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Does whole body cryotherapy (WBC), which essentially involves standing in a deep-freezing tank for several minutes, actually help you lose weight, reduce pain, improve athletic performance, improve sleep and slow aging as has been claimed? Or is WBC just another "cool" fad with claims that will eventually be refuted by scientific studies and potentially serious risks? Or is the answer somewhere in between? Some high profile athletes and celebrities have touted WBC's benefits but the recent death of 24-year old Chelsea Patricia Ake-Salvacion during a cryotherapy treatment has brought some increased scrutiny on a practice that has been growing in use worldwide.
Cryo- comes the Greek word “krous,” which means “icy,” “cold” or “frost.” Therapy means…well…”therapy” or “treatment.” So any use of ice or very cold materials to treat something technically qualifies as cryotherapy. The most long-standing and common form of “cryotherapy” is the application of ice or cold packs to injuries to cause blood vessels to constrict, which reduces blood flow and alleviates pain, swelling and inflammation. While there is still some debate over the longer-term effects on healing, such localized (i.e., applied to specific part of the body) “cryotherapy” certainly seems to have clear short-term benefits and has long been standard practice among health professionals. Another type of localized “cryotherapy” that is often called “cryosurgery” is the use of very cold substances such as liquid nitrogen to freeze and remove lesions such as skin tags, moles and prostate cancer.
Unlike localized cryotherapy, WBC consists of exposing the entire body to very low (subzero) temperatures, sometimes below -200 degrees Fahrenheit, for a few minutes (typically between 2 and 4 minutes). Often, the person will stand in a tank or closet-like device, wear minimal clothing and be bathed in liquid nitrogen or refrigerated cold air…like taking the ultimate cold shower. (Some may think of Han Solo, during The Empire Strikes Back, when Darth Vader places Mr. Solo into a freezing chamber. But the differences are that with WBC “carbonite” gas is not used, you do not emerge frozen in a block of ice, and Princess Leia will not search for you after you are done.) Originated in Japan in the latter half of the 1970s (with Japanese rheumatologist Toshima Yamaguchi often credited for first developing WBC), WBC is a growing business worldwide. (Ironically, many cryotherapy centers have surfaced in warm-weather locations such as Southern California and Florida, where people go to flee colder weather.) Owners of WBC facilities range from people with formal medical training to those with little to no healthcare credentials. Elite athletes and celebrities who use WBC include Kobe Bryant, Lebron James, Demi Moore, Mandy Moore, Kate Moss, Jessica Alba, Jennifer Aniston and the Dallas Mavericks, with a number of them saying that they feel better and stronger after WBC. Some people claim that WBC can even improve appearance, slow aging and shed body weight, with WBC even being labeled as a new weight loss trend.
So why should placing yourself in bitter cold for several minutes (and paying to do so) have any benefit? You’ll find a variety of claims on the Internet, particularly from those running cryotherapy facilities, ranging from decreasing inflammation to redirecting blood flow to vital organs to convincing the body that it is in danger so that it boosts its immune system and metabolism. Is there actually any evidence for these claims or are they just blowing cold smoke up your...?
A closer look shows that many of these claims are not yet grounded in credible scientific evidence. For example, there is no real scientific support that WBC is effective as a weight loss or obesity prevention measure. It is unclear how and where such beliefs emerged, especially since time and time again, evidence has shown that there is not a single "magic solution" to weight loss or obesity. Most of the existing (albeit limited) evidence focuses around the effects of WBC on musculoskeletal pain and inflammation. Health professionals have used WBC to relieve pain and inflammation from conditions such as arthritis, fibromyalgia, ankylosing spondylitis and injuries. However, a recently published systematic review of the literature did not find compelling scientific evidence that WBC is effective in preventing and treating muscle soreness after exercise in adults. Without nearly enough scientific evidence, the U.S. Food and Drug Administration (FDA) has not yet approved WBC as a medical treatment.
Of course, the current dearth of scientific evidence supporting WBC does not mean that we won’t eventually find true benefits from WBC. There just has not been enough scientific studies yet. More WBC practitioners need to conduct or provide resources for legitimate scientific studies, before making scientifically unsubstantiated claims. At the same time, the medical community should examine WBC more closely through research and education. Compared to studies on disease treatments, historically there has been less funding for scientific research on preventive health measures that do not involve medications.
The other important question is safety. If no real risk were involved, it may not be as important to find scientific evidence backing a “therapy” that seems to make at least some people feel better. (After all, no one is clamoring for scientific studies of twerking or cat videos on the Internet.) However, blasting people with frigid air (colder than the South Pole) in an enclosed space is not completely benign . Enclosed locations can cause anxiety and panic attacks (especially for those with claustrophobia) or even suffocation, as what appeared to have happened on October 20 to Ms. Ake-Salvacion at the Rejuvenice spa in Las Vegas. Cold exposure can result in frostbite, as was the case with Gold-medal sprinter Justin Gatlin. Cold exposure for longer period of time also can lead to dangerous drops in body temperature, otherwise known as hypothermia. Dropping body temperature can slow brain, heart and breathing activity, triggering heart attacks or abnormal heart rhythms. You can become confused and suffer memory loss, which can make it more difficult for you to detect when something is wrong. What is not clear is how much of a risk WBC may be and who and how many people may be at risk for such complications, what precautions are needed and which WBC practitioners are taking necessary precautions.
In the wake of Ms. Ake-Salvacion’s death, the state of Nevada’s health department issued some guidelines for WBC use. As reported by Sally Ho of the Associated Press, this included recommendations that you should not use WBC machines if you are under 18 years of age, pregnant or under 5 feet in height or have a history of stroke, high blood pressure, seizures, certain types of infections, claustrophobia or pacemaker placement. The guidelines established limits in WBC session frequency (no more than once per day) and duration (no more than three minutes) and requested that WBC practitioners equip their facilities with nitrogen monitors, emergency kits, defibrillators and signs with appropriate warnings and disclaimers. The guidelines also included verbiage urging WBC practitioners not to make unsubstantiated claims about WBC’s benefits. However, it is unclear how exactly the guidelines will be enforced, how compliance with the guidelines will be monitored and what the repercussions may be for failure to follow guidelines. Moreover, it is unclear if and when other states will establish any guidelines or oversight. Currently, there is no widely accepted formal training, certification process or standards for WBC, so the use, practices and safety of WBC may vary widely. Therefore, you may not necessarily receive the same treatment and care that professional athletes and celebrities receive.
So, at the moment, the jury is still out on WBC. Ice and cold packs have long been mainstays for injury and pain relief. Some people, including high profile athletes and celebrities, have been vocal about the benefits of WBC, and some have claimed benefits beyond pain relief. But who knows how much of this is psychological versus actual physical improvement? We just do not have enough evidence to determine whether WBC has legitimate longer-term physical benefits and what are the potential risks. Also, the WBC market is still its “Wild West” stages (even though it originated in Japan), meaning that it is unregulated with wide variability in experience, expertise and use. Keep all of these in mind if you want to drop a “cool” $50 to $90 (the typical price range) for a session. WBC may make you feel better in the short term, but before you believe that whole-body cryotherapy (WBC) can actually shed weight, slow aging, and have any longer lasting benefits, just "chill"... and wait for some real evidence and proper scientific studies.
