Cryotherapy for Inflammation and Recovery: What the Evidence Shows

Cryotherapy can reduce some signs of inflammation, but the effect is modest, mostly short term, and supported only by small studies. Local cold eases pain and swelling at an injured spot, and repeated whole body cryotherapy (WBC) sessions at -110 to -130 degrees Celsius shift some blood markers of inflammation, yet a 2015 Cochrane review by Costello and colleagues rated the evidence for reduced post-exercise soreness as very low quality, and the FDA has not cleared any WBC device to treat inflammation or any other medical condition.

Cryotherapy has become a staple of athletic recovery and wellness culture, with whole body cryotherapy chambers appearing in professional sports facilities, spas, and dedicated recovery centers worldwide. The claims range from legitimate (reduced post-exercise soreness) to implausible (anti-aging, weight loss, cancer prevention). Sorting through these requires looking at the actual physiology and the clinical trial record, not athlete testimonials or wellness marketing.

The honest summary: cryotherapy has real physiological effects, the evidence for athletic recovery is encouraging but built on small trials, the evidence for chronic pain and inflammation is encouraging but preliminary, and the wellness and anti-aging claims are largely unsupported. Here is the full picture.

Does Cryotherapy Reduce Inflammation?

Cryotherapy reduces inflammation in two different ways, and the strength of the evidence depends on which one you mean. Local cold, such as an ice pack or cryo-cuff on a sprained ankle, narrows blood vessels and slows nerve signaling, which lowers pain and limits swelling at that spot for as long as the tissue stays cool. That local effect is well established and is why cold packs remain a first-line comfort measure for acute soft tissue injuries.

Whole body cryotherapy, also called cryostimulation or a cryo chamber session, aims at systemic inflammation instead. Repeated WBC sessions change the balance of some circulating cytokines and raise norepinephrine, a stress hormone with anti-inflammatory effects. The trials behind those findings are small, often unblinded, and use different temperatures and session counts, so they show that markers move rather than that a disease improves.

For a chronic inflammatory condition such as rheumatoid arthritis, cryotherapy works best as an add-on to standard medical care, not a replacement for it. The table below summarizes how the main forms of cold therapy compare on inflammation specifically.

The Physiology of Cold Exposure: What Happens in the Body

When the body is exposed to extreme cold, it responds through a coordinated set of physiological mechanisms. Understanding which of these are activated, and how strongly, requires distinguishing between localized cryotherapy (ice packs, cryo-cuffs, cold water immersion of a limb) and whole body cryotherapy (WBC), where the entire body except the head is exposed to cryogenic temperatures.

Norepinephrine Release

Cold exposure triggers a significant sympathetic nervous system response, including release of norepinephrine from nerve terminals and the adrenal medulla. A 2008 study by Leppäluoto et al. in the Scandinavian Journal of Clinical and Laboratory Investigation (n=10 healthy women per group) found that WBC at -110 degrees Celsius for 2 minutes, 3 times a week for 12 weeks, produced a 2 to 3 fold increase in plasma norepinephrine after every session. The same study found no change in IL-1 beta, IL-6 or TNF-alpha after cold exposure, so the norepinephrine rise is the most consistent finding. Norepinephrine has anti-inflammatory properties and is also involved in mood regulation, which may explain some of the reported psychological benefits of cold exposure.

Cold Shock Proteins and Cellular Adaptation

Cold shock proteins (CSPs) are a class of proteins upregulated in response to rapid temperature drops. The best-studied is RNA-binding motif protein 3 (RBM3), which Peretti and colleagues showed in a 2015 Nature study in mice to promote synaptic repair and protect against neurodegeneration when the animals were cooled. Human data on cold shock protein activation after brief WBC sessions are limited, and the clinical significance in healthy adults receiving brief cold exposure is not established. The CSP angle is often cited in anti-aging and neuroprotection marketing, but the evidence for meaningful clinical benefit in humans from short cold exposures is preliminary at best.

