Cryotherapy

Systemic cryotherapy applied to healthy persons or suffering from rheumatic or degenerative diseases for
2-3 minutes in the temperature of -140°C (+/- 10°C) induces numerous clinical, hormonal and
biochemical effects. Cryotherapy is effective and harmless and few complications or side-effects.

Indications
 Treatment of injury or disease (sports medicine)
 Treating acute soft tissue injuries
 Used to reduce the recovery time as part of the rehabilitation program both after acute injuries
and in the treatment of chronic injuries
 Reduce pain effectively in the post-operative period after reconstructive surgery of the joints.
 Relaxation of the muscles
 Cold increases the pain threshold, the viscosity and the plastic deformation of the tissues but
decreases the motor performance
 Decrease the inflammatory reaction in an experimental situation
 Positive impact on psyche - betterment of mood

Prolonged application at very low temperatures should be avoided as this may cause serious side-effects,
such as frost-bite and nerve injuries.

Contraindications
 Cryoglobulinemia
 Multiple myeloma
 Raynaud disease
 Cold urticaria
 Previous history of cold induce injury at the site or limb
 Poor circulation at the site or in that limb (vascularly impaired)  may lead to undesired tissue
necrosis.
 Cryofibrinogemia
 Purulent or gangrenous skin diseases
 Agammaglobulinemia
 Diseases of central nervous system
 Neuropathy of sympathetic system
  Hypofunction of thyroid
 Significant deficiency of blood
 Action of some medicines especially neuroleptics and alcohol
 General cachexia and hypothermia
 Claustrophobia
 Little experience of persons applying the treatment
 Any technical defect of the device

After thorough examination, marking hemodynamic indicators and spirometry examination of patients
before and after therapy in cryochamber it was possible to indicate absolute contraindications concerning
cardiovascular and respiratory system. These are as follows:
 Defects of aortic valves
 Diseases of cardiac muscles or valves during cardiac failure
 Acute effort angina pectoris or spontaneous angina pectoris
 Disturbance of heart operation at the pulse rate higher than 100/min
 Arteriovenous leakage in lungs
 Acute diseases of respiratory tract

Relative contraindications
 Age over 65 years
 Overcome venous blood clots
 Embolism of circumferential arteries
 Excessive emotional liability resulting in eg. excessive perspiration

Ozone Therapy
O3 therapy combines a mixture of oxygen (O 2)-O3, with a diverse therapeutic range (10–80 μg/ml
of gas per ml of blood). O3 therapy administration is variable based on treatment goals and location of
therapy. The first and most popular is O 3 autohemotransfusion (O3-Aht). O3-Aht has grown in popularity
because it allows for a predetermined amount of blood to be taken and thus, using stoichiometric
calculations, a precise concertation of O 2-O3 can be infused. This small amount of blood is subjected to
O2-O3 ex vivo is then administered to the patient. Extracorporeal blood oxygenation and ozonation are
very similar techniques. However, its goal is to obtain higher blood volume than the 200–300 mL seen in
O3-Aht.
 Other modalities of therapies include direct injection via the intramuscular, intradiscal, and
paravertebral site of administration. Rectal insufflation of O 3-O3 is another common site of
administration. However, insufflation of the nasal, tubal, oral, vaginal, vesical, pleural, and peritoneal
cavities have proven to be prudent routes of administration. Cutaneous exposure has also had likely
outcomes and can be achieved by sealing the portion of the body in a chamber or bag and insufflating
with O3-O3 mixture. Saline with O3-O3 dissolved is used to avoid the risk of embolism when administered
intravenously. Clinical use can be arranged systematically into cardiovascular, subcutaneous tissue,
peripheral vascular disease, head and neck, orthopedic, gastrointestinal, and genitourinary.

