Cold Therapy and Nerve Damage

Patients who are not warned about the risk of using a cold therapy machine for too long can suffer devastating nerve damage (peripheral neuropathy) and other injuries. This is why patients should check their skin frequently for symptoms of nerve damage — including numbness, pain, cold sensitivity, loss of fine motor skills, and more.

Does Cold Therapy Cause Nerve Damage?

Cold therapy machines can cause permanent nerve damage (also known as “peripheral neuropathy”) as a complication of cold injuries like frostbite and skin necrosis. These injuries occur when patients use the machines for several hours of “continuous cold therapy” without checking their skin for symptoms of nerve damage.

Experts recommend taking several steps to reduce your risk of nerve damage and other injuries from a cold therapy machine:

• Talk to your doctor about the risks of cold therapy, proper temperature, duration of treatment, and how to recognize symptoms of nerve damage.
• Protect your skin from extremely cold temperatures by placing a towel under the compression pad.
• Check your skin every 20-30 minutes for symptoms of nerve damage and allow your skin to warm up while deeper tissues stay cool.
• The therapeutic benefits of cold therapy do not increase below 15ºC (59ºF), but the risk of skin and nerve damage increases.

Patients at Risk of Nerve Damage

Patients who are at high risk of nerve damage should not use a cold therapy machine unless specifically directed by a physician. These patients include:

• Raynaud’s phenomenon
• Cold allergy
• Cryoglobulinemia (disease that causes damaged blood vessels)
• Paroxysmal cold hemoglobinuria (disease that causes release of hemoglobin after exposure to cold temperature)
• Arthritis
• Pheochromocyotoma (disease that can cause abnormal skin sensations and other complications)
• Anesthetic skin (numbness)
• Severe cardiovascular disease
• And more

Symptoms of Nerve Damage

The symptoms of nerve damage vary depending on the types of nerves that have been injured and the extent of the injury. The nerves that sense pain are delicate branching structures that extend into the upper layers skin (epidermis). Nerves that sense heat and cold are located deeper in the skin. Because pain nerves are the first to be damaged by cold therapy, patients often fail to realize when they are getting too cold. The result is that patients may become numb or feel abnormal sensations (tingling, burning, warmth, etc.) instead of cold.

Symptoms of nerve damage from cold therapy include:

• Tingling and burning sensation
• Deep pain
• Numbness (loss of feeling in arms and legs)
• Muscle weakness
• Loss of fine motor coordination
• Skin discoloration, redness, swelling, or hardness
• Cold sensitivity