efficacy of cryotherapy in alleviating chronic pain. Methods A PubMed database search was performed to find human studies between the years 2000 and 2020 that included the application of cryotherapy in patients with chronic pain associated with chronic diseases. A review of the relevant references was also performed to gather more articles. Data was extracted, summarized into tables, and qualitatively analyzed. Results Twenty-five studies (22 randomized controlled trials, one prospective analysis, 1 one-group pretest/posttest study, and one case-control study) were included after the literature search. Both local and non-local cryotherapy applications show promise in reducing chronic pain associated with various chronic diseases including those of rheumatic and degenerative origin. Cryotherapy appears to be a safe therapy in carefully selected patients, with only minimal adverse effects reported in the literature. Limitations Meta-analysis was not possible given the many differences between studies. Cross-study data homogenization and comparison between studies proved fairly difficult due to the lack of standardized studies, various uses and practice types of cryotherapy, and lack of control groups in some studies. Conclusions Local and non-local cryotherapy can be low-risk and easy treatment options to add in the management of chronic pain in carefully selected patients. However, long-term effects, a standardized approach, and careful study of other chronic pain syndromes should be considered in future research to further support the use of cryotherapy in the management of chronic pain.

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