Indications
 Chronic inflammatory processes and immune overactivation
 Musculoskeletal disorders
 Common vertebral column degenerative diseases
 Low back pain (LBP)
 Knee osteoarthritis (KOA)
 Disorders of tendon
 Lateral chronic epicondylitis
 Rheumatic diseases
 Fibromyalgia

Figure 2. The main means of administration of O2O3 therapy in the field of rehabilitation.
Contraindications
 Glucose-6-phosphate dehydrogenase deficiency (the red blood cell breakdown triggered by the
oxidative stress induced by the O3).
 Pregnancy
 Uncontrolled hyperthyroidism
 Severe cardiovascular diseases
 Heart failure

O2O3 concentrations should be set to a specific range to ensure safety; however, patients might
present a sensation of heaviness at the injection site that spontaneously decreases in a few minutes. On the
contrary, other adverse effects might be related to an incorrect administration technique, including vagal
crisis, pain, hematoma in the injection site, local infections, and even death. In this context,
ultrasonography has been recently proposed as a non-invasive and real-time technique that could guide
O2O3 injection, allowing the physician to precisely target the area of interest and to monitor the gas
spreading in the tissues, in order to reduce the occurrence of adverse events.

Infra Red
Infrared (IR) or thermal radiation is a band of energy in the complete electromagnetic
spectrum. IR are the radiations of longer wavelength than the red end of the visible spectrum and
extend to the microwave region, i.e., from 760 nm to 1 mm. IR radiation is generated by Sun. Many
ancient therapies have utilized sunlight for wound healing and pain relief. When Sun rays reach the
ground, they get absorbed by gases or water molecules in the atmosphere. The human body is made
of 70% water, so it can potentially accumulate a large amount of energy that could modulate
biological processes by strong resonant absorption of IR radiation from sunlight mediated by water
molecules.
IR includes wavelengths between the 780 nm to 1000 μm. IR is divided into different bands: Near-
Infrared (NIR, 0.78~3.0 μm), Mid-Infrared (MIR, 3.0~50.0 μm) and Far-Infrared (FIR, 50.0~1000.0
μm) as defined in standard ISO 20473:2007 Optics and photonics -- Spectral bands.

Indications
 Chronic low back pain
 Reduce postoperative pain
 Cardiovascular disease
 Diabetes mellitus
 Chronic kidney disease
 Decrease muscle spasm
 Increases the sensory nerve conduction velocity, increase in endorphins influencing the pain
gate mechanism
 Acceleration of healing and tissue repair

Side Effects
 Burns
 Skin irritation
 Eye damage
 Dehydration
  Low blood pressure
 Defective arterial blood flow

Contraindications
 Impaired cutaneous thermal sensations
 Defective arterial cutaneous circulation
 Dermatitis or eczema
 Tumors
 Skin damage due to ionizing radiation
 Fever

Colonic Therapy
Indications
 Constipation of different etiologies
 Diarrhea
 The phenomena of autointoxication (headaches, unmotivated weakness, decreased efficiency,
unpleasant odor from the body)
 Dyskinesia of the large intestine
 Parasitic infections
 Preparation for colon examination
 Hemorrhoids (mild to moderate)
 Prostatitis and prostate adenoma
 Vaginitis, cervical erosion
 Signs of impaired immune system function (frequent respiratory diseases, dermatitis of unclear
etiology)
 Preparation for surgical intervention
 Detoxification after alcohol and drug intoxication, poisoning with chemicals, contamination with
radionuclides

Contraindications
 Anal Fissure/Fistula (a tear in the colon)
 Anemia (severe)
 Aneurysm.
  Cardiac Disease (severe, uncontrolled hypertension or congestive heart failure)
 Cirrhosis.
 Colon Cancer.
 Acute abdominal pain
 Recent history of GI or rectal bleeding
 Uncontrolled hypertension
 History of seizures
 Carcinoma of the rectum
 Abdominal surgery (within 12 weeks of treatment)
 Intestinal perforation
 Abdominal hernia
 Recent colon or rectal surgery
 Diverticulitis
 Recent heart attack
 General debilitation
 Renal insufficiency
 Epilepsy or psychoses
 Severe hemorrhoids
 Fissures or fistula
 Pregnancy (in first and last trimesters)
 Ulcerative colitis
 Acute Crohn’s disease
 Rectal or abdominal tumors

Salt Therapy/Halotherapy
Breathing in air with tiny salt particles to improve your breathing. Halotherapy is often done in spa-like
salt rooms. This therapy can also help you relax and may help with skin conditions and allergies.

