When patients come to you with minor sports injuries or back pain, the conventional approach is usually to prescribe RICE (rest, ice, compression, elevation) and possibly medication when the pain and swelling are most severe. While this treatment is effective, offering cryotherapy or contrast therapy allows you to provide a more effective treatment and also sends the message that you are staying on the cutting edge in your field.
Two possible recommendations for post-surgical patients and those recovering from injuries are cryotherapy and contrast therapy.
Cryotherapy and Contrast Therapy Techniques
Technology has come a long way since RICE therapy has been prescribed for injuries and recovery after surgery. New techniques for applying safe and consistent therapeutic cold and/or heat have made this reliable treatment protocol even more effective.
Cryotherapy is simply the application of therapeutic cold for treatment of injury but it has been improved with the development of cold therapy devices that simultaneously provide active compression. Wraps are designed to conform to the body using pneumatic compression, while ice water circulates through the wrap. A control unit allows you to set the temperature, pressure, and treatment time.
Contrast therapy is applied by quickly alternating therapeutic heat and cold. Historically, this is done through immersion in water baths, but new medical devices have been designed to provide adjustable rapid temperature change through similar body-conforming wraps.
Pros and Cons of Each Method
When comparing cryotherapy and contrast therapy, it’s important to know the pros and cons of each and when they should be used.
The many benefits of using a cryotherapy system may include:
- More efficient and faster cooling
- Improved surface contact for better cold delivery
- Better blood flow and delivery of nutrients
- Enhanced lymphatic drainage
- Slower cellular metabolism
- Reduced pain medication
- Reduced formation of edema
- Increased cell rejuvenation for faster healing
Contrast therapy may provide many similar benefits, such as:
- Reduced pain and swelling
- Recovery from surgery or injury with reduced pain medication
- Faster recovery after physical therapy or exercise
Both cryotherapy and contrast therapy systems offer convenience over conventional methods. Because integrated wraps provide the cold, heat, and compression, there is no need for ice packs or water baths. Patients appreciate the comfort factor, and professionals can deliver all these benefits with one safe and effective system.
One potential disadvantage of these systems is that they are not readily available for home use. However, a prescription from a professional can allow a patient to rent a cryotherapy system as needed. A multi-modal system that combines both types of treatments can be used in a clinical setting to deliver treatment during physical therapy sessions.
Who Benefits from Which Therapy?
Patients recovering from surgery and individuals who have suffered an acute soft-tissue injury may benefit from both types of therapy. The primary factor when deciding which treatment is appropriate is where they are in the recovery process.
Healing from acute trauma or surgery takes place over four phases:
- Initial acute recovery
- Inflammatory response
- Fibroblastic repair
- Maturation remodeling
Cryotherapy may be used during these phases as it helps control the body’s natural inflammatory response by reducing swelling and preventing the formation of edema. Contrast therapy should only be used during the final two phases of recovery. Applying any type of heat during the first two phases can actually contribute to inflammation as it increases blood flow.
The best way to determine which therapies are appropriate is by the symptoms the patient has and not by the amount of time that has elapsed. Although the first two phases have often run their course about a week after the injury or surgery, everybody recovers at a different pace.