Cold therapy or cryotherapy has the same local effects of reducing pain as heat in relation to local pain, pain due to muscle spasm, and myofascial pain.
The analgesic effects of cold last longer than heat. The more frequent use of heat probably relates to patient comfort and preference. Cold therapy may be performed with ice massage, cold packs, or vapo-coolant sprays, such as ethyl chloride.
Cold therapy should not be used in areas where there is diminished sensation or vascular insufficiency, or in patients with Raynaud’s syndrome or other cold hypersensitivity.

Cold:
- Reduces pain, bleeding, and swelling due to vasodilatation, which helps in healing and hematoma resolution. It is an effective first-aid treatment post-injury when combined with rest, compression, and elevation.
- Ethyl chloride spray and ice massage are counterirritants that have been used in the treatment of myofascial pain.
- Can raise pain threshold significantly; ice therapy is more effective than heat in treatment of pain.

Core Curriculum for Professional Education in Pain, edited by J. Edmond Charlton, IASP Press, Seattle, © 2005.
Woodruff R. Palliative medicine evidence-based symptomatic and supportive care for patients with advanced cancer. 4th ed. Oxford University Press, 2004. p. 165.