How to Do Cryotherapy: Step-by-Step Procedure

Cryotherapy involves deliberately exposing your body to extreme cold for a short, controlled period, and the specific steps depend on which form you choose. The most common version seen at wellness centers and sports clinics is whole-body cryotherapy (WBC), where you step into a chamber cooled to roughly −110 °C to −140 °C for two to three minutes while wearing minimal clothing. But cryotherapy also includes cold water immersion, localized ice application, and partial-body cryosaunas, each with its own procedure and quirks. The steps are straightforward once you know what to expect, though the details matter more than most facilities let on.

Understanding the Different Formats

Before you can follow a step-by-step procedure, you need to know which type of cryotherapy you’re dealing with. They are not interchangeable, and the preparation, execution, and risks differ significantly between them.

Whole-body cryotherapy (WBC) takes place inside an enclosed cryogenic chamber where electrically cooled air drops to between −110 °C and −150 °C. Your entire body, head included, is inside the chamber. Sessions typically last two to four minutes.¹ These chambers are usually walk-in rooms that accommodate one or several people at a time, and the cold is generated by refrigeration systems rather than direct contact with liquid nitrogen.

Partial-body cryotherapy (PBC) uses a cryosauna, which looks like a barrel or upright capsule. Your head and neck stick out above the rim, and the interior fills with a mist of liquid nitrogen and air at about −190 °C.² This is the version most commonly found in commercial wellness spas, in part because the equipment is cheaper and easier to install. A safety review noted that PBC imposes both cold stress and mild hypoxia simultaneously, since the nitrogen displaces some oxygen around the body, making it a meaningfully different experience from WBC in an enclosed chamber.²

Cold water immersion (CWI) is the simplest and most accessible version. You submerge yourself in water cooled to roughly 10–15 °C, usually in a tub or natural body of water, for anywhere from five to fifteen minutes. Localized cryotherapy, meanwhile, involves applying ice packs, cold gel wraps, or commercial cryotherapy units directly to a specific body part. Each method has a different procedure, so the sections that follow walk through them separately.

Step by Step for a Whole-Body or Partial-Body Chamber Session

Whether you’re visiting a WBC chamber or a PBC cryosauna, the preparation is similar. You’ll strip down to underwear or a bathing suit. Facilities will provide or require you to wear dry socks, slippers or insulated shoes, and gloves to protect your extremities. Some also provide a headband or face mask. Every item of clothing must be completely dry, because moisture against the skin in sub-zero air dramatically increases the risk of frostbite. You should also remove all jewelry, piercings, and any metal accessories, since metal conducts cold faster than skin can tolerate.

Before entering, staff should ask whether you have any cardiovascular conditions, Raynaud’s phenomenon, cold urticaria, uncontrolled hypertension, or a history of seizures. These are standard contraindications. If the facility does not ask, that’s a red flag about their operating standards.

Once you step inside, here is the typical sequence:

• Entry: Walk into the chamber or step onto the platform inside the cryosauna. In a WBC chamber, the door closes fully. In a PBC unit, your head remains above the rim.
• Initial cooling: The temperature drops rapidly. You’ll feel intense cold across exposed skin within the first 30 seconds. Some people experience a brief gasp reflex.
• Hold position: Stay relatively still. Most facilities advise slow rotation or gentle arm movements to ensure even exposure. Avoid touching the walls of the unit directly.
• Duration: A typical first session lasts two minutes. Experienced users may stay up to three or, rarely, four minutes. The operator should be timing the session and will tell you when it’s over. If you feel numbness, sharp pain, dizziness, or chest tightness at any point, exit immediately. The door is never locked.
• Exit: Step out when signaled. Your skin temperature will have dropped substantially, but your core temperature barely changes during such a short exposure.³

In a PBC cryosauna specifically, the operator adjusts the platform height so your head clears the rim, then activates the liquid nitrogen flow. The mist fills the barrel from below. Because the nitrogen is heavier than air, it pools around your torso and legs. This is where the hypoxia concern comes in: if the unit malfunctions or the mist rises too high, you could inhale nitrogen-rich air. Reputable operators monitor this with oxygen sensors and keep your head well above the rim at all times.