Cytokine and Inflammatory Marker Changes

Multiple studies have measured inflammatory markers before and after WBC sessions in both athletes and clinical populations. A 2011 study by Lubkowska et al. in the Scandinavian Journal of Clinical and Laboratory Investigation (n=45 healthy men) gave 5, 10 or 20 daily 3 minute sessions at -130 degrees Celsius and found that IL-10 (an anti-inflammatory cytokine) and IL-6 rose while IL-1 alpha fell, with the 20 session series producing the longest lasting changes. A 2009 study by Banfi et al. in the Journal of Science and Medicine in Sport (n=10 elite rugby players on the Italian national team) found that high sensitivity CRP was unchanged after a week of daily WBC sessions.

The cytokine changes are real but relatively modest in magnitude, and they do not always point the same way across studies. They are comparable in direction (though not magnitude) to what is seen with exercise itself, which also reduces chronic inflammation through repeated acute inflammatory responses. Whether these changes translate to meaningful clinical outcomes depends heavily on the baseline inflammatory state of the individual.

Evidence for Athletic Recovery

Athletic recovery is where WBC has the most RCT evidence. The key question is whether WBC reduces delayed onset muscle soreness (DOMS) and accelerates functional recovery faster than passive rest or competing recovery modalities like contrast water therapy or cold water immersion (CWI).

A 2015 Cochrane review by Costello et al. analyzed 4 RCTs with 64 physically active, mostly young male participants, comparing WBC to passive recovery or control. Soreness scores were lower after WBC at 1, 24, 48 and 72 hours, with standardized mean differences of 0.57 to 0.77, but the confidence intervals at 24 hours and later also included no difference. The reviewers rated all of the evidence very low quality, noted that no trial actively monitored adverse events, and concluded that the evidence was insufficient to say whether WBC reduces soreness.

A 2011 crossover trial by Hausswirth et al. in PLoS One (n=9 well-trained runners) compared WBC to far-infrared therapy and passive recovery after a simulated trail run designed to damage muscle. Muscle strength and perceived pain, tiredness and well-being recovered after the first WBC session, took 24 hours with far-infrared therapy, and did not recover within 48 hours with passive rest, while creatine kinase did not differ between conditions. Evidence grade: Low to moderate for reducing DOMS and subjective recovery, based on small trials. Emerging for performance-related outcomes.

WBC vs. Cold Water Immersion

Cold water immersion (CWI), which involves sitting in an ice bath at roughly 10 to 15 degrees Celsius for 10 to 15 minutes, has a longer and more substantial evidence base than WBC. A 2012 Cochrane review by Bleakley et al. pooled 17 small trials with 366 participants and found some evidence that CWI reduces DOMS compared with rest. When directly compared, CWI and WBC produce broadly similar recovery outcomes, with some studies favoring CWI. Given that ice baths cost essentially nothing compared to a $50 to $100 WBC session, the practical question of whether WBC is worth the premium is legitimate. The answer likely depends on individual tolerance: many people find WBC easier to tolerate than full-body ice immersion, which may affect compliance with recovery protocols. Our comparison of cryotherapy and ice baths covers the tradeoffs in more detail.

Can Reducing Inflammation Slow Training Gains?

Blunting post-exercise inflammation is not always helpful. Roberts and colleagues reported in the Journal of Physiology (2015) that regular cold water immersion after strength training reduced long term gains in muscle mass and strength over 12 weeks compared with active recovery. Athletes in a strength building phase often save cold therapy for competition periods, when short term recovery matters more than adaptation.

Evidence for Chronic Pain and Inflammatory Conditions

Rheumatologists, physiatrists and physical therapists in Europe have used cold chambers as part of inpatient rehabilitation for decades, which is why most of the chronic disease research comes from Poland, Germany, Finland and Italy. In the United States, WBC is mostly sold as a wellness service, and sessions are typically cash pay rather than covered by insurance.

