*CRYOTHERAPAY

PRESENTED TO:
DR.ARSALAN

PRESENTED BY:
MAHNOOR SHAHZAD
* Definition
* History
* Techniques of applications
* Basic Principal
* Physiological Effects
* Indications and Contraindications
* Cryotherapy Facts

*Road Map
Cryotherapy is defined as:

The application of cold for various therapeutic

purposes.

The local or general use of low temperatures in

medical therapy.

The removal of heat from a body part.

*Definition
 * History

* Cryotherapy is a process dating back to the 19th century, with

local applications of cooling being used for pain control.

* Ancient Egyptians in 2500 BCE used cold to treat injuries and

inflammation
* The way which ice is applied will vary according to
the required effects
* It may be applied in the following ways
* Ice packs
* Commercial cold packs
* Immersion in cold and cold whirlpool
* Ice massage
* Excitatory cold
* Vapocoolant sprays

*Techniques of
application
* In this technique ice is placed in a polythene bag and
applied over the body tissue
* To make an ice pack at home you will need:
* Ice cube, crushed ice, ice flakes
* a plastic bag
* a towel or pillow case
* Thepressure of application should be minimal and
movement should be to and fro and circular.
* Donot leave the ice on the skin longer than 20
minutes.

*Ice Packs
* These are basically plastic bags filled with a mixture
of water and some substance like silica gels.

* Wet towel should be placed between the skin and

the pack to avoid excessive cooling.

* The main advantage of it:

* reusable.
* mold themselves according to the body part treated

*Commercial Cold
Packs
* Immersion involves placing the part to be
treated in water ranging in temperature from
cool to icy.

* Appropriate for treatment of an extremity or

large body areas.

* Thetotal duration of the treatment is around

10 minutes.

*Immersion
* 1 minute plunge (try to relax as much
possible),

* 2 minute out of water (air temperature),

* Repeat 5 times.

* When very brave, 5 minutes straight

*Example of
Immersion
* Used for two distinct reasons
* 1. Counter-irritant action
* 2. Muscle stimulation
* For the relive of pain ice block is moved over
the part using a slow circular massage
* For neurological facilitation the ice should be
applied only briefly

*Ice Massage
* Sprayinga rapidly evaporating liquid on the skin has
the effects of cooling the surface.
* The liquid is sprayed on to the area to be cooled in a
series of short strokes of 5 s each.
* The nozzle of the spray is held about 45 cm from the
skin.
* Cooling from such sprays not lasts very long.
* They are used in sporting activities and athletic
injuries.
* Fluromethane or ethylchloride sprays

*Evaporating Sprays
* When cold is applied in an appropriate way on
the skin, it increase the excitatory around the
anterior horn cell.
* This can often produce contraction of an
inhibited muscle (only with intact peripheral
nerve supply).
* This effect can be used when muscle are
inhibited postoperatively or in the later stages
of regeneration of a mixed peripheral nerve.

*Excitatory Cold
* When ice is applied to the skin heat is
conducted from the skin to the ice in order to
melt it.

* Icechanges its state from solid to liquid by

absorbing heat.

*Basic Principles
* The ice required considerable energy to rise the
temperature of 1 gram of ice at 0oC to 1 gram of water at
37oC required 491 J.

* Whereas to rise 1 gram of water at 0oC to 37oC requires

only 115 J.

* Forcooling the body tissues, it is better to use ice for

treatment rather than water.

*Basic Principles
* Circulatory Response

* Neural Response

*Physiological Effects
* The initial skin reaction to cooling is an
attempt to prevent heat. It is accomplished by
an initial vasoconstriction this hemostatic
response has the effect of cooling of body part.

* After a short period of time vasodilation

follows with alternating periods of constriction
and dilation this is called the lewis`s hunting
reaction.

*Circulatory Response
* During the vasodilation the arterovinous
anastomosis is closed, thus causing an increase
blood flow through the capillaries.
* This is benefical in the treatment of swelling
and tissue damage.
* The reduced metabolic rate of cooled tissues
allows cooled muscle to contact many more
times before fatigue sets in.
*

*Circulatory Response
* The skin contains primary thermal receptors.
* Cold receptors are several time more numerous than
warm receptors
* The rate of conductions of nerve fibers in a mixed
motor and sensory peripheral nerve is reduced by
cooling. The first fibers affected by gradual cooling
are the A fibers (myelinated) and eventually at very
low temperatures the B and C fibers (non-myelinated)
are affected.
* The major effects of ice application are to relive pain

*Neural response
* The probable mechanism involved is the stimulation of
cold receptors which send back the impulses, which
have to pass into the spinal cord via the posterior root.
* These impulses which arrive through the relatively large
diameter nerves effectively block the pain impulses
attempting to gain access to the cord and thus pain gate
is closed.
* It is also possible that the increased circulating by the
cold could carry away chemical substances which are
stimulating nociceptors and thus the pain is reduced.

*Neural response
 Provide Promote
excitatory
Muscles repair of
stimulus
Pain spams
Swelling Spasticity
to
the
inhibited damaged
muscles tissues

*Indications
 Peripheral Peripheral
Cardiac Psychologi Vasospastic Cold
Nerve Vascular
Conditions cal Disease Sensitivity
injuries Disease

*Contraindication
* Cold therapy is one of the most popular
methods when it comes to the first aid
treatment of some injuries.

* Now a days, local cold application may be

applied by the use of various forms of ice or
frozen gel packs.

* Often skin temperature is reduced to 10oC

*Cryotherapy Facts