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Cold water plunge stopped prolonged pain

Cold exposure proved more effective than pills and physiotherapy

Adrian O'Dowd

Tuesday, 13 February 2018

People swimming in cold open-water may enjoy relief from severe persistent pain after surgery instead of relying on strong painkillers or physiotherapy, suggests a report* published today in the journal BMJ Case Reports.

In a case study in the journal, doctors from the universities of Cambridge and East Anglia said they had observed the effect in a 28-year-old man (not identified) who had been experiencing ongoing pain after having undergone the surgical procedure of endoscopic thoracic sympathectomy to curb his excessive facial flushing.

The surgery involved cutting the triggering nerves inside his chest and although the procedure was successful, 10 weeks later, the usual postoperative prescription of strong painkillers and staged physiotherapy had had little impact in the severity of his pain.

The man had explained that exercise and movement made the constant pain worse, preventing him from completing his rehabilitation and recovery.

Before his surgery, the man had been a keen triathlete, which involves swimming competitively in open-water, so he decided to have a cold water swim to distract him from the pain.

After plunging into cold water, the man found his pain had stopped and he has felt no more pain since, the authors reported.

His preoperative quality of life has been fully restored and he has resumed his usual sporting activities without having to take any more painkillers.

The authors said this was only one case report, adding: “Due to the nature of retrospective case reports, it is unclear, without further evidence, whether the exposure to forced cold water swimming is causally and specifically related to pain remission.”

Nevertheless, they argued that given the time frame and the absence of any alternative explanations other than pure chance, it seemed as if the cold water plunge might have afforded some instant pain relief, at least in this case.

How this might have happened was unclear, they admitted, but they suggested some possible biological explanations.

The shock of the sudden cold water immersion might have induced a wave of sympathetic nervous system activity and the body’s response to this has been linked to an altered state of consciousness. This in turn might have altered pain perception, offering instant relief.

The authors theorised that the reason why the man’s pain disappeared completely over the long-term was perhaps due to the fact that his previously reduced mobility had helped maintain the pain and the pain relief he felt in the water would have enabled him to move freely, so breaking that cycle.

They concluded: “Further prospective [exploratory] investigation is needed to assess the replicability and feasibility of forced cold water swimming as a potentially effective, natural intervention to enhance recovery outcomes from common postoperative complications.”

*Mole, T and Mackeith, P. Cold forced open-water swimming: a natural intervention to improve postoperative pain and mobilisation outcomes? BMJ Case Rep 2018. DOI:10.1136/bcr-2017-222236

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