Fibromyalgia

Fibromyalgia is characterized by widespread musculoskeletal pain, fatigue, and sleep disturbance, with an underlying neurological hypersensitivity component. Several small studies have examined WBC for fibromyalgia with encouraging results. A 2013 study by Bettoni et al. in Clinical Rheumatology followed 100 patients, 50 of whom received 15 WBC sessions while 50 did not, and found larger improvements in pain (VAS), quality of life (SF-36) and fatigue scores in the WBC group, although patients were not randomized. A 2018 randomized crossover trial by Rivera et al. in Rheumatology International (n=60) found that pain fell by 3.0 points on a visual analogue scale after WBC compared with 0.3 points after rest, although one author held shares in the company that makes the cabin used. Evidence grade: Preliminary for fibromyalgia, but the effect size is meaningful enough to warrant further investigation. Our fibromyalgia treatment guide places cryotherapy alongside exercise therapy, sleep care and medication.

Rheumatoid Arthritis

WBC has been used in European rheumatology settings, particularly in Germany and Poland, as an adjunctive treatment for rheumatoid arthritis (RA) for several decades. A 2015 study by Gizińska et al. in BioMed Research International (n=44 RA patients) compared WBC at -110 degrees Celsius plus kinesiotherapy with traditional rehabilitation and found similar improvements in pain, disease activity and fatigue in both groups, along with similar drops in IL-6 and TNF-alpha. A 2006 randomized trial by Hirvonen et al. in Clinical and Experimental Rheumatology (n=60) found that pain fell most with WBC at -110 degrees Celsius, but disease activity scores did not differ between groups, and the authors concluded that WBC was not superior to local cryotherapy. The anti-inflammatory cytokine effects of WBC may complement pharmacological management in RA, though no studies have examined whether WBC reduces the need for DMARDs or biologics. Evidence grade: Preliminary.

Ankylosing Spondylitis and Inflammatory Arthropathies

Several small studies from Eastern European rheumatology centers have examined WBC in ankylosing spondylitis and other inflammatory arthropathies, generally showing modest pain and stiffness improvements. The evidence is thinner and more methodologically limited than for fibromyalgia or RA. These conditions are better managed primarily through established pharmacological treatments, with WBC potentially serving as an adjunctive tool. Evidence grade: Preliminary.

Osteoarthritis and Joint Pain

Osteoarthritis involves lower grade joint inflammation than RA, and people with knee or hand osteoarthritis often use ice packs at home for flare-ups. Controlled trials of whole body cryotherapy for osteoarthritis are scarce, so local cold remains the practical option for most people. The arthritis treatment guide covers the options with stronger evidence, including exercise therapy and injections.

Localized vs. Whole Body Cryotherapy

Localized cryotherapy, including the application of ice packs, cryo-cuffs, and targeted cryo devices, has stronger evidence for acute injury management than WBC. The R.I.C.E. (rest, ice, compression, elevation) protocol for acute soft tissue injuries has been the standard for decades, though more recent guidelines have shifted toward recommending less aggressive icing to avoid blunting the acute inflammatory phase that is necessary for healing. The PEACE and LOVE framework published by Dubois and Esculier in the British Journal of Sports Medicine (2020) reflects that shift by leaving ice out of its early injury steps. For acute injuries, the current recommendation is gentle, brief cold application for pain relief rather than prolonged icing.

FDA Regulatory Status and Safety Concerns

The FDA stated in a July 2016 consumer update that it has not approved or cleared any whole body cryotherapy device for any medical indication, and that it has no evidence WBC effectively treats conditions such as fibromyalgia, rheumatoid arthritis, migraine, anxiety or chronic pain. That same year the agency sent at least one cryotherapy company a warning letter about unsupported medical claims. WBC facilities continue to operate as spa or wellness services rather than medical practices, which means they are not subject to the same oversight as medical devices or procedures.