Types of Halotherapy
‌Salt therapy is usually done in salt rooms, which can be active or passive.
 Active salt room. This room has a machine called a halogenerator, to which salt is added. The
equipment breaks down the salt into tiny particles that circulate in the room.
 ‌Passive salt room. This type of room does not have a machine to break down the salt. Instead, the
room is filled with different types of salts, such as Himalayan salt. It looks like a salt cave, with
 controlled temperature and humidity. The salt concentration in passive salt rooms is lower than in
active salt rooms. These rooms are usually used for relaxation and meditation rather than
halotherapy.

Salt therapy itself has two types.

 Dry salt therapy. This type is the kind known as halotherapy. It is done in active salt rooms with the
help of a halogenerator. This allows the small, dry salt particles to spread in the air and enter your
lungs and skin.
 W
‌ et salt therapy. This involves bathing in salty water containing minerals, gargling with or drinking
salty water, or passing salty water through your nasal canal.

Salt is a natural and safe ingredient. It does not have any notable side effects. It is also:
 Mucoactive, clearing up mucus from your airways
 Antibacterial, helping prevent infections
 Anti-inflammatory
 Immunity-boosting
 Anti-allergic

Indications
 Lung infection
 Throat infection or pharyngitis
 Chronic obstructive pulmonary disease (COPD)
 Smoking-related breathing problems
 Respiratory allergies
 Asthma
 Bronchitis
 Cold or cough
 Pneumonia
 Sinusitis
 Rhinitis
 Tonsillitis
 Cystic fibrosis
 COVID-19
 Postoperative period after coronary artery bypass grafting
Tiny salt particles used in halotherapy can also help repair your skin cells and protect your skin from
aging and infection. This therapy can be used to treat:
 Acne and rosacea
 Skin allergies
 Rash
 Eczema
 Psoriasis
 Dermatitis
 Fungal infection such as onychomycosis
 Wrinkles and signs of aging skin

Side effects
 Coughing
 More mucus secretion
 Skin irritation
 Conjunctivitis

Contraindications
 Hyperthyroidism
 High blood pressure (hypertension)
 Tuberculosis
 Heart problems
 Respiratory failure
 Blood disorders like anemia, hemophilia, or clotting
 Infectious diseases
 Fever
 Open wounds
 Malignant diseases such as cancer
 Claustrophobia

Reference:
1. Brennan D. What is Halotherapy?. WebMD. https://www.webmd.com/balance/what-is-
halotherapy
 2. Chervinskaya A. Halotherapy in Controlled Salt Chamber Microclimate for Recovering
Medicine. Clinical Research Respiratory Center of Central Clinical Hospital 122 of Federal
Medical and Biological Agency, St. Petersburg

Vitamin Drip
 Vitamin C
Contraindications
o Blood disorders like thalassemia, G6PD deficiency, sickle cell disease, and
hemochromatosis
o Diabetic patients should take vitamin C supplements with care as it raises blood sugar
levels
o Oxalate nephropathy/nephrolithiasis

Side Effects
o Nausea
o Vomiting
o Heartburns
o Stomach cramps
o Headache
 Vitamin B
Contraindications
Sensitivity to medication

Side Effects
o Mild transient diarrhea
o Polycythemia vera
o Peripheral vascular thrombosis
o Itching transitory exanthema
o Feeling of swelling of entire body
o Anaphylactic shock and death.
 Glutathione
Contraindications
Asthma (inhaled use)
Hyperbaric Chamber
The principle strategy of HBOT is to increase the oxygen content of the blood, improve blood
oxygen partial pressure, improve blood oxygen dispersion and increase the tissue oxygen “effective
diffusion distance” while constricting blood vessels and promoting the establishment of collateral
circulation. HBOT can affect many physiological processes. In different disease states, HBOT is
associated with decreased apoptotic cell death, reduced inflammation, a balance of oxygen free radicals,
and the activation of stem cells and other mechanisms.

