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Friday, March 23, 2018

A Polar Plunge Can Provide Lasting Relief From Pain from Dr. Mercola

A Polar Plunge Can Provide Lasting Relief From Pain

Story at-a-glance

  • A 28-year-old man was suffering from severe, persistent pain after receiving surgery for excessive facial flushing
  • “Desperate to get some relief,” he decided to go for a swim in a cold body of open water; he stayed in the water for only about a minute, and when he got out he was pain free
  • Beyond pain relief, exposing your body to cold temperatures for short periods of time improves health by inducing incredibly mitochondrial-dense brown adipose tissue (BAT) to improve metabolic function
  • You can gain the benefits of cold thermogenesis by taking a cold shower, taking a dip in a cold pool or even turning down the thermostat in your house in the winter to about 60 degrees F
By Dr. Mercola
Could taking a swim in cold water be a viable solution for pain relief? It was for one man, a 28-year-old who was suffering from severe, persistent pain after receiving surgery for excessive facial flushing. The surgery involves cutting nerves in the chest, and while it served its purpose for the facial flushing, it left the man — a former triathlete — dealing with debilitating chronic pain.1 Conventional pain treatments did little to help, and the pain was made worse by movement so physical therapy was of no use.
“Desperate to get some relief,” he told the BBC he decided to go for a swim in a cold body of open water. He figured the cold swim would be a “long shot” to help his pain, but he took the plunge anyway, climbing to the top of a rocky outcrop and then jumping into the frigid water.2 He stayed in the water for only about a minute, and when he got out he was pain free.

Cold, Open-Water Swimming Leads to Immediate Pain Relief

In a case report of the incident published in BMJ Case Reports, authors describe “a case of unexpected, immediate, complete and sustained remission of postoperative intercostal neuralgia after the patient engaged in an open-water swim in markedly cold conditions.”3 While pointing out that it’s possible the pain relief occurring after the swim occurred by chance, the fact that it occurred immediately afterward makes a causal relationship possible.
Further, the benefits of cold thermogenesis, or cryotherapy, are well-known. As for what may have led to the pain relief in this man’s case, the authors suggested the sudden immersion in cold water may have triggered a “wave of nervous system activity” that, along with the fear of drowning, may have altered his perception of the pain. It may also have served as a high-intensity form of distraction that had a lasting effect on his pain perception.
In addition, since the pain was causing the man reduced mobility on land, which may have ultimately made the pain more persistent, moving freely in the water may have broken the pain cycle. It should be noted that jumping into a cold body of water is not without risk in itself. This particular man’s athletic history may have played a role in the favorable outcome. He noted:4
“I initially thought ' … this is so cold I'm going to die!' and I just swam for my life … Once I was in the water, I had tunnel vision — for the first time in months, I completely forgot about the pain or the fear of shooting pains in my chest if I moved. My entire body tingled with the cold.
I just knew if I didn't keep swimming, I'd soon freeze. After a few moments I actually enjoyed it — it was just an immersive rush of adrenaline. When I came out of the water, I realized the neuropathic pain had gone away. I couldn't believe it."

Czech Seniors Credit Their Health, Vitality to Cold-Water Swimming

The BMJ case isn’t the first report of cold-water swimming leading to health benefits. In the Czech Republic, a number of seniors, some in their late 80s, credit the practice with their ability to resist illness and maintain vitality. Jitka Tauferova, who’s in her mid-70s, told Time that since starting cold-water swimming, "The last time I had flu was 25 years ago … [My] back pain disappeared. Better blood circulation improves healing broken bones and my heart is like a hammer. I feel great."5
In fact, people in Russia and Scandinavia have been taking so-called polar bear plunges for centuries, often right after coming out of a hot sauna. In the Czech Republic, about 20 cold-water swimming competitions are held annually, every weekend during the cold months of October to March.6 Once people try it they often get hooked, Tauferova told Time:7
"The story is always the same … They start in summer and continue until fall and winter, gradually hardening to the cold. Then their dream — to swim in a river in winter — comes true, but they never stop. They become winter swimmers forever."
The U.S. is also home to so-called “polar bear clubs” of its own. The oldest “winter bathing club” in the U.S. is the Coney Island Polar Bear Club, which was founded in 1903 by Bernarr Macfadden, an early advocate of physical fitness and natural foods, who believed immersing yourself in the ocean during the winter was “a boon to one’s stamina, virility and immunity.”8 Today, members swim every Sunday from November to April.

Cold Thermogenesis Is Not Only for Pain Relief — It’s for Health

Exposing your body to cold temperatures for short periods of time improves health by inducing incredibly mitochondrial-dense brown adipose tissue (BAT) to improve metabolic function. One of the physiological functions of body fat is to be used as fuel to heat your body if you have active BAT metabolism. This is accomplished by uncoupling the mitochondria from producing ATP and actually producing heat instead.
By regularly exposing yourself to cold, you build up a mitochondria-rich tissue in brown fat and help your body generate heat, which actually lowers your blood sugar and decreases insulin resistance. Beige fat is a derivative of brown fat and is recruited through your white fat, which can then be used to heat your body and maintain a more active-passive metabolism.
Indeed, the conclusion I reached after many decades of studying health is that burning fat as your primary fuel is a key to preserving and maintaining your health. There are a number of ways to reach this goal, including through diet, but there’s also a tremendous synergy with cold thermogenesis.
Human newborns have a supply of brown fat to keep warm, but by adulthood they lose most of their stores of it. Brown fat has been located in the neck area, around blood vessels (helping to warm your blood) and "marbled" in with white fat in visceral fat tissue. In one study, scientists found that they were able to activate brown fat in adult men by exposing them to cold temperatures.9
Research published in 2009 also found that cold temperatures increased activity in the subjects' brown fat regions, and cold-induced glucose uptake was increased by a factor of 15.10 More recently, a study published in Bioscience Reports looked at the impact of cryotherapy — exposure to cold — on the mitochondrial structure in BAT and skeletal muscle, both of which are thermogenic sites,11 revealing that cold exposure increases whole-body metabolic rate via the following mechanisms:
Oxygen consumption increases Enzymatic activity in the mitochondria of your muscle is upregulated
Fibroblast growth factor 21, IL1α, peptide YY, tumor necrosis factor α and interleukin 6 are induced, and appear to play an important role in coordinating the various physiological adaptations to cold, and in the cross-communication that occurs between BAT and muscle Insulin and leptin are downregulated
BAT becomes browner The number of mitochondria increases