Safety concerns with WBC are real but manageable with proper protocols. Frostbite is the most significant risk and occurs when the skin is wet or when protective gear (gloves, socks, ear protection) is inadequate. The FDA also lists burns, eye injury and asphyxiation as hazards, because nitrogen vapor in chambers cooled with liquid nitrogen can lower the oxygen level in the room. The exposure time is short enough that frostbite in properly protected individuals is rare. Deaths have been reported from WBC, including a 2015 case where a Nevada spa employee was found dead in a WBC chamber after apparently entering alone and outside operating hours. Proper protocols require attendant supervision throughout the session. People with cold urticaria, Raynaud’s phenomenon, cryoglobulinemia, cardiovascular disease, or severe hypertension should not use WBC without physician clearance.

Who Should Avoid Whole Body Cryotherapy?

People who should avoid WBC or get medical clearance first include anyone with uncontrolled high blood pressure, a recent heart attack or stroke, heart rhythm problems, peripheral artery disease, cold allergy, Raynaud’s phenomenon, active infection, open wounds, or pregnancy. A 2023 scoping review by Legrand and an international consortium of cryotherapy researchers in the European Journal of Medical Research identified 16 documented adverse events across 5 case reports and 2 RCTs and concluded that the risks stay within acceptable limits when providers follow existing contraindications and safety guidelines.

Practical Session Protocols

For athletic recovery, most protocols involve WBC sessions within 1 to 2 hours post-exercise, 3 to 5 times per week during high training load periods. Single sessions are used acutely around intense competition or training blocks. For chronic pain applications, clinical studies have generally used 10 to 20 sessions over 2 to 4 weeks as an induction protocol, with maintenance sessions as needed based on response.

Before each session, the skin must be completely dry and all metal jewelry removed. Protective gloves, wool socks, and wooden clogs are standard. The head remains outside the chamber. Most providers check contraindications at each visit. Sessions typically last 2 to 4 minutes, with the first session kept shorter (1 to 2 minutes) to assess tolerance.

How to Use Cryotherapy for Inflammation

Using cryotherapy for inflammation works best as a planned trial alongside your existing care, with a clear goal and a way to tell whether it helps. These steps reflect how the clinical studies above were run.

1. Match the type of cold to the problem: an ice pack or cryo-cuff for a single sore joint or a fresh sprain, and whole body cryotherapy only when the goal is widespread pain or post-exercise soreness.
2. Talk to the clinician who manages your condition, such as a rheumatologist, sports medicine physician or primary care doctor, before starting WBC, especially if you have heart disease, high blood pressure or Raynaud’s phenomenon.
3. Keep taking prescribed medication, because the RA and fibromyalgia trials tested WBC as an add-on to medication and exercise therapy.
4. Record a baseline pain and stiffness score before the first session, then rescore after the course of 10 to 20 sessions that the studies used.
5. Stop and reassess if you see no change after the full course, since continuing an unhelpful cash pay treatment adds cost without benefit.

Finding a Cryotherapy Provider

Cryotherapy is offered by recovery centers, medical spas, sports medicine practices, chiropractic offices and some physical therapy clinics. The cryotherapy treatment guide explains the main session types, and the national list of cryotherapy clinics lets you compare providers by city. When you contact a provider, ask whether a trained attendant stays with you for the whole session, how they screen for contraindications, and whether a licensed clinician is involved for medical goals.

Regenerated.com is free for patients, and listing order in the directory is not paid ranking. Featured slots are labeled and capped, and Verified means the clinic completed credential checks, not that it paid for placement. The guide to Featured, Verified and organic listings explains each label, and inclusion in the directory is not an endorsement.

The Bottom Line

Whole body cryotherapy has real physiological effects including norepinephrine release, cytokine modulation, and cold shock protein activation. The evidence for reducing post-exercise muscle soreness and accelerating athletic recovery is encouraging but rests on small trials that a 2015 Cochrane review rated very low quality, and cold water immersion may achieve similar results at much lower cost. For chronic pain conditions like fibromyalgia and rheumatoid arthritis, early evidence is promising but not yet sufficient to position WBC as a first-line or standard adjunct treatment.