How Cold Water Immersion Works in Practice

Cold water immersion requires less specialized equipment, and the procedure is more forgiving in terms of timing. You fill a tub, barrel, or inflatable pool with cold water, adding ice if needed to bring the temperature down to roughly 10–15 °C. Some people go colder, but the diminishing returns show up fast, and water below 5 °C raises the risk of cold shock response in untrained individuals.

Submerge yourself up to the chest or neck and stay in for 10 to 15 minutes. Controlled breathing is critical in the first 30 to 60 seconds, when the cold shock reflex triggers rapid, involuntary gasping. Breathing steadily through the nose and exhaling slowly through the mouth helps bring the reflex under control. After the initial shock, the discomfort typically becomes more manageable.

One advantage of CWI over air-based cryotherapy is that water conducts heat away from the body far more efficiently than cold air. A meta-analysis of 27 studies found that cold water immersion significantly reduced subjective muscle soreness for up to 96 hours after exercise.⁴ A head-to-head comparison found that CWI was more effective than body cryotherapy for reducing delayed-onset muscle soreness in the first 24 hours.⁵ By 48 hours, though, the difference between the two methods faded.

Localized Ice Application

For a specific injury site, such as a sprained ankle, a sore shoulder, or post-surgical swelling, localized cryotherapy is the oldest and most studied approach. The procedure is simple: apply a commercial ice pack, a bag of crushed ice wrapped in a thin cloth, or a circulating cold-water device to the affected area. Keep it in place for 15 to 20 minutes, then remove.

The cloth barrier matters. Direct ice-to-skin contact for extended periods causes localized frostbite, and case reports document burn injuries from even single sessions of improperly applied cryotherapy.⁶ For dermatological cryotherapy using liquid nitrogen, such as wart or actinic keratosis removal, frostbite risk climbs with freeze durations beyond 30 seconds and with repeated freeze-thaw cycles.⁷

One thing that surprises most people about localized icing is how long the effect lingers. After cooling the skin surface, blood flow to the area stays depressed well after you remove the ice pack, even as skin temperature climbs back up. Research using multiple commercial cryotherapy devices found that blood perfusion remained significantly reduced during the entire rewarming period.⁸ A separate study confirmed this hysteresis effect, showing vasoconstriction that persisted despite skin temperatures returning toward baseline.⁹ In practical terms, this means the anti-swelling effect of ice continues working for a while after you take the pack off.

What Your Body Is Actually Doing During Cold Exposure

The therapeutic rationale for cryotherapy rests on a few interconnected responses. When your skin temperature drops, blood vessels near the surface constrict, redirecting blood flow away from the periphery. This initial narrowing of blood vessels is driven by sympathetic nerve activity, but as cooling continues, the mechanism shifts to non-adrenaline pathways that sustain the constriction even after warming begins.¹⁰ That shift explains why the reduced blood flow persists longer than the cold itself.

Cold also slows nerve conduction. A study measuring nerve signals at the ankle found that cooling the skin to 10 °C progressively reduced nerve conduction velocity by about a third, and simultaneously raised pain threshold and pain tolerance.¹¹ This is the main mechanism behind cryotherapy’s immediate pain-relieving effect: the nerves simply transmit pain signals more slowly when cold.

On a systemic level, whole-body exposure triggers a norepinephrine surge. One study found that norepinephrine roughly doubled after a single session at −110 °C, and heart rate variability markers associated with parasympathetic activity also increased over a week of daily sessions.¹² The norepinephrine spike, which many users experience as a rush of alertness and elevated mood after exiting the chamber, is a consistent finding across studies and probably accounts for much of the subjective “feeling better” that people report.

