We always tell clients that "signing up for just one cryotherapy treatment is similar to expecting weight loss results from just one healthy meal" - a sustainable outcome requires a commitment. But how many sessions is enough, and can there be too many?
Numerous studies have been performed to establish the most effective whole body cryotherapy treatment regimen to achieve the best results. The recommendations differ - the number and the frequency depend on the condition and the purpose, it's different in healthy people versus patients.
This article only refers to studies of painful conditions, like rheumatoid inflammatory diseases and fibromyalgia, where inflammation markers, levels of oxidative stress and lipid profiles (cholesterol levels) were assessed. The recommendations for athletic performance and recovery will be addressed separately, as they are NOT the same.
The 10 research articles used where published in Germany, Poland, and Finland between 2000 and 2014.
The pain level after application of the cold therapy decreases significantly. The immediate pain reduction lasts about 90 minutes after the treatment.
To achieve sustainable results, consecutive treatments are required.
The studies compared the results of 5, 10 and 20 3-minute long whole-body cryo-stimulations, performed once a day at -130°C (-202°F).
It was concluded that noticeable improvement occurred after at least 10 cryotherapy sessions, while the most advantageous sequence was the series of 20 cryo-stimulations due to the longest lasting effects after the completion of the whole series of treatments - up to 3 months of significant pain relief.
One study also concluded that after 3 months of repeated WBC the results were attenuated, which may be interpreted as an adaptation of autonomic function. In this case, it’s recommended to take a break in treatment regimen. Measuring blood pressure before and after each cryotherapy treatment is the best indication of the body’s reaction. There should be at least a several point increase in systolic pressure, unless the body has already adapted to the repeated shock by extreme cold.
Although WBC treatment protocols should be condition-, as well as person- specific, and there is no “one size fits all” approach, some common rules have been formulated.
Below, we will be referring to the experience and recommendations by Dr. Alan Christianson, NMD, one of the early adopters of whole body cryotherapy in the United States.
He suggests looking at several factors to establish the best regimen:
Pain score (see the suggested questionnaire below). Pain level of 6 points and up will require more intense treatment schedule to produce the best results
The number of trigger points involved. The below picture depicts 18 common pain trigger points. 14 or more would require a longer and more concentrated treatment
Presence of additional symptoms, like weakened immunity, headaches, or insomnia
In evaluating pain, a subjective scale can help to understand the intensity level of the client’s pain. The most widely used example of this is the “McGill Pain Questionnaire”:
The scale is also useful to repeat regularly to document the client’s progress. In many cases people are aware of immediate pain but not aware of changes in pain. Using a measurement tool can help them understand their progress.
Fibromyalgia Treatment Protocol A
Number of treatments: 20
Frequency of treatments: Five days per week (weekdays)
Duration of treatments: 4 weeks
This protocol will be best for people with higher subjective pain scores, and more secondary chronic symptoms:
Fibromyalgia Treatment Protocol B
Number of treatments: 12
Frequency of treatments: twice weekly
Duration of treatments: 6 weeks
This regimen could be recommended to clients with lower subjective pain scores and fewer or no secondary chronic symptoms:
Arthritis Treatment Protocol A
This protocol is best for those with long-standing chronic arthritis involving multiple joints and with higher average pain scores:
Minimum number of treatments: 20
Recommended frequency of treatments: Five days per week (weekdays)
Duration of treatments: at least 4 weeks
Arthritis Treatment Protocol B
This protocol will serve those with more recent onset arthritis involving fewer joints and with lower average pain scores:
Minimum number of treatments: 10
Best frequency of treatments: Five days per week (weekdays)
Duration of treatments: 2 weeks
For even better results, whole body cryotherapy may be combined with a local treatment of particularly painful spots. If one or the other needs to be chosen, cooling of the entire body has proven to produce more significant pain relief and longer lasting effect.
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