As early as 1959, doctors of physical therapy noticed that their patients with multiple sclerosis (MS) experienced reduced symptoms in response to "cool baths." For example, Boynton et al. 1959a & Boynton et al. 1959b reported that all 10 of his patients "chronically ill with multiple sclerosis... reported a feeling of relaxation with less muscle spasm and greater ease in the sitting or standing position. Three of 10 patients have shown immediate and rather remarkable increase in their ability to ambulate following cool bath treatment." (Emphasis added).
That was 60 years ago.
Given that there is no cure for MS, and that treatment consists only of speeding recovery from and alleviating symptoms in exactly the way that cold water therapy has been shown to do, you might be surprised to discover that the National MS Society makes no mention of cold therapy for management of the disease. They list over a dozen medications, but never mention cold -- although they do caution against overheating, and provide a list of products intended to keep MS patients cool during the summer.
In fact, the most recent update of The Use of Disease-Modifying Therapies in Multiple Sclerosis: Principles and Current Evidence (2019) lists 11 different medical doctors among the reviewers, includes 320 citations, tabulates the 17 different medications that have been approved by the FDA for treatment of MS...
... and never mentions cold therapy.
And yet, scientific evidence supporting use of cold therapy for treatment of MS keeps trickling in.
A 1995 study in the Italian Journal of Neurological Sciences found that cold exposure improved strength and reduced fatigue for six MS patients.
A 1997 technical bulletin from NASA compared two MS patients who received different levels of exposure to cold. The patient with the greater cold exposure demonstrated higher cognitive function than the patient who was cooled less.
A 2003 article published in the journal Neurology criticized prior studies for being "limited by uncontrolled designs, unblinded evaluations, reliance on subjective outcome measures, and small sample sizes." So they conducted "a randomized, controlled study of acute and chronic effects of cooling therapy for MS". And what did they find? Cooling therapy improves motor and visual functions in MS patients, and the more cold exposure they get, the more improvement they enjoy.
A 2008 study revealed that cooling just one hand of MS patients walking on a treadmill increased exercise durations by 33%.
A 2016 study demonstrated that just 10 sessions of whole body cryotherapy improves fatigues and mood scores among patients with multiple sclerosis.
A 2017 article published in Journal of Clinical Nursing reported that cooling suit therapy "significantly improved levels of fatigue and independence in activities of daily living," for MS patients.
All of which would have escaped our attention if it were not for the coincidence of meeting two new MS patients seeking relief from their symptoms in an ice bath.
Both patients were in excellent physical condition, irrespective of their disease, at their time of diagnoses, and both discovered the benefits of cold therapy by experiencing it for themselves (rather on the recommendation of a doctor).
One patient says her ice bath is her "new best friend" and that she's "in and out of my ice bath 20 times a day."
The other describes his discovery of cold exposure therapy as his physical and psychological turning point out of depression.
The mechanisms by which cold therapy works for MS patients aren't described in the scientific literature. All we know is that cold exposure helps MS patients manage symptoms of fatigue, muscle weakness, cognitive dysfunction, and loss of visual acuity.
Because MS is an auto-immune disorder that attacks the protective sheathing around nerve fibers, it makes sense to hypothesize that cold therapy either impacts the immune system, or the nervous system, or both. What's interesting is that other literature describing the physiological response to subjects in ice baths describe both immune system and nervous system effects. In other words, the body's response to cold exposure is likely to be systemic, in which a number of hormonal, psychological, and neurological responses coordinate in a holistic adaptation to the challenge of the cold.
And it isn't just in MS patients. People without the disease benefit from cold exposure, too.
The link between cold therapy and MS now appears so promising, and so in need of additional research, that Morozko Forge will donate ice bath equipment to any medical researcher working to expand the body of scientific knowledge related to the experience, effects, mechanisms, or consequences of ice bath therapy for MS patients. Moreover, Morozko Forge will fund open access fees for any scientific journal publication resulting from the study, so that people without access to a university library can obtain the article for free online.
Morozko is convinced of the value of cold exposure therapy for the management of multiple sclerosis, even if the National MS Society, MS doctors, and the FDA are not. And because the reality right now is that MS patients aren't being told about the benefits of cold therapy by their doctors, we're prepared to connect them to better sources of new knowledge:
Each other.
About the Author
Thomas P Seager, PhD is an Associate Professor in the School of Sustainable Engineering at Arizona State University. Seager co-founded the Morozko Forge ice bath company and is an expert in the use of ice baths for building metabolic and psychological resilience.