What to Do After the Session

After any form of cryotherapy, the rewarming phase matters more than most people realize. Passive rewarming, simply sitting still and letting your body warm up on its own, is the default at most facilities. After WBC, skin temperature bounces back rapidly, but intramuscular temperature stays depressed for much longer.³

If your goal is to restore normal tissue temperature quickly, for instance before an athletic event, light exercise dramatically accelerates the process. A study found that walking on a treadmill at a moderate pace for 10 minutes after ice-pack treatment brought intramuscular temperature back to within about half a degree of baseline, while subjects who simply rested were still nearly 7 °C below baseline 30 minutes later.¹³ The takeaway: if you’re icing before competition or between training bouts, a short walk or light movement afterward helps your muscles return to a functional temperature.

On the other hand, if your goal is to maximize the anti-inflammatory and vasoconstriction effects, for instance after an acute injury, passive rest may be preferable. The comparison between ice packs and cold whirlpool found that intramuscular temperature actually continued to drop after cold whirlpool treatment even during the 30-minute rest period, while ice pack temperature climbed back slowly.¹⁴ Choosing active versus passive rewarming depends on what you’re trying to achieve.

How Many Sessions and How Often

There is no universally agreed-upon dosing schedule for WBC or PBC, but the patterns seen across clinical studies offer rough guidance. Most research protocols use daily or near-daily sessions over the course of one to two weeks, typically 5 to 10 sessions in total. For athletic recovery, sessions are usually timed immediately after or within a few hours of intense exercise.

Whether repeated sessions produce cumulative benefits is an open question. One review noted that repeated WBC treatments did not appear to produce straightforward cumulative effects, but instead triggered adaptive changes in the body’s antioxidant systems, particularly when sessions accompanied intense training.¹⁵ The norepinephrine response also seems to blunt slightly with repeated use: one study found the rise was significant after the first session but no longer reached statistical significance by the fifth.¹² Your body adapts, in other words, which may mean that the acute alertness and mood boost feel strongest in the early sessions.

For clinical applications like fibromyalgia, studies have tested 10 to 15 sessions spread over two to three weeks, with results showing meaningful pain reduction compared to control groups.¹⁶ For ankylosing spondylitis, similar protocols showed decreased disease activity scores after a series of WBC sessions.¹⁷

Safety Considerations and Who Should Not Do This

The cardiovascular response to extreme cold deserves attention even in healthy people. Heart rate, blood pressure, and total peripheral resistance all shift during WBC. In healthy non-professional athletes, heart rate rose by about 10 beats per minute during and after a session, and systolic blood pressure nudged upward slightly, though all values stayed within normal range.¹⁸ In people with essential hypertension, the cardiovascular profiles differed meaningfully from those of healthy subjects, leading researchers to recommend that anyone with cardiovascular problems of any degree be carefully screened before treatment.¹⁹

A scoping review of documented adverse events from WBC and PBC found only 16 total across the literature, spread across five case reports and two randomized trials.² That number is low, but it partly reflects under-reporting, since most cryotherapy occurs outside clinical trial settings and minor incidents go unrecorded. The review also stressed that public health agencies like the FDA have raised safety concerns, but some of those concerns were based on incidents from PBC devices that were mislabeled as WBC, muddying the picture.

Frostbite is the most tangible risk. For localized liquid-nitrogen cryotherapy used by dermatologists, patients who received freezing for more than 30 seconds or underwent multiple freeze-thaw cycles had significantly higher frostbite rates.⁷ Medications that cause vasoconstriction, like epinephrine combined with local anesthetics, can compound the risk. For WBC and PBC, the main frostbite danger comes from wet clothing, exposed metal jewelry, or sessions that run too long.

People who should generally avoid whole-body or partial-body cryotherapy include those with uncontrolled hypertension, a history of heart attack or stroke, Raynaud’s disease, cold urticaria (hives triggered by cold), deep vein thrombosis, open wounds, untreated seizure disorders, and severe anemia. Pregnant women are also routinely excluded from sessions. If you’re on blood-pressure medication or have any circulatory condition, get clearance from a physician first.

