Whilst ice or extreme cold treatments are used for acute muscular pain and inflammation, they are often far from best friends with chronic pain. This is particularly so in the case of CRPS where ice therapy of any kind can cause the condition to worsen or even spread. With this in mind, an interesting case is reported in the most recent edition of the British Medical Journal (BMJ).
The study concerns a 28 year old man, formerly a keen triathlete, who developed severe post-operative neuropathic pain. Conventional treatments failed to help him, with physiotherapy simply exacerbating his pain and preventing him from completing a course of rehabilitation. Desperate for pain relief, he decided to see whether a cold, open water swim might help distract him from the pain. This involved jumping from a rocky outcrop into deep, extremely cold, open water and swimming for around a minute before he could reach a point where he could climb ashore.
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The subject’s account
The subject reported that:
“I initially thought ‘damn this is so cold I’m going to die!’ and I just swam for my life.” However, “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 realised the neuropathic pain had gone away. I couldn’t believe it.”
What might have ‘cured’ his pain?
Whilst it remains unclear why his pain was cured, researchers say that it is too much of a coincidence for the swim not to have been responsible. They say that among a number of possible explanations are that:
- The sudden shock to his body and the very real fear of drowning might have triggered an altered level of consciousness leading to altered pain perception.
- The subject’s previous forced inactivity may have played a role in the maintenance of his pain. The pain relief he experienced in the water which enabled him to move more freely may have broken the cycle of pain.
- The activity may have resulted in various high intensity distraction stimuli that effectively outcompeted the pain signals from his nerve endings, preventing the perception of pain.
Extreme caution required
Whether or not you suffer chronic pain, the activity undertaken here is extremely dangerous and risks, among other things, hypothermia and drowning.
Further, the authors of the study caution strongly that this very much the experience of one person. Considerable further research is required “to assess the replicability and feasibility of forced cold water swimming as a potentially effective, natural intervention to enhance recovery outcomes from common post-operative complications.”