Lowering local body temperature for therapeutic purposes is called cryotherapy. In terms of physical therapy, it is defined as cold below 18 degrees, cool between 18-24, warm between 24-33 and neutral temperature of 33-35.


Physiology of local cold application
1- Reducing pain
Due to the decrease in the activity of the Na-K pump in free nerve endings, repolarization and excitability decrease. Nerve conduction velocity slows down. It provides analgesia through the gate control mechanism. It increases the release of endorphins. It also reduces pain by secondary mechanisms such as solving cold spasm and anti-inflammatory effect.
2- Anti-inflammatory effect
To prevent inflammation, cold should be applied in the acute period and especially in the first 72 hours.
3- Slowing down of metabolism
Decreased metabolism prevents the formation of ischemic damage by reducing the oxygen requirement of the tissue. Cold prevents secondary tissue damage by reducing enzymatic activity.
4- Reducing muscle spasm and spasticity
With cold application, the receptors in the skin are initially stimulated, alpha motor activity is facilitated, and muscle tone increases. If cooling continues, the activity of the muscle spindle and gamma motor neuron decreases.

- Musculoskeletal traumas: It should be applied within the first 72 hours of trauma before swelling and hemorrhage develops. On the first day, cooling is done for 20-30 minutes every 1.5-2 hours. It is terminated when edema and bleeding are prevented. Unnecessary application delays healing. Cold application is done with rest, compression and elevation.
- Neurological diseases: for the purpose of reducing spasticity and retraining the muscle
- Acute inflammatory diseases: It can be applied 3-4 times a day for 10-20 minutes in acute gout attacks, active periods of osteoarthrosis and rheumatoid arthritis, tendinitis, bursitis, epicondylitis.
- Myofascial pain syndrome: One of the most important treatment methods is passive stretching of the muscle and simultaneous cryotherapy.
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