Immune-Mediated Inflammatory Disorders ￼
Immune-mediated inflammatory disorders are those in which the autoimmune processes have been identified as a cause of the disease. The experience in cryotherapy includes great number of these disorders: rheumatoid arthritis, ankylosing spondylitis, psoriasis (with or without arthritis) and multiple sclerosis.
What causes these diseases?
The immune system has highly specialized cells and proteins called cytokines. Under certain physiological conditions and after having detected harmful factors, they develop important functions to protect the human organism and defend it from agents that they destroy using a process of acute inflammation.
The potential to recognize harmful elements for the organism (antigens) appears during the embryonic development. It becomes an effective defense after having faced different pathogens throughout life. Nevertheless, it seems that it might stop working properly due to root causes (endogenous) or secondary causes (acquired). This would produce a loss of some of these specific properties leading to immune tolerance or absence of response to proper and foreign antigens, as well as self-aggressive immune reactions manifested by a chronic primary inflammation that destroys tissue. The cause of this phenomenon is still unknown, but genetic research is helping understand how immunology works. In this context, it has been recently discovered that a fault in chromosome 6 is responsible for the development of autoimmune diseases, including rheumatoid arthritis and multiple sclerosis. A risk gene for Crohn’s disease has been found in chromosome 16. This is a chronic inflammatory disease of the intestine that also produces self- aggression.
Although autoimmune diseases are systemic diseases (the entire body is affected), they also have very specific target organs, body areas where they affect specifically and manifestly. These are:
- Joints (rheumatoid arthritis).
- Spine (ankylosing spondylitis, mainly).
- Central nervous system (multiple sclerosis).
- Skin and joints (psoriasis, with arthritis).
- Intestine (Crohn’s disease).
Cytokine TNF-α (tumor necrosis factor alpha) plays an obvious main role in these processes. The over-production of this protein by cells from the immune system triggers a chain reaction of inflammatory processes that foment self-aggressive function of immune cells. New cytokines are released and activated, and the walls of the blood vessels become permeable to the aggressive immune cells, allowing them to enter the target zone or target organ. These immunological discoveries, especially the destructive effect of TNF-α, have allowed the development of highly efficient treatments for these diseases.
Whole-body Cryotherapy enhances the state of health, reduces pain and signs of inflammation, improves general mobility and allows reducing medicine intake.
Cryotherapy For Rheumatoid Arthritis
The pathological processes of this autoimmune disease appear mainly in joints. The membrane that covers the joint capsule is inflamed and the structures of cartilage and bone are destroyed. New principles have been adopted for treating this disease (blocking the TNF-α), but the treatment still requires a complex procedure, since rheumatoid arthritis is basically a systemic disease that weakens the whole organism. Then, the medicine or surgical treatment, or eventually kynesiotherapy, physical therapy -use of heat or cold- or psychological support have to be linked to the personal coping strategies of the patients and be coordinated.
An excellent and extensive bibliography about this topic has been published by relevant self-help organizations.
Rheumatoid arthritis is a systemic, chronic and progressive disease whose cure is yet to be found despite all the therapeutic advances. Therefore, this treatment aims to produce a decrease of intensity of the symptoms in order to stop or slow their progression.
Whole-body Cryotherapy must be understood in this context as an additive physiotherapy that can help achieve the objective of the treatment if it is used correctly. It has not been conceived to replace other tested treatments, but the experience and research have shown that it usually helps reduce the medicine intake.
Whole-body Cryotherapy should be used within the framework of a clinical treatment, inpatient, two sessions per day (or three when there is great activity) during 2-3 weeks. Medical evaluations about the progress of the treatment should take place every 2-3 days.
Nevertheless, in outpatient cases, 10-15 sessions of exposure to cold are usually sufficient even when there is a high degree of inflammatory activity. This causes a relief of the symptom picture in terms of pain reduction and movement restrictions.
Therapeutic activities related to movement (kynesiotherapy, physiotherapy…) will not be abandoned under any circumstances during the cryotherapy cycles. Exercise enhances the synovial fluid in joints and benefit the nutrient supply to joint cartilage, which fights muscular atrophy caused by inactivity that would ultimately produce secondary damages, for example to the skeleton.
In essence, a cryotherapy program is advantageous in two different levels:
- It improves general mobility as well as joint capacity in up to 60 % of the patients.
- It reduces medicine intake (corticosteroids and anti-inflammatory medication) in 35 to 40% of the patients.
Pain relief can be kept by increasing the length of time of the cycle regime. The improvement in joint mobility is a long-term result whose effects can be observed during a long period after therapy.
On balance, Whole-body Cryotherapy enhances the state of health, reduces pain and signs of inflammation, improves general mobility and allows reducing medicine intake.