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Cryotherapy: the latest miracle money-waster

October 29th, 2010

cryosauna

At the risk of sounding a bit cranky, I’m going to complain about another piece of new-fangled sports technology. Doug Binder of TrackFocus has an interesting article about Alberto Salazar’s Nike group in Oregon using a “Space Cabin” for cryotheraphy to cool down after workouts:

Step inside this metallic cylinder and liquid nitrogen-cooled air (say, 170 degrees below zero) rushes in and cools your skin to a chilly 30 degrees, yet penetrates just a half millimeter. You slowly rotate for two and a half minutes, holding your hands up and out of the freeze, wearing socks on your toes, and at least some underwear to cover your privates.

Okay, I’m down with ice baths, and maybe this is a super-ice-bath – though I’m certainly curious about how much one of these gadgets costs, and whether it’s actually any better than a simple ice bath. What got me cranky was the manufacturer’s website, which claims that the benefits of this device include (but are not limited to):

* Decreased fatigue
* Decreased muscle soreness
* Decreased injury recovery time
* Quicker surgical recovery
* Psychological competitive edge [okay, this one I believe]
* Decreased anxiety
* Decreased depression
* Decreased incidence of colds and flu
* Tighter, healthier skin
* Cellulite reduction
* Stronger, fuller hair
* Stronger nails
* Fewer skin blemishes
* Increased libido
* Increased sexual stamina

And of course, “it f-ing prints money!” I mean, seriously. They must have lots of evidence to back up those claims, right? Why yes, FAQ no. 17 is “Are there any studies regarding Whole Body Cryotherapy (WBA) in the USA?” The answer is:

Yes, there is. We recently installed cryosauna in the office of Dr. Jonas Kuehne in Beverly Hills, Los Angeles, California. During a six month study, Dr. Kuehne successfully served his clients with cryoprocedures. HERE you can find a video clip with some results of his studies.

Click on the link and, if you don’t poke your eyes out with a fork, you can watch a lame infomercial by some doctor who makes no mention of a “study” and who simply reasserts that these machines can do everything including your taxes.

Anyway, perhaps I’m being premature in my scorn. Maybe the studies demonstrating all these wonderful effects just haven’t been published yet. After all, it’s fancy new technology, right? As FAQ no. 1 says:

The process was originally developed in Japan in 1978, and the benefits have been studied and refined in Europe since that time.

Silly North Americans, ignoring all these wonderful benefits for the last 32 years!

(Okay, so what’s my real message here? When I first read the story, I was interested to find out more about this technology. But what really turned me off was the wildly inflated claims on the website with a complete lack of evidence. It’s entirely possible that this technique will have some benefits for Salazar’s athletes, but the snake-oil website lowers my confidence in it dramatically.)

  1. October 29th, 2010 at 10:59 | #1

    Here’s the only study I found on it:
    http://www.ncbi.nlm.nih.gov/pubmed/20524715

  2. alex
    October 30th, 2010 at 03:39 | #2

    @steve

    Thanks for posting that, Steve — I’d missed it (and just now saw it on your Twitter feed!). At least I now know that there IS some scientific literature about this machine! Having read through the paper, I’m still not sold on its benefits — except maybe as a quicker, more comfortable way of ice-bathing after a workout (though even that use hasn’t been experimentally validated). Still, for elite athletes working out 2-3 times a day who could benefit from an ice bath pretty much daily, maybe the convenience really does make it worthwhile. As long as Nike’s picking up the tab. :)

    As an overall comment on the literature, though, I’m not superimpressed by studies that perform some procedure, measure 100 blood markers to see what changed, then pick the three that changed and formulate some hypothesis about what beneficial effect these microscopic changes MIGHT have…

  3. Eric Teske
    October 31st, 2010 at 18:48 | #3

    Great post, I hadn’t heard anything about a cryotheraphy chamber until now. I’ll add it to my growing list of expensive quackery.

    Along these same lines, I’d love to hear your take on ultrasound therapy. It’s a very impressive procedure for physical therapists, and I’m sure gives a great placebo, but does it do anything a heat pack can’t?

  4. alex
    October 31st, 2010 at 22:39 | #4

    @Eric Teske
    Thanks, Eric. Yeah, ultrasound… Gina Kolata wrote an article in the Times earlier this year that basically argued that there’s no evidence for most physical therapy modalities, including ultrasound. I haven’t done the research myself, but I’m not aware of any compelling research showing that it works.

    Ultrasound does have some purported uses that are a little different from heat packs — for example, it’s supposed to help break down scar tissue. (For simple heating, short-wave diathermy apparently works better than ultrasound.)

    I have to admit, I always found the ultrasound gel to be very soothing when it was spread on. Great placebo effect, as you point out! But as for real evidence, I haven’t seen any.

  5. November 1st, 2010 at 20:19 | #5

    Hi Eric and Alex,

    You can pretty much make the argument that all forms of rehabilitation (physio modalities, manual therapy, spine manipulation, ART, stretching, “core” stability) have very little unequivocal research behind them for the majority of injuries. Yet, as therapist we do try different therapeutic routes for unresolved aches and pains and sometimes things work where other therapies failed. Even when the majority of research studies might suggest our treatment is ineffective or most likely there is no research behind it (e.g. ART breaking up an “adhesion”). While placebo is certainly powerful there are other explanations.

