Cold Exposure Therapy Health Benefits

 in the potential perks of cold water 

In recent years, the topic of cold exposure therapy has, at times, felt inescapable in the health and wellness space. From Olympic athletes touting the benefits of ice baths, to influencers showing off the results of frigid facials, and maybe even your own doctor recommending trying contrast showering to help relieve symptoms of a chronic illness, these and other cold immersion treatments have been, well, hot. But should we believe the hype? Are there any real, proven benefits of ice baths, or is it all just talk?

We spoke with three physicians to find out whether it’s worth plunging yourself into icy water for the sake of your health.

What Is Cold Exposure Therapy?

Cold exposure therapy, also known as “cryotherapy,” refers to the use of cold temperatures to treat a medical condition or symptom, or benefit a person’s health. Though it can take various forms, we’re going to focus on cold water therapy (such as submerging yourself in an ice bath)—in other words, the kind that’s taken over everyone’s social media feeds. But what, exactly, is it?

“Cold water therapy typically involves water temperatures between 45 and 55 degrees Fahrenheit, with some situations calling for colder temperatures down to 38 degrees,” says Jeffrey Kutcher, MD, a neurologist specializing in sports medicine at Henry Ford Health in Detroit. "Regimens of differing frequencies and durations of cold water exposure are used for different conditions and situations."

In addition to water in its traditional liquid form, cold water therapy can also involve frozen water, like ice baths, or even vapors. Take whole-body cryotherapy (WBC), for example, which consists of exposing your body to vapors ranging from -200 to -300 degrees Fahrenheit for between two and four minutes, while enclosed in a small, booth-like space.

Other examples of cold water therapy include cold water immersion (spending time in a tub or pool of water below 59°F so that it covers your entire body up to your neck), cold showering, contrast showering (alternating between warm and cold water), and swimming outdoors in a lake, river, or ocean.

Why Take an Ice Bath?

Starting your day with a cold shower may help jolt you awake, but when we talk about cold water as a type of therapy, we’re referring to its application as a way to improve health. According to Dr. Kutcher, cold water therapy works on many different levels, including directly on tissues and indirectly via stimulation of the nervous system.

“The goal of cold water therapy is to affect or modulate basic metabolic or biologic processes, such as inflammation, pain, and autonomic nervous system control,” Dr. Kutcher explains. “It can be used to help recover from strenuous exercise, reduce problematic inflammation, improve control of mood disturbances, and [manage] sensory regulation that can help reduce the effects of pain syndromes such as a migraine.”

Much of the recent attention on cold water therapy has centered on stimulating the vagus nerve: one of 12 pairs of cranial nerves that run down both sides of the body, communicating with most organs along the way. The vagus nerve also activates the parasympathetic nervous system, which slows heart and breathing rates, lowers blood pressure, and promotes digestion to relax the body after bouts of stress. Multiple viral social media posts claim that different types of cold water therapy can be used to stimulate the vagus nerve to reduce anxiety and promote better sleep.

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Are There Real Benefits of Ice Baths (and Other Forms of Cold Therapy)?

The truth is, while there’s plenty of anecdotal evidence purporting a range of benefits of ice baths and other types of cold water therapy, the empirical research is largely lacking. There is a limited but growing number of mostly smaller studies that appear to suggest that cold exposure therapy, including cold water therapy, could be beneficial to a person’s health. For now, more research—controlled studies in particular—is needed to determine the effectiveness of these cold immersion therapies, the conditions and/or symptoms they treat, and the correct dosages to achieve these benefits.

Below are several of the most studied and suggested benefits of cold immersion therapies like ice baths, whole-body ice immersion, cold showers, cold plunges, and similar modalities.

Pain, Stiffness, Fatigue, Mood Regulation

“In some limited circumstances, evidence shows [that cold water therapy] can be effective,” says Lora Scott, MD, division chief of pediatric sports medicine at Dayton Children's Hospital in Dayton, Ohio. More specifically, it “can improve general health and quality of life, with significant results in patients dealing with pain, fatigue, physical function, stiffness, and psychological variables,” she adds.

Similarly, Dr. Kutcher points out that cold water therapy can reduce pain and inflammation from injury or exercise, improve mood regulation, and decrease the effects of certain pain syndromes.

“In the right situation, I recommend cold water therapy in patients who are having a hard time managing frequent migraine headaches and related symptoms, as well as those who are having a hard time regulating their mood,” Dr. Kutcher says. “Benefits in these patients may extend to other important areas of health, such as sleep, and exercise tolerance as well. My recommendations are made after careful consideration of possible negative consequences, particularly in patients with heart disease or peripheral vascular disease, or who have an increased risk of stroke.”

Immune System, Nervous System, Metabolism, Cardiovascular Health

According to Claudia Dal Molin, DO, a primary care sports medicine physician at the University of Maryland Medical Center, cold water immersion is the most studied type of cold water therapy. For instance, a 2022 article published in the International Journal of Circumpolar Health reviewed the findings of 104 studies looking into the effects of cold water immersion on human health. It found potential benefits for the cardiovascular system, insulin resistance and sensitivity, mental health, and the immune system (e.g. tolerance for stress and respiratory infections).

These findings are promising and warrant further investigation.

Some of the other potential benefits of cold water therapy supported by at least some research include reduced heart rate through vag. 

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