Kältebehandlung rheumatischer Erkrankungen: Wirkungsweise, Verfahren und therapeutische Prinzipien

Abstract

Cold treatment has its roots in ancient medicine, but is actual still today. Cold treatment is defined physically as »Thermotherapy by withdrawal of heat«.Usually, the term cold treatment means more the longer and intense cold applications and not the short cold stimuli which are typical for hydrotherapeutic procedures according to Kneipp. Effects of cold treatment can only be understood, when it is discriminated carefully between short and longlasting cold applications, because there are significant differences between these two kinds of treatment. Inhibition of inflammation is only possible with longer cold applications (20-30 minutes), however, facilitation of neuromuscular function can be achieved only with short cold stimuli. Cold treatment can be used alone or in combination with exercise therapy, basing on neuromuscular principles. With regard to rheumatology, analgesic, muscle-relaxing and edema-inhibiting effects of cold are especially attractive. Cold ist the most potent antiphlogistic agent in physical medicine which we know. Under certain conditions cold-induced vasoconstriction, cooling of muscles and increasing viscosity of synovia may have unwanted side effects. Cold applications are the treatment of choice in all acute inflammations, but are proved in many other rheumatological indications too. Though cold treatment has not so much contraindications than heat treatment, it is not indifferent and regards special experience and consideration of the patient's specific tolerance.