    As a former biomechanics researcher who saw tonnes of variability in everything that I measured (e.g. one athlete’s ab muscle fires at 60% of max during a curlup while another athlete’s same muscle fires at 10% of max) we often chalk up the lack of solid research to the observation that every injury and every individual are different.

    Maybe ultrasound only works on 2 out of 10 people with a certain type of shoulder pain at a certain stage in their injury. When research projects are designed we usually don’t stratify patients/subjects into highly specific different groups that might tease out these differences. We just put them into a control or an experimental group. You can lose a lot of information when you deal with these generalizations.

    Good research is very hard to do. The absence of evidence is not the same as evidence of absence.

    Keep up the great site,

    Greg

  6. alex
    November 1st, 2010 at 23:08 | #6

    “The absence of evidence is not the same as evidence of absence.”

    Very good point, Greg. The analogy I sometimes use is to glasses — if you took 10,000 people with vision problems and gave them all a pair of my dad’s prescription lenses, we’d conclude fairly strongly that glasses don’t help people to see better on average. And of course, we’d be wrong, because you need the right glasses for the each specific vision problem.

    Here’s what I wrote on the blog when Gina Kolata’s physio-had-no-evidence article first came out: “the fact is, if we limited ourselves to the modalities that have solid peer-reviewed evidence, we’d all just be lying in bed for a few weeks every time we got injured. So much as I like evidence-based medicine, I think we have to be realistic about the current state of knowledge.”

    So what’s the difference between cryotherapy and, say, ultrasound? What irked me most about the cryotherapy website was all the bold but unsupported claims. If they’d said something like what you just wrote, acknowledging the limits of their current research, I wouldn’t have blinked. The other thing is cost: I think the more expensive or invasive a treatment or gadget is, the higher the standard of evidence you should expect for it. (Of course, for the Nike athletes in Portland, the potential upside of an injury averted is so great that the cost-benefit calculation is quite different than it would be for most of us.)

  7. John Lofranco
    November 3rd, 2010 at 12:14 | #7

    Stonger, fuller hair? Sign me up!

  8. James
    November 18th, 2010 at 15:39 | #8

    Cool running water, such as a mountain stream, is the best cooling recovery aid. Remember: We are mostly water.

  9. dieselmex
    December 9th, 2010 at 06:05 | #9

    OK… here I go. This may seem a bit weird, but, hey, isn’t mostly EVERYTHING weird? I was in a meeting today with a group of physicians and scientists that wanted our company to make a new Whole Body Cryogenic Chamber (WBCC). The rest of the day has been poring through tons of the most amazing papers (and I mean academic, scholar papers) published in the past ten years. Maybe the guys who make this super-low-temp gadget are just making money, but the truth is: Cryogenic treatment goes well beyond the benefits he claims. Mind you, when I say well beyond, I mean it.

    Just to show how important this is, many rugby teams in Ireland travel to Poland every week to be passed through a couple of chambers -60C and
    -160C to recover from injuries, develop better muscle tone and achieve better speeds.

    Treatments thoroughly documented throughout ten years prove the effect cryotherapy has on arthritic pain and many other chronic deep pains. Also, as crazy as it may seem, many psychiatric conditions are treated with deep cold therapy, as depression, anxiety and bi-polar disorder.

    An extremely interesting thing happens to the skin, the circulatory system, the liver and -this is amazing: the muscle and cartilage tissues, and it is the deep, sudden and massive oxygenation of tissues. This translates into producing new cells to recover even very traumatised or degenerated connective fibres and an increase in new cells.

    I suppose our problem is that when we hear about miracle medical advances that haven’t been blessed by the Holy Fathers of mainstream medicine, everything SHOULD be rejected. I ask myself why, in cities like Warsaw or Wadowice, or London, this centres are paid by the Social Security, are free and have increased (sensibly) the well being of many workers?

    We should always keep an open mind and investigate: Whole Body Cryotherapy has been in the mainstream in Japan since the late 70′s!

  10. Karolina
    January 20th, 2011 at 18:16 | #10

    I’m from Poland and Im glad that silly north americans finally caught on to this. Cryotherapy saunas and chambers are used a lot over there. You find them in aqua parks quite often (that’s where I tried it :) and you see people getting in and out of them constantly… like a revolving door! Why would people put themselves in such cold temperatures if it doesnt help them with something?? I only went in once so I dont know if I reaped any long term benifits but I loved the way I felt after I got out! I couldnt stop giggling and I didnt know why! They told me it was the edrenalin. Man I was in such a good mood and had a ton of energy. As for studies there are a few but the ones I read were in polish. You guys should google Kriotherapy (thats how the british spell it) or Kriokomora if you want to give it a whirl in Polish :) I hope you stubborn North Americans learn to see past your ignorance to the rest of the world and try something before you knock it

  1. August 18th, 2011 at 11:51 | #1