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Whole body cryotherapy in cryo-chamber for treating fibromyalgia

Individuals afflicted with fibromyalgia frequently have the experience that the therapeutic procedure greatly depends on the opinion of the doctor about the cause of this disease. Too little is known about how fibromyalgia arises, and attempts to explain the pathogenesis are still far too inconsistent to be able to treat it in a uniform and root-cause related manner. Unfortunately this circumstance has frequently led to changing ones doctor, a fact which in itself is very detrimental towards achieving therapeutic success. On top of this it is hard to convince the patients to assume a large part of the required therapeutic effort in their own hands.

In order to assess cryotherapeutic relevance I shall assume here that fibromyalgia primarily represents a stress and pain processing disorder that is characterized by

–   a chronic course,

–   pain distributed over the whole body of changing intensity,

–   diverse, but not obligatory vegetative, functional and psychological disorders

(see figures 4.2 and 4.3).

Fig. 4.2 Main symptoms (1) and other features (2) of fibromyalgie

1

Musculo-skeletal pain
– spontaneous
– lasting at least three months
– close to the trunk and periarticular (mainly muscle and tendon attachments near large joints)
with a reduced pain threshold

Generally increased tenderness of the soft tissues

2

Reduced psycho-physical capacity and rapid fatigue
Sleep disorders
Swelling feeling in tender parts, at the joints and morning stiffness
Headache
Depressive moods, sometimes anxiety states
Reduced stress tolerance

The therapy of fibromyalgia regularly pursues a multimodal approach that might include the following components that may not be neglected when applying whole body cryotherapy:

–   Clarification/therapy of possible causes in the somatic as well as psychosocial field,

–   physical therapies,

–   encouragement of moderate activity,

–   relaxation therapies,

–   pain and stress coping therapies, and

–   pharmaceutical therapy.

Fig. 4.3 Functional / vegetative disorders that can accompany a fibromyalgia

Cardiac and respiratory complaints
Circulatory disorders
Gastrointestinal complaints
Disruptions in bladder function
Oral and ocular dryness
Globus feeling

Giddiness
Tendency to sweat a lot
Shivers
Paralgesias (inappropriate sensations)
Cold sensitivity of the fingers
Menstrual problems

Warm and cold applications are judged differently by patients with regard to tolerance and therapeutic success. Whole body cryotherapy has been successfully applied in the treatment of fibromyalgia for some time now. It should only be applied if it is accepted by the patient and general well-being does not suffer as a result of it. It should be stated, however, that patients are often prejudiced against the use of cold due to earlier experiences from the application of therapeutic heat. The patients often switch modes after a “test”.

Figure 4.5 lists the symptoms and organic causes of fibromyalgia that can be positively influenced by whole body cryotherapy.

Fig. 4.5 Targets for whole body cryotherapy with fibromyalgia

pain, Schmerzgedächtnis, disrupted muscle relaxation, muscular fatigue, central activity level, sleep disorders, depressive moods, regulatory disruption, spinal diseases, inflammatory-rheumatic diseases, psoriasis, fibromyalgia, whole body cryotherpy, cold sauna, cryo-chamber

The often very severe soft tissue pains and the increased tendency of the musculature to fatigue stand out of course as major symptoms. Restrictions in mobility of the joints result from this. After about twenty to thirty cold exposures clear improvements are observed with these symptoms. The success rate for gradual changes lies at between 40 and 80%. Regarding the possibility of forming a pain memory and treat this, please refer to sections 3.2 and 4.4 in the book. In the interests of a lasting therapeutic success, if this is at all possible, whole body cryotherapy should be combined with activating treatments. Gymnastic exercises are effective in the period between one and three hours after the cold application, whereby the burden is increased only slowly and does not lead to any increase in pain. Straining and extension of the musculature should not to be maintained for too long. It must be considered that pains and strains can affect muscle groups to differing extents. Protection of some and overstraining of other muscle groups are often then the outcome. Gymnastics should act here as a balancing agent. A moderate controlled endurance burden can be useful in a mobilization therapy program. It is important to find one’s own optimal measure, and not to strive for “peak performance”, to respect fatigue, to acknowledge any pain-free increases in performance and to address the patient gladly.

As we have already seen, whole body cryotherapy can help us to regulate a disrupted central activity level (section 3.5 of book). Such an effect acts positively on sleep disorders that often concur with fibromyalgia as well as on the occasionally occurring depressive symptoms. Both sleep disorders and depressive moods are frequently caused by chronic pain. The reduction as well as elimination of pain and the centrally balancing effect of cold not rarely lead to more restful sleep after a number of treatment days. The combination of whole body cryotherapy and Jacobson’s progressive muscle expansion has proven effective, since with its help and in interaction with the attainable psychological equilibrium, tension and relaxation states of the musculature can be perceived and learned.

Due to its strong stimulus, whole body cold acts in a regulatory manner on the tone of the blood vessels in the capillary areas of the skin and contributes (in combination with athletic activity adapted to an individual’s ability to be burdened) to a alleviation of orthostatic regulatory disorders (see also section 4.9 – primary hypotonic regulatory disorders) as well as to an improvement in well being.

It can also be assumed that the increased muscular circulation after whole body cold (section 3.4) contributes to a regulation of metabolism in the musculature and with that a reduction in complaints.

Possible organic causes of fibromyalgia, such as spinal syndromes and immunologically mediated diseases (secondary fibromyalgia), are not dealt with here separately since the cryotherapy of these diseases is fully discussed in sections immune mediated inflammatory diseases, osteoarthritis, spinal syndromes and tendopathis.

For further useful information about whole-body cryotherapy at -110 ° C, and the mechanisms of action, we recommend the book "The Power of the Cold" by Prof. Dr. sc med Winfried Papenfuss, published by Edition K Wolfsegg. Large parts of the content of this website were taken from this book. 

The catchy standard work is suitable for both professionals and interested readers. With pleasure we forward your order of "The Power of the Cold" directly to the publisher.