Cold Water Therapy: How It Works, Types And Benefits

“Cold water therapy, also known as cold hydrotherapy, is the practice of using water around 59 degrees Fahrenheit to treat health conditions or stimulate health benefits,” says Wan Na Chun, an Indianapolis-based registered dietitian and personal trainer who recommends cold water therapy in her practice. “Studies show that cold water immersion [can] lead to decreased stress levels after a one-hour session and induce significant physiological and biochemical changes in the body, such as improved blood pressure, metabolism and peripheral blood flow,” she adds.

These changes may have secondary effects on metabolism and heart disease by reducing body fat and improving insulin resistance, two factors associated with chronic conditions like diabetes and cardiovascular disease.

Cold water therapy is performed in a variety of ways, from topical skin exposure to full-body ice baths.

The origins of using cold water therapy for health and muscle recovery may date back to ancient Greece, according to research. Types of cold water therapy range from a quick spray or rinse to full-body immersion in icy water.

Cold water therapy is a form of cryotherapy, a broad field that encompasses using cold therapies to attain health and wellness benefits. Examples of cryotherapy include cold water immersion, applying ice/cold to the skin and other general uses of cold for therapeutic needs. “Cold water immersion and cryotherapy chambers are generally considered the most effective forms of cold therapy, as they provide the most significant benefits,” says Chun.

Below are the most common types of cold water therapy.

• Cold water immersion, such as the Wim Hof Method, involves an individual submerging their entire body from the neck down in water no warmer than 59 degrees Fahrenheit for up to 15 minutes. The Wim Hof Method is known for combining breath work and cold water immersion often in natural, scenic environments.
• Cold showers: One small study found that a 15-minute cold shower after cycling improved heart rate recovery among nine cyclists. However, more research is needed to draw definitive conclusions about this benefit.
• Contrast bath therapy: Similar to cold water therapy, contrast water therapy involves switching limbs from cold water to warm water for varying amounts of time (30 minutes total).

While more research is needed to make conclusive claims about cold water therapy, preliminary studies demonstrate compelling potential mental and physical health benefits.

May Aid Muscle Recovery and Decrease Pain

In a 2016 study in Medicine, participants who performed a set amount of exercise and then immersed themselves in a cold water pool (no warmer than 59 degrees Fahrenheit) afterward reported experiencing less muscle soreness compared to those who didn’t undergo hydrotherapy^[1]Yeung SS, Ting KH, Hon M, et al. Effects of Cold Water Immersion on Muscle Oxygenation During Repeated Bouts of Fatiguing Exercise: A Randomized Controlled Study. Medicine (Baltimore). 2016;95(1):e2455. .

The body regulates temperature through the same nerve pathways that signal pain, which is why icing injuries helps moderate pain, says Joseph Bunn, a personal trainer and physical therapist assistant in Warrenton, Virginia. Alternatively, using cold showers or cold water immersion techniques may decrease pain and improve muscle recovery.

Cold water therapy works to alleviate pain by constricting blood vessels and reducing blood flow to peripheral body parts. Research suggests this blood flow redistribution improves oxygenation of muscles and may enhance exercise performance.

May Help Regulate the Nervous System

Exposure to cold water—including splashing it on your face or plunging into a cold lake—stimulates the vagus nerve. The vagus nerve is the main nerve of the autonomic nervous system responsible for regulating breathing and heart rate. For example, an ice bath helps one learn how to regulate intense emotion and essentially breathe through it, says Renee Solomon, Ph.D., a licensed psychologist and CEO and clinical director of Forward Recovery, a counseling practice focusing on the treatment of anxiety, depression, addiction and more. Dr. Solomon uses cold water therapy in her practice.

May Decrease Stress and Improve Mood

“[While] no randomized controlled trials exist, case reports and anecdotal evidence suggest cold water therapy can be beneficial for mood, treat depression, increase libido, reduce stress and improve stress regulation,” says Sid Khurana, M.D., a board-certified adult, child and adolescent psychiatrist and medical director of outpatient services at Nevada Mental Health.

According to research, immersing oneself in cold water is linked to reduced cortisol levels, indicating it may offer stress relief, says Chun. Research of cold water therapy’s effect on mood is in its preliminary stages, but there’s compelling evidence that people may experience a mood boost within days of trying cold water exposure.

Similarly, adults in a small 2023 study in Biology noted feeling more alert, inspired and attentive after a single five-minute session in a 68-degree bath. In the study, brain scans taken before and after cold water therapy revealed an increased connection between the regions of the brain controlling attention, emotion and self-regulation after cold water immersion^[2]Yankouskaya A, Williamson R, Stacey C, Totman JJ, Massey H. Short-Term Head-Out Whole-Body Cold-Water Immersion Facilitates Positive Affect and Increases Interaction between Large-Scale Brain Networks. Biology. 2023;12(2):211. .

“Cold exposure [is thought to increase] the production of the hormone and neurotransmitter norepinephrine,“ says Dr. Solomon. “Norepinephrine is associated with focus, attention, natural high [feelings] and improved mood. Cold water therapy [may produce] feelings of calmness and happiness and generally [may improve] well-being,” she adds. However, additional research suggests that high levels of norepinephrine can also be associated with depression, anxiety, panic attacks and hyperactivity (in spite of a brief period of potential euphoria).

More research is needed regarding the long-term effects cold water therapy may have on mood and focus.

May Have a Metabolism-Boosting Effect

Researchers at the Arctic University of Norway observe a metabolic increase in individuals after they experience cold water immersion. However, this type of research is often carried out among small sample sizes, and further studies are needed to understand cold water therapy’s effect on metabolism, including body fat percentages and weight loss.

The potential metabolism-boosting effect is credited to brown adipose tissue, a type of fat in the body that can produce heat when exposed to cold, burning more calories. This metabolism increase appears to be small, and research is inconclusive regarding whether cold water therapy supports long-term, significant weight loss.

Before attempting cold water therapy of any kind, it’s best to speak with a health care provider about any unique individual risks that may arise.

Cold water therapy is safe, although the American Heart Association cautions that the most dangerous time is within the first 60 seconds until breathing regulates. Speak with a trusted health care provider prior to practicing cold water therapy to ensure it’s a safe and beneficial option for your unique goals.

Who to Speak With About Cold Water Therapy

Physical therapists often use topical ice application and cold water immersion for muscle recovery and pain reduction, and many other types of health care providers, such as dietitians, personal trainers, athletic trainers and mental health professionals, also utilize cryotherapy and cold water exposure as part of their treatment plans. Speak with a trusted provider for reliable guidance on how to incorporate this modality into a daily wellness routine.