Cold Temps Benefit Your Brain, Stress Tolerance

Aside from the metabolic benefits, when you're exposed to cold your body increases production of norepinephrine in the brain, which is involved in focus and attention. It also improves mood and alleviates pain, partly because it lowers inflammation. You can increase norepinephrine twofold just by getting into 40-degree F water for 20 seconds, or 57-degree F water for a few minutes, according to biological scientist Rhonda Patrick, Ph.D.
While best known as a neurotransmitter, norepinephrine also acts as a hormone. One of its functions is causing vasoconstriction, which helps your body conserve heat. Norepinephrine also acts as a signaling molecule to make more mitochondria in your fat tissue (your main energy reserves), and a byproduct of energy production is heat. This also helps prepare you for the next time you're exposed to cold.
The more times you're exposed to cold, the more mitochondria you make in your fat cells and the better you can withstand lower temperatures, a process sometimes referred to as “hardening.” Hardening is the exposure to a natural stimulus, such as cold water, that results in increased tolerance to stress and disease. This was demonstrated by a study involving 10 healthy people who swim regularly in ice-cold water during the winter.
“A drastic decrease in plasma uric acid concentration was observed during and following the exposure to the cold stimulus,” the researchers explained,12 which is notable because when your uric acid level exceeds about 5.5 mg per deciliter, you have an increased risk for a host of diseases including heart disease, fatty liver, obesity, diabetes, hypertension, kidney disease and more.
The cold stimulus also increased glutathione, which is an intracellular antioxidant found inside every cell in your body that aids detoxification. Whole-body cryotherapy has even been found to cut anxiety and depression scores by about half,13 while taking a cold shower has been suggested as a potential treatment for depression. According to researchers:14
“Exposure to cold is known to activate the sympathetic nervous system and increase the blood level of beta-endorphin and noradrenaline and to increase synaptic release of noradrenaline in the brain as well. Additionally, due to the high density of cold receptors in the skin, a cold shower is expected to send an overwhelming amount of electrical impulses from peripheral nerve endings to the brain, which could result in an anti-depressive effect.”
Cryotherapy may also temporarily relieve pain from diseases such as rheumatoid arthritis, osteoarthritis and fibromyalgia (in the latter case the cryotherapy involved cold air cooled by addition of nitrogen blown on the patients in an open cabin).15
In another study, fibromyalgia patients who received whole body cryotherapy reported significantly improved quality of life, with the beneficial effects lasting for at least one month after treatment. “Based on recent findings, it can be expected that whole body cryotherapy can improve health-reported quality of life by alleviating the symptoms of musculoskeletal pain and fatigue,”16 the researchers noted.

How to Use Cryotherapy to Boost Your Health

Using cryotherapy to your advantage may help to improve your health by boosting mitochondrial function and metabolic efficiency. If you want to give it a try, there are many options, from expensive cryotherapy booths found at high-end spas to taking a cold shower at home. Some of the simplest options include:
Applying an ice pack or cold gel pack Applying an iced towel (simply wet a towel and freeze it) or massaging with ice cubes
Taking a cold shower or alternating between cold and hot in your shower Taking an ice bath
Exercising in cold weather wearing few articles of clothing Jumping into an unheated pool following sauna or exercise
Swimming in the ocean when water temperatures are low Turning down the thermostat in your house in the winter to about 60 degrees F
Be sure to start off gradually and keep exposures short — no more than a few minutes to 10 or 20 minutes after you have acclimated. Further, cryotherapy is contraindicated for pregnant women, young children and those with high blood pressure or a heart condition. Cold causes acute vasoconstriction, which can be potentially dangerous if you have high blood pressure or heart failure. A quick cold shower would probably be OK, but avoid ice baths or other extreme cold water immersion techniques.
If you’re planning to try cold-water swimming, as in the featured study, use extra caution and be sure you have a buddy with you. Jumping into a body of near-freezing water is not an activity to be taken lightly, and if you do decide to do it, you should be in relatively good shape first. To put it simply, the cold water will generate an enormous shock to your system, which will result in:
  • An initial “cold shock,” which will leave you gasping for air and unable to hold your breath
  • Blood vessels along your outer body will constrict, attempting to shift blood to your inner organs
  • Your muscles will get very cold and may become paralyzed or weak
Drowning, even after just one or two minutes, is therefore a very real risk if you’re not careful. To gain benefits, however, it is not necessary to swim in ice water. Instead, start slowly around 70 degrees F or so and gradually work your way down to the 40s, giving your body a chance to acclimate in the process.
Always listen to your body, but you may be surprised at how invigorated you feel following a cold shower or a quick dip in a cold pool. Regularly exposing yourself to cold temperatures is a simple way to help improve your mitochondrial function, which is a foundation of good health, and if you’re suffering from chronic pain, it may help to provide lasting relief for that, too.
+ Sources and References

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