Whole Body Cryostimulation: A New Adjuvant Treatment in Central Sensitization Syndromes? An Expert Opinion

Abstract

Central sensitisation is defined as a multifactorial etiopathogenetic condition involving an increase in the reactivity of nociceptive neurons and alterations in pain transmission and perception in the central nervous system. Patients may present with widespread chronic pain, fatigue, sleep disturbance, dizziness, psychological (e.g., depression, anxiety, and anger) and social impairment. Pain can be spontaneous in onset and persistence, characterised by an exaggerated response and spread beyond the site of origin, and sometimes triggered by a non-painful stimulus. Whole-body cryostimulation (WBC) could be an adjuvant therapy in the management of this type of pain because of its global anti-inflammatory effect, changes in cytokines and hormone secretion, reduction in nerve conduction velocity, autonomic modulation, and release of neurotransmitters involved in the pain pathway. In several conditions (e.g., fibromyalgia, rheumatoid arthritis, and chronic musculoskeletal pain), WBC affects physical performance, pain perception, and psychological aspects. Given its multiple targets and effects at different organs and levels, WBC appears to be a versatile adjuvant treatment for a wide range of conditions of rehabilitation interest. Further research is needed to fully understand the mechanisms of analgesic effect and potential actions on pain pathways, as well as to study long-term effects and potential uses in other chronic pain conditions.

Keywords: central sensitization; chronic pain; cryotherapy; whole-body cryostimulation; widespread pain.

Figure 1

Multidimensional nature and overlapping manifestations of central sensitization syndromes.

Figure 2

A schematic illustration of the neurobiological processes underlying central sensitisation, showing the increased responsiveness of the central nervous system to nociceptive stimuli.

Figure 3

Overview of the impact of whole body cryostimulation. A diagram detailing its multiple and systemic benefits, including immune modulation, anti-inflammatory responses, and circulatory effects. A graphic roadmap for understanding the wide-ranging implications of this emerging therapeutic approach.