Serial whole-body cryotherapy in fibromyalgia is effective and alters cytokine profiles

Abstract

Introduction Whole-body cryotherapy (WBC) has shown to be beneficial in the treatment of fibromyalgia (FM). There is cumulative evidence that cytokines play a crucial role in FM. It’s unknown whether clinical effects of WBC can be demonstrated at the molecular level and how long the effects last. Methods We compared effects of serial WBC (6 sessions (−\u2009130\u2009°C in 6\u2009weeks) in FM patients and healthy controls (HC). Primary outcome was the change in pain level (visual analogue scale 0–100\u2009mm) after 6 sessions. Secondary outcomes were a change in disease activity (revised Fibromyalgia Impact Questionnaire) and pain after 3 sessions and 3\u2009months after discontinued therapy and in cytokine levels (interleukin (IL-)1, IL-6, tumor necrosis factor α (TNF-α) and IL-10). The patients’ opinions on the satisfaction, effectiveness and significance of WBC were evaluated. Results Twenty-three FM patients and 30 HC were enrolled. WBC resulted in a significant reduction in pain and disease activity after 3 and 6 sessions. No clinical benefit could be measured 3\u2009months after discontinued treatment. Overall, probands were satisfied with WBC and considered WBC to be important and effective. FM patients had significantly different levels of IL-1, IL-6, TNF-α and IL-10 at each reading point compared to HC. Levels of IL-1, IL-6 and IL-10 were significantly altered over time in FM patients. Compared to HC FM patients showed a significantly different response of IL1, −\u20096 and −\u200910 to WBC. Conclusion Serial WBC is a fast acting and effective treatment for FM. Proven effects of WBC may be explained by changes in cytokines.