The wellness claims, including anti-aging, weight loss, and general immune enhancement, are not supported by clinical trial evidence. If you are an athlete or someone managing chronic pain who wants to try cryotherapy, the risk profile is low when proper protocols are followed, and the athletic recovery benefits are real enough to justify the cost for many users. Go in knowing what the evidence actually supports, use it as part of a broader recovery or treatment strategy, and do not expect it to do things the clinical trials have not demonstrated it can do.

Frequently Asked Questions About Cryotherapy and Inflammation

Does cryotherapy reduce inflammation?

Cryotherapy reduces inflammation locally and modestly shifts inflammation markers in the blood. An ice pack or cryo-cuff lowers pain and swelling at the treated spot while the tissue stays cold. Repeated whole body cryotherapy sessions raise norepinephrine and change some cytokines, such as IL-6, IL-10 and TNF-alpha, but the trials are small and the results are mixed. The FDA has not cleared any whole body cryotherapy device to treat inflammation or any inflammatory disease.

How many cryotherapy sessions does it take to reduce inflammation?

Clinical studies of whole body cryotherapy for inflammatory and pain conditions have generally used 10 to 20 sessions over 2 to 4 weeks. Lubkowska and colleagues (2011) found that a series of 20 daily sessions produced longer lasting cytokine changes than 5 or 10 sessions. Those study protocols are a starting point rather than a set dose for any one person, so track your pain and stiffness before and after a full course and stop if nothing changes.

Is cryotherapy or an ice bath better for inflammation?

Ice baths have the larger evidence base for post-exercise soreness. A 2012 Cochrane review pooled 17 small trials and found some evidence that cold water immersion reduces delayed onset muscle soreness, while a 2015 Cochrane review found insufficient evidence for whole body cryotherapy. When the two are compared directly, results are broadly similar. Whole body cryotherapy is shorter and many people find it easier to tolerate, while an ice bath costs far less.

Can cryotherapy help rheumatoid arthritis or fibromyalgia?

Cryotherapy may ease pain in rheumatoid arthritis and fibromyalgia as an add-on to standard care, but the evidence is preliminary. In a 2006 trial by Hirvonen and colleagues, pain fell most with whole body cryotherapy at -110 degrees Celsius, yet disease activity did not differ from local cold. Fibromyalgia trials by Bettoni (2013) and Rivera (2018) reported larger pain improvements after cryotherapy than without it. Neither condition should be managed with cryotherapy alone, so keep your rheumatologist involved.

Is whole body cryotherapy FDA approved?

No whole body cryotherapy device is FDA approved or cleared for any medical use. The FDA stated in a 2016 consumer update that it has no evidence WBC treats conditions such as rheumatoid arthritis, fibromyalgia or chronic pain, and it lists frostbite, burns, eye injury and asphyxiation from nitrogen vapor as hazards. Some localized cold therapy devices are FDA cleared for specific uses. Most WBC centers in the United States operate as wellness businesses, and sessions are typically paid out of pocket.

Who should not do cryotherapy?

People with uncontrolled high blood pressure, recent heart attack or stroke, heart rhythm problems, Raynaud’s phenomenon, cold urticaria, cryoglobulinemia, active infection, open wounds or pregnancy should avoid whole body cryotherapy unless a physician clears them. Anyone with heart disease should get medical advice first. A well run center screens for these conditions at every visit, requires dry skin and protective gloves and socks, and keeps an attendant with you for the whole session.

Related Reading

• Arthritis Guide: Rheumatoid Arthritis and Osteoarthritis
• Chronic Pain Guide: Types, Mechanisms, and Regenerative Treatment Options
• Cryotherapy: How It Works, Benefits, Risks, and What the Research Shows
• Fibromyalgia: Causes, Diagnosis, and the Complete Treatment Guide
• Rheumatoid Arthritis
• Chronic Inflammation: Causes, Symptoms, and How to Reduce It