Emergency indications
 Acute carbon monoxide poisoning and other harmful gas poisoning
 Gas gangrene, tetanus and other anaerobic bacteria infections
 Decompression sickness
 Air embolism syndrome
 After cardiopulmonary resuscitation (CPR) due to a variety of risks for acute brain dysfunction
 Aid in the treatment of shock
 Brain edema
 Pulmonary edema (except cardiac pulmonary edema)
 Crush syndrome
 Limb (finger, toe) and the blood supply after skin transplantation
 Drug and chemical poisoning
 Acute ischemia anoxic encephalopathy.

Non-emergency Indications
 Carbon monoxide poisoning or other toxic encephalopathy
 Sudden deafness
 Ischemic cerebrovascular disease (cerebral arteriosclerosis, transient ischemic attack, cerebral
thrombosis, cerebral infarction)
 Craniocerebral injury (concussion, cerebral contusion of intracranial hematoma removal surgery,
brain stem injury)
 Cerebral hemorrhage recovery
 Poor healing fracture
 Central serous retinal inflammation
 Vegetative state
 Plateau adaptation insufficiency syndrome
 Peripheral nerve injury
 Intracranial benign tumor surgery
 Periodontal disease
 Viral encephalitis
 Facial paralysis
 Osteomyelitis
 Aseptic osteonecrosis
 Cerebral palsy
 Fetal developmental delays
 Diabetes and diabetic foot
 Coronary atherosclerotic heart disease (angina and myocardial infarction)
 Rapidity arrhythmia (atrial fibrillation, premature beat, tachycardia)
 Myocarditis
 Peripheral vascular disease, vasculitis, e.g., Raynaud’s, deep vein thrombosis, etc
 Vertigo
 Chronic skin ulcer (arterial blood supply obstacles, venous congestion, bedsore)
 Spinal cord injury
 Peptic ulcer
 Ulcerative colitis
 Infectious hepatitis (use the special chamber of infectious disease)
 Burns
 Frostbite
 Plastic surgery
 Skin grafting
 Sports injuries
 Radioactive damage (bone and soft tissue, cystitis, etc.
 Malignant tumors (with radiotherapy or chemotherapy)
 Otic nerve injury
 Fatigue syndrome
 Angioneurotic headache
  Pustular
 Psoriasis
 Pityriasis rosea
 Multiple sclerosis
 Acute Guillain-Barre syndrome
 Recurrent oral ulcer
 Paralytic ileus
 Bronchial asthma
 Acute respiratory distress syndrome.

Absolute Contraindications
 Untreated pneumothorax, untreated pneumomediastinum
 Pulmonary bulla
 Active hemorrhage and hemorrhagic disease
 The formation of tuberculous cavity and hemoptysis.

Relative contraindications
 Severe upper respiratory tract infection
 Severe emphysema
 Bronchiectasis disease
 Sinus infection
 All degree atrioventricular block
 High blood pressure SBP > 180 mmHg, DBP > 110 mmHg)
 Bradycardia (<50 times/min)
 Untreated malignant tumor
 Retinal detachment
 The early stage of pregnancy (3 months)
 Intraventricular external drainage
 Fracture of the skull base with cerebrospinal fluid leakage
 Birth weight < 2000 g in premature and low birth weight infants
 Patients with chronic obstructive pulmonary disease with CO2 retention.
Reference:
Yan, L., Liang, T. & Cheng, O. Hyperbaric oxygen therapy in China. Med Gas Res 5, 3 (2015).
https://doi.org/10.1186/s13618-015-0024-4