ICY COMFORT: EFFECTIVENESS OF CRYOTHERAPY IN MANAGEMENT OF RHEUMATOID ARTHRITIS PAIN

Main Article Content

Jeena Thomas
Jeeva George
Sonia Raj

Keywords

Cryotherapy, Pain, Rheumatoid arthritis

Abstract

Rheumatoid Arthritis affects an estimated 10million Indians. ¾ of them are women. It is a long term disease that causes inflammation of joints and its surrounding tissues resulting in pain, swelling and stiffness. Currently there is no curative therapy for RA therefore patients are subjected to various lifelong adjustments and treatment modalities. Cryotherapy embraces vast varieties of uses like pain reduction, reduce swelling and promote healing. This study aimed to assess the pain level of the patients with Rheumatoid Arthritis pre and post cryotherapy. The study had adopted a quantitative approach with a  quasi experimental study includes patients with RA between age group of 30 to 65yrs who visited orthopaedic centre  for a period of three months. Pretest of levels of pain assessed with Mc Caffery numerical rating Scale of Pain Assessment. This test was done for 20min.Consecutive 5days of Cryotherapy was administered and post-test was done on the 6th day of pre-test. Among samples 30% were between the age group of 46-50 yrs. Out of 100%,30% were males and 70% were females.80% of patients were with 3-4 year of disease,73.3% were with 3-4year of treatment. Majority 77% of patients had pretest pain score >8, Post test pain score <3 is found for 87% of patients after cryotherapy. Thus, cryotherapy is found effective in reduction of pain in 73.3% of patients with RA. The present study assessed effectiveness of Cryotherapy in reducing pain among patients with RA. The overall findings leads to necessity to enhance education regarding the effective use of cryotherapy in pain management among patients with RA. Potential risk in Cryotherapy is minimal, it is considered to be the best technique in effective management of pain. Adequate knowledge and guidance should be imparted to the patients about cryotherapy.  

Abstract 153 | PDF Downloads 80

References

Aciksoz S, Akyuz A, Tunay S. The effect of self-administered superficial local hot and cold application methods on pain, functional status and quality of life in primary knee osteoarthritis patients. J Clin Nurs. 2017;26:5179–90.
2. Algafly AA, George KP. The effect of cryotherapy on nerve conduction velocity, pain threshold and pain tolerance. Br J Sports Med. 2007;41:365–9.
3. Aroyah N. Cold therapy (cold therapy) in the management of sports injuries. J Educator and FIK UNY Recreation. 2012:17-23
4. Asikin M, Nasir M, Podding TS. Musculoskletal System Surgical Medical Nursing. Erlangga Jakarta. 2016;31-45.
5. Ayuningtyas WR. Experiences of Rheumatoid Arthritis Sufferers When Getting Therapy with a Psychocal Approach. Guided Imagery in Comm. 2018;2(1):79-88.
6. Behrens BJ, Beinert H. Physical agents: theory and practice. 3rd ed. Philadelphia: F. A. Davis Company; 2014.
7. Bettoni L, Bonomi FG, Zani V, et al. Effects of 15 consecutive cryotherapy sessions on the clinical output of fibromyalgic patients. Clin Rheumatol. 2013;32:1337–45.
8. Bouzigon R, Grappe F, Ravier G, Dugue B. Whole- and partial-body cryostimulation/cryotherapy: current technologies and practical applications. J Therm Biol. 2016;61:67–81.
9. Chanliongo PM. Cold (cryo) therapy. In: Lennard TA, Walkowski S, Singla AK, Vivian DG, editors. Pain procedures in clinical practice. Philadelphia: Elsevier; 2011. p. 555–8.
10. Dantas LO, Breda CC, da Silva Serrao PRM, et al. Short-term cryotherapy did not substantially reduce pain and had unclear effects on physical function and quality of life in people with knee osteoarthritis: a randomised trial. J Physiother. 2019;65:215–21.
11. Denegar CR, Dougherty DR, Friedman JE, et al. Preferences for heat, cold, or contrast in patients with knee osteoarthritis affect treatment response. Clin Interv Aging. 2010;5:199–206.
12. García-Espinoza ÓA, Salas-Fraire Ó, Flores-Garza PP, Salas-Longoria K, Valadez-Lira JA. Analgesic effect of whole body cryotherapy in patients with trapezius myofascial pain syndrome: a longitudinal, non-blinded, experimental study. Med Univ. 2017;19:115–22.
13. Gizińska M, Rutkowski R, Romanowski W, Lewandowski J, Straburzyńska-Lupa A. Effects of whole-body cryotherapy in comparison with other physical modalities used with kinesitherapy in rheumatoid arthritis. Biomed Res Int. 2015;2015:1–7.
14. Hartrick CT. Special features of pain studies. In: Abd-Elsayed A, editor. Pain. Cham: Springer; 2019. p. 87–90.
15. Herrera E, Sandoval MC, Camargo DM, Salvini TF. Motor and sensory nerve conduction are affected differently by ice pack, ice massage, and cold water immersion. Phys Ther. 2010;90:581–91.
16. Kelechi TJ, Mueller M, Madisetti M, Prentice MA, Dooley MJ. Effectiveness of cooling therapy (cryotherapy) on leg pain and self-efficacy in patients with chronic venous disease: a randomized controlled trial. Int J Nurs Stud. 2018;86:1–10.
17. Lubkowska A, Szyguła Z, Chlubek D, Banfi G. The effect of prolonged whole-body cryostimulation treatment with different amounts of sessions on chosen pro-and anti-inflammatory cytokines levels in healthy men. Scand J Clin Lab Invest. 2011;71:419–25.
18. Rivera J, Tercero MJ, Salas JS, Gimeno JH, Alejo JS. The effect of cryotherapy on fibromyalgia: a randomised clinical trial carried out in a cryosauna cabin. Rheumatol Int. 2018;38:2243–50.
19. Sadura-Sieklucka T, Solłtysiuk B, Karlicka A, Sokolłowska B, Kontny E, Ksiezopolska-Orlłowska K. Effects of whole body cryotherapy in patients with rheumatoid arthritis considering immune parameters. Reumatologia. 2019;57:320–532.
20. Sastra L, Despitasari L. Effect of Cryotherapy Cold Therapy on Pain Reduction in Closed Extremity Fractures. J Health Hesti Wira Sakti. 2018;2(1);78-83.
21. Schlesinger N, Detry MA, Holland BK, et al. Local ice therapy during bouts of acute gouty arthritis. J Rheumatol. 2002;29:331–4.
22. Stanek A, Sieroń-Stołtny K, Romuk E, et al. Whole-body cryostimulation as an effective method of reducing oxidative stress in healthy men. Adv Clin Exp Med. 2016;25:1281–91.
23. Straub RH, Pongratz G, Hirvonen H, Pohjolainen T, Mikkelsson M, Leirisalo-Repo M. Acute cold stress in rheumatoid arthritis inadequately activates stress responses and induces an increase of interleukin 6. Ann Rheum Dis. 2009;68:572–8.
24. Westerlund T, Oksa J, Smolander J, Mikkelsson M: Thermal responses during and after whole body cryotherapy (-110°C). J Therm Biol 2003; 28: 601-8.