Key facts
- Modality: Cold therapy (cryotherapy)
- Primary effects: short-term pain numbing, swelling support, reduced local blood flow
- Common contexts: new injuries with swelling, acute flare-ups, post-activity soreness for some people
- Common forms: cold packs, cooling wraps, cold water exposure, clinical cryotherapy
- Poor fit: impaired sensation, circulation disorders, cold hypersensitivity conditions
- Decision support: Heat vs Cold Therapy
How cold therapy works
Local physiological response
Cooling tissues is associated with vasoconstriction (reduced local blood flow) and slower nerve conduction. In practice, this combination is commonly used for temporary pain numbing and swelling support.
System-level response
Whole-body cold exposure can trigger a sympathetic alerting response (for example, faster breathing and a temporary rise in heart rate). Some studies report changes in stress-related hormones after cold exposure, and responses vary based on protocol and health status.
Inflammation context
Cold therapy is often discussed in the context of inflammation because it can reduce local blood flow and swelling. At the same time, inflammation is part of tissue repair. Many clinical frameworks emphasize symptom-guided use rather than rigid schedules.
When cold therapy is commonly chosen
Cold therapy is commonly chosen when symptoms include visible swelling, tenderness, and a desire for short-term pain relief. Clinical advice varies by condition, and it is often used as an adjunct rather than a standalone treatment.
Common forms of cold therapy
Cold packs and compresses
Localized cooling using gel packs, ice packs, or chilled compresses. In most guidance, a cloth barrier is used to reduce skin injury risk.
Cooling wraps and sleeves
Wearable options that combine cooling with light compression. These are commonly used for joints and areas where a wrap stays in place.
Cold water exposure
Partial or whole-body cold water exposure used in recovery and wellness routines. System responses vary and depend on exposure intensity and individual tolerance.
Clinical cryotherapy
Facility-based modalities (for example, controlled cold air exposure). Evidence and indications vary by condition and clinical context.
For implementation details, see Contrast Therapy Setups.
When cold therapy is a poor fit
Cold therapy is commonly avoided in situations where circulation is impaired, sensation is reduced, or cold exposure triggers abnormal reactions.
Risks and safety considerations
Cold exposure can cause skin injury, excessive numbness, and (in whole-body settings) cardiovascular stress. Whole-body cold exposure should be approached conservatively and with attention to individual risk factors.
Stop cold exposure if you experience chest pain, severe shortness of breath, faintness, confusion, or persistent numbness.
How cold therapy fits in the system
Cold therapy is one of the two foundational thermal modalities. Heat therapy is commonly used for stiffness and relaxation contexts, while cold therapy is commonly used when swelling and acute tenderness are prominent.
For decision support, see Heat vs Cold Therapy. For the alternating approach, see Contrast Therapy.
Where to go next
- Heat Therapy
Learn about heat therapy mechanisms in depth.
- Heat vs Cold Therapy
Choose the modality based on timing, symptoms, and goals.
- Contrast Therapy
Understand when alternating warm and cold is discussed.
Sources & review
Reviewed: 2026-01-21. Reviewed for clarity and citation coverage.
- [1] AAPM&R PM&R KnowledgeNow. Therapeutic Modalities – Thermal. now.aapmr.org
- [2] Cleveland Clinic (2025). Ice vs. Heat: What Is Best for Your Pain? health.clevelandclinic.org
- [3] NHS. Sprains and strains (general guidance on ice/heat use and safety). www.nhs.uk
- [4] Gloucestershire Hospitals NHS Foundation Trust. Ice and heat treatment (patient leaflet). www.gloshospitals.nhs.uk