What the Evidence Actually Shows About Recovery and Pain

The research on cryotherapy for exercise recovery is more nuanced than the marketing suggests. For subjective outcomes like perceived soreness and fatigue, cryotherapy consistently helps. The meta-analysis of 27 studies found that cooling reduced delayed-onset muscle soreness significantly through 96 hours of recovery compared to control conditions.⁴ But the same analysis found no evidence that cooling improved any objective recovery variable, such as muscle strength, power, or blood markers, over that same period.

That gap between “feels better” and “performs better” is important. A study comparing WBC, cold water immersion, and a placebo after marathon running found that WBC actually had a harmful effect on muscle function compared to CWI, despite participants in the WBC group perceiving less training stress.²⁰ Another trial after resistance exercise found that WBC reduced soreness at 24 hours and improved peak force at 48 hours, but many other outcomes either favored the placebo condition or were unclear.²¹ Both papers hint at a strong psychological component: when you step out of a chamber that was −110 °C and feel that rush of norepinephrine, you perceive yourself as more recovered than your muscles may actually be.

For inflammation specifically, a meta-analysis of 11 randomized controlled trials found that WBC lowered the pro-inflammatory marker IL-1β and raised the anti-inflammatory marker IL-10, with athletes and obese individuals appearing to benefit most.²² For multiple-session cryosauna protocols used after exercise-induced muscle damage, blood markers of inflammation and muscle breakdown (leukocytes and creatine kinase) were significantly lower in the cryotherapy group compared to controls out to several days post-exercise.²³

Chronic Pain and Clinical Applications Beyond Sports

Most of the popular discussion around cryotherapy focuses on athletic recovery, but some of the more compelling clinical evidence comes from chronic pain conditions. Fibromyalgia has received the most attention. A randomized trial in a cryosauna cabin found that patients who received WBC had dramatically larger reductions in pain scores and overall functional impairment compared to controls.¹⁶ A narrative review of the chronic pain literature reported that across multiple studies using different temperatures, fibromyalgia patients consistently experienced meaningful pain reduction, and some also showed improvement in self-rated quality of life.²⁴

For inflammatory joint diseases, a study of ankylosing spondylitis patients found that WBC at −110 °C decreased disease activity and lowered the pro-inflammatory cytokine IL-8, though it also increased a marker of oxidative stress.¹⁷ That oxidative stress finding is a useful reminder that cryotherapy is not purely anti-inflammatory in every direction. The body’s response is complex, and some pathways get activated even as others get suppressed.

These clinical applications are generally studied as adjunct therapies alongside medication and physical therapy, not as standalone treatments. If you’re considering WBC for a chronic pain condition, it’s worth bringing the idea to your treating physician, both to discuss contraindications and to set expectations about what the evidence currently supports.

Why the Chamber Type Actually Matters

One source of confusion in the cryotherapy world is the casual interchangeability of terms. Walk-in cryochambers and single-person cryosaunas are often both marketed as “whole-body cryotherapy,” but they work differently and carry different risk profiles. In a WBC chamber, electrically cooled air surrounds your entire body including your head, and oxygen levels remain normal. In a PBC cryosauna, liquid nitrogen is injected into the barrel to produce extreme cold, your head stays outside, and the nitrogen displaces some oxygen in the space around your torso.²⁵

The practical difference extends to temperature consistency. A study measuring actual temperatures inside a cryosauna during sessions found that the air temperature experienced by the person can vary significantly from the set point, because the liquid nitrogen mist does not distribute evenly in the small space. Chambers tend to offer more uniform cold. The safety review from the international consortium emphasized that regulatory bodies have sometimes conflated PBC adverse events with WBC data, leading to blanket warnings that may not apply equally to both formats.²

When choosing a facility, it’s worth asking which type of device they use, what the actual air temperature inside is during a session, whether they monitor oxygen levels (relevant for PBC), and what their protocol is if you feel distress mid-session. A well-run facility has an operator present for the entire session, an emergency stop button within reach, and will not push first-timers to stay in longer than two minutes.