The use of cold therapy is very popular when we have some type of pain, but do we really know when to apply it and why? In this article we will try to reveal these unknowns and clarify when it is advisable to apply cold and why. The application of cold for a therapeutic purpose is called cryotherapy, and cold therapy consisting of lowering body temperature until physiological changes occur in our body. These effects are hemodynamic, neuromuscular, anti-inflammatory, and analgesic.

EFFECTS OF COLD ON THE BODY

Hemodynamic effects: delays the appearance of the hematoma in a muscle injury due to the constriction of the tissue vessels and the reduction of blood flow. This occurs by a reflex mechanism of the Autonomous Nervous System, the cold acts on the smooth muscles of the blood vessels and on the excitation of the sympathetic fibers. If exposure to the cold lasts from 10 to 15 minutes at a temperature below 10 ° C, a defense mechanism of the organism appears which causes vasodilation, so it starts one cycle of vasoconstriction-vasodilatation. This is what is known as the hemodynamic effect.

Neuromuscular effects: increases blood viscosity, which reduces metabolism and nerve conduction speed, reducing pain caused by the injury. The pain sensation is less, noticing considerable relief. What happens is a mechanism of action that totally or partially blocks the transmission of nerve impulses from the nociceptors to the cerebral cortex due to the cold. Anti-inflammatory and analgesic effect: the reduction in metabolism will produce a lower number of vasoactive substances, which is related to the decrease in the inflammatory response, reducing the edema and inflammation that may exist.

 PRECAUTIONS AND CONTRAINDICATIONS

The application of cryotherapy is simple, but it is advisable to take into account a series of precautions to avoid complications. The main precautions are: Do not use cold on open wounds or burns. Do not apply in areas where the nerve is very superficial Take special care with freezing phenomena, controlling application times, which, as we have already mentioned, should not exceed 15 minutes.

There are a number of contraindications:

• Peripheral vascular diseases
• Arteriosclerosis
• Hypersensitivity and hyposensitivity to cold
• Dermatological lesions
• Serious cardiovascular disease

WHEN THE COLD THERAPY APPLIED?

Cold is mainly used in acute traumatic injuries or in pathologies that have an inflammatory and painful process (sprains, tendinitis in the acute phase, trauma …), due to its analgesic and anti-inflammatory properties, and the ability to reduce metabolic processes and formation of edema. The most recommended are bags of cold gels or “cold-packs”, or in case we do not have, a bag of frozen peas will be worth it. The application will normally be 15 minutes, 3 times a day. On the other hand, if we go to the sports field, cold water baths will be very beneficial for post-competition recovery. After an intense physical exercise, the bathtub will be filled with ice cold water, and we will enter the bathtub for about 15 minutes trying to relax our body. This favors venous return and muscle recovery.