Cold therapy is known in scientific terms as cryotherapy. It is a technique that involves the exposure of the body to temperatures that are extremely cold. The exposure generally lasts for several minutes. Cryotherapy is usually delivered to a particular area of the body. Some people may prefer whole-body cryotherapy where the cold is dissipated to every part of the body. Localized cold therapy can be delivered in various ways such as ice massages, ice baths, cold therapy wraps, coolant sprays, and more. For the purpose of today’s article, we are going to touch mostly on cold therapy for knee pain.
What Role Does Cold Therapy Plan In The Treatment of Knee Pain?
The therapy works by minimizing the flow of blood to a particular region of the body (the knee in this case). This in turn drastically minimizes swelling and inflammation that causes pain, especially around a joint or tendon. It causes a temporary reduction in neural activity, which can also relieve pain. The application of cryotherapy (cold therapy) is an extremely popular (and effective) treatment that is used as part of the R.I.C.E. protocol. The RICE-protocol is an abbreviation for rest, ice, compression, and elevation. When using this protocol, there are some important things that you need to be aware of in order to derive maximum benefit from it. Before we get into that though, we will examine how and why this protocol succeeds.
Why is R.I.C.E. So Successful?
The R.I.C.E. method aims to minimize swelling at the joints after you’ve just sustained an injury. The duration taken for full recovery is determined by the degree of swelling, as there will be need for the lymphatic system to transport the extra fluid away. Of course this will take some time. Preventing swelling within the first few hours of injury is important as it can reduce your recovery time significantly. Here are more details on the different R.I.C.E. steps:
- Rest – This is the first step and an extremely important one. It is an understatement to say that one should rest the injured knee joint. Especially within the first two days (48 hours) of injury. Moving the injured joint too frequently will drastically slow down the healing process – something that you do not want. This is why athletes are advised to stop all exercises and movement when an injury occurs. After the 48-hour rest, the body has already started the process of healing. At this point, light movement will help facilitate the healing process (1).
- Ice – It is at this point that the cold therapy (cryotherapy) is applied. Applying ice to the injured knee joint is a very important part of this whole process. The cold temperatures that the ice produces will reduce swelling by drastically inhibiting hemorrhage in the injured joint. By keeping the swelling at a lower level (which also restricts the population of cells in the injured knee joint), you are increasing the availability of oxygen to all cells. Because cryotherapy minimizes cell metabolism, oxygen requirement is decreased even further. This explains why it is important to prevent excessive swelling. A failure to do so means frequent cell death due to poor oxygen circulation (2).
- Compression – This steps involves the use of a compression sleeve, or some sort of wrap to apply pressure to the injured area, which in combination with the icing step above, further decreases the swelling of the knee joint. When these forces of compression are applied, you prevent pooling of extra fluid in the joint, thus reducing the time taken for recovery, as it usually takes time to get rid of too much swelling (3).
- Elevation – Elevating the injured knee joint means keeping it at heart level. When you do this, you employ the force of gravity to draw away unwanted fluid from the site of injury. This will also help to reduce swelling. So after application of compression and ice, place your injured joint on the table (3, 4).
To summarize, cold therapy aims at reducing the rate at which cells at the knee joint metabolize, hence reducing swelling, oxygen requirement, and unnecessary cell death. Also, applying cold packs also reduces pain and inflammation. it’s extremely important NOT to skip this step. Make use of improvised ice packs if you must, but be sure to apply ice on the joints.
Applying Cold Therapy The Right Way
There are certain things that you must pay attention to while applying ice. You may want to prevent frostbite by placing some sort of barrier between your skin and the ice. You can use something as simple as a wash cloth, a towel, or some paper tissues. Just make sure that you keep the material slightly moist to enhance the cold distribution. How long the ice will be applied is dependent on the nature of the injury. Usual recommendations range from 10 to 20 minutes. Remember though that too much cold can cause damage to the muscle tissues, skin damage, or even inhibit a response from the immune system. It’s better to apply it for a short amount of time, every 2-3 hours throughout the day. After the first 48 hours have gone by, then continue as needed.
If you are applying cold therapy for the first time, monitor how your skin reacts to the cold after the first few minutes. If you see any any blisters, red marks, or other bad reactions, stop using it right away.
As you can see, cold therapy can significantly help with your knee pain. Having said that, it’s also really important that you consult your doctor before attempting any new form of treatment. They will understand your situation better than you can and may suggest something else depending on the severity of your injury. If you’ve had any luck with cold therapy for knee pain relief, we’d love to hear from you. Just leave a comment below!
1. Bleakley, Chris M.; O’Connor, Seán R.; Tully, Mark A.; Rocke, Laurence G.; Macauley, Domhnall C.; Bradbury, Ian et al. (2010): Effect of accelerated rehabilitation on function after ankle sprain: randomised controlled trial. In BMJ 340, pp. c1964. Available online at http://www.bmj.com/content/340/bmj.c1964.pdf%2Bhtml.
2. RICE – Acute Sports Injury Care – Sports Injury Info (2012). Available online at http://www.sports-injury-info.com/rice.html, updated on 2/02/2012, checked on 25/06/2012.
3. Coleman, Sydney R.; Sachdeva, Kulveen; Egbert, Barbara M.; Preciado, Jessica; Allison, John (2009): Clinical efficacy of noninvasive cryolipolysis and its effects on peripheral nerves. In Aesthetic Plast Surg 33 (4), pp. 482–488. Available online at http://www.ncbi.nlm.nih.gov/pubmed/19296153.
4. Wolfe, M. W.; Uhl, T. L.; Mattacola, C. G.; McCluskey, L. C. (2001): Management of ankle sprains. In Am Fam Physician 63 (1), pp. 93–104. Available online at http://www.aafp.org/afp/2001/0101/p93.html.