By Niki Moore, Vice President of Product Management, One Call
Pretend for a moment, a co-worker fell at your workplace and suffered a minor sprain. One of the first treatments they would likely receive is the application of extreme cold – such as ice – to the injury. This is known as cryotherapy, or more simply, cold therapy. While cryotherapy has its purpose and can be helpful in providing immediate pain relief, it is not a long-term solution.
Phases of Inflammation
Inflammation occurs in three phases: acute, sub-acute, and chronic. At the onset of injury, the body initiates an acute inflammatory response. Several types of mediator cells rush to the area, operating as a defense mechanism to prevent further damage and infection. This reaction is non-specific, immediate, and includes five fundamental signs: heat, redness, swelling, pain, and loss of function.1 We often associate inflammation with swelling, but it is two distinct processes. Inflammation is the initial phase of tissue repair, while swelling is the waste at the end of the inflammatory process that has yet to be evacuated.2
For years, the accepted treatment for acute minor injuries has been the RICE method – rest, ice, compression, and elevation.3 While applying ice or cold treatment to the affected area causes the blood vessels to constrict and stops the transportation of additional inflammatory cells or neutrophils, some inflammation is needed to assist with the healing process.
Prolonged icing may actually inhibit healing during the acute phase. Instead, ice needs to be applied in moderation for short, designated periods of time as prescribed by the treating physician.
After the acute phase of injury, there may still be times when inflammation occurs, such as post-surgery. Surgery produces a sub-acute inflammatory response, reigniting the healing and recovery process. Following a surgical procedure, cryotherapy – as prescribed by a doctor – can be beneficial for pain control and reducing inflammation.
For injured workers with chronic inflammation, daily short-term use of ice may be indicated for the analgesic aspect, rather than inflammation reduction, to help manage sudden pain flare-ups.
Cryotherapy Methods and Devices
There are many different types of cryotherapies, including ice packs, cold therapy units, commercial cryotherapy units, whirlpool or ice bath, and coolant sprays.
The use – and costs – of these therapies generates a lot of attention and differing opinions within healthcare, including the workers’ compensation industry. It’s important to have a strong understanding of the different therapies to facilitate conversations with the physician, determine medical necessity, and properly follow treatment guidelines.
There are several important factors to consider when evaluating various cryotherapies:
- Modalities – What key features does this therapy type offer? (i.e., hot, cold, compression)
- Temperature control range – How hot or cold will therapy become?
- Compression rates – What level of compression does this therapy offer?
- Deep vein thrombosis – Is this therapy designated to prevent DVT and its symptoms?
- Thermoelectric versus ice – Does it rely on actual ice or will I need to plug it in?
- Billing cycles – Are there options to purchase or rent (daily or monthly)?
Examining Next Steps
Unfortunately, there is not a lot of industry specific data to support or negate the use of cryotherapy. More research and case studies are needed to examine patient usage and compliance. Once more research is available, we can use it to drive conversations and create partnerships with providers, removing any interpretation of financial incentive.
In the meantime, medical trends will continue to arise that create animosity amongst vendors, care providers, and payors. The parties involved often fail to have quality conversations that foster true change. When this occurs, stay focused on your injured worker’s recovery goals, know the various cryotherapy options, and don’t be afraid to ask why certain items or treatment options are needed.
It’s time to shift the narrative when it comes to cryotherapy. As an industry, let’s stop being as cold as ice. Let’s focus on conducting research, developing partnerships, and creating conversations rooted in data, so the injured workers we serve don’t pay the price.
1Hannoodee, Sally; Dian N. Nasuruddin. (2022, November 14). Acute Inflammatory Response. Retrieved from the NIH National Library of Medicine: National Center for Biotechnology Information. https://www.ncbi.nlm.nih.gov/books/NBK556083/#:~:text=Acute%20inflammation%20is%20an%20immediate,tissue%20damage%20(tissue%20necrosis)
2Scialoia, Domenic; Swartzendruber, Adam J. (2020, October 30). The Sport Journal. Retrieved from The R.I.C.E Protocol is a MYTH: A Review and Recommendations. https://thesportjournal.org/article/the-r-i-c-e-protocol-is-a-myth-a-review-and-recommendations/
3National Institute of Arthritis and Musculoskeletal and Skin Diseases. (2021, September). Sports Injuries: Diagnosis, Treatment, and Steps to Take. Retrieved from National Institutes of Health. https://niams.nih.gov/health-topics/sports-injuries/diagnosis-treatment-and-steps-to-take
About Niki Moore
Niki Moore joined One Call in 2023 as a vice president of product management, overseeing the durable medical equipment, home health, and complex care solutions. She joined the organization with more than 20 years of experience as a nurse leader with extensive knowledge in the management and medical file review of complex injuries.
Prior to One Call, she served as associate vice president, clinical operations for Sedgwick, where she led the telephonic case management program for more than 350 nurses across the U.S. and Guam. In her role, she was responsible for growing revenue across the existing customer base and creating growth through the implementation of a new claims management program.
Niki’s professional career also includes nearly 10 years with Publix Super Markets, Inc. where she served as a team leader of medical administration. In this role, she managed a highly skilled nursing team responsible for the company’s workers’ compensation injuries, specifically the management of complex medical and litigated claims and the development of medical care policies and procedures.
Niki started her career as a nurse case manager, spending 10 years serving various companies, including three years with WorkComp Solutions. She is a certified claims adjuster (CCA) and a certified case manager (CCM).
Niki’s impressive career is rooted in an equally strong education. She received her Master of Science in Nursing Leadership from Florida State University and her Bachelor of Science in Nursing from Polk State College.
About One Call
As a leader in the workers’ compensation industry, One Call has an unwavering commitment to getting injured workers the care they need when they need it. Leveraging more than 30 years of industry experience and innovative solutions, we are moving injured workers through their care journeys better than ever before, providing exceptional, predictive, and responsive care coordination. For more information and the latest news, visit us at onecallcm.com, LinkedIn (One Call), Facebook (@onecallcm), and Twitter (@onecallcm).
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