A new company in Bend is offering whole-body cryotherapy, a treatment that exposes people to air temperatures as low as minus 250 degrees Fahrenheit for as long as three minutes.

The technique is popular among celebrities and professional athletes who claim it reduces inflammation and pain. But experts say there is little scientific evidence to support its use and warn of potential risks from the extreme temperatures, including asphyxiation or loss of consciousness, frostbite, burns and eye injuries. A Las Vegas woman died in 2015 after she passed out in a cryotherapy chamber.

“I think it’s almost entirely hype right now,” said Tim Caulfield, a professor of law and public health at the University of Alberta. “It’s this idea that if these celebrities and athletes are using it, it must work.”

Forever Free Cryotherapy began offering cryotherapy sessions earlier this year, marketing the procedure as a way to speed muscular recovery, increase metabolism and reduce inflammation.

Clients strip down to the bare essentials, donning socks, slippers and gloves to protect their extremities. They then enter a shower-like cylinder with only their head emerging from the top. Liquid nitrogen is used to cool the air to temperatures between minus 200 and minus 250 degrees.

“You start to see benefits within two minutes, so if somebody is struggling you want to make it at least until two,” said Rachel Ahlberg, who owns Forever Free with her husband, Garrett Ahlberg. “We try to make it fun. We have a speaker in there. You can play your favorite pump-up song to knock out those three minutes.”

The cold air, they say, does not provide any direct benefit, but stimulates a response akin to hypothermia. Blood vessels constrict, bringing the blood supply back into the core of the body where it can be reoxygenated. Once the person steps out of the cryotherapy chamber, blood vessels expand, bringing that oxygen and other nutrients back to damaged tissues and joints.

“It’s just overall helping with decreasing inflammation and pain sensation,” said Garrett Ahlberg, who has a degree in exercise physiology.

Rachel Ahlberg ran track at the University of Texas at Austin, and experienced a career ending injury that left her with chronic pain in her right leg. She said cryotherapy treatments have helped to manage her pain and resume normal activity.

The Ahlbergs said most of the research done on cryotherapy is from Europe, where cryotherapy has caught on in recent decades. They noted two small studies that found the treatment could reduce markers of inflammation in the body.

“I think there is more evidence to come,” Garrett Ahlberg said. “But there are numerous studies showing just the effectiveness of decreasing inflammation, biochemical markers, joint inflammation, arthritis.”

A 2015 review of the evidence behind cryotherapy by researchers in the U.K. found only four small randomized controlled trials testing cryotherapy. They involved a combined 64 test subjects. The researchers concluded there was insufficient evidence to determine whether the technique reduced muscle soreness or promoted faster recovery. More study was needed to determine whether cryotherapy had any potential harms, they said.

Two years ago, the Food and Drug Administration warned consumers that despite the claims made by spas or wellness centers, the agency has no evidence that cryotherapy treats diseases like fibromyalgia, rheumatoid arthritis, multiple sclerosis, stress, anxiety of common pain. No whole body cryotherapy device, FDA officials said, has been cleared or approved by the agency.

“We found very little evidence about its safety or effectiveness in treating the conditions for which it was being promoted,” said Dr. Aron Yustein, a medical officer in the FDA’s Center for Devices and Radiological Health.

Garrett Ahlberg said the federal agency is failing to see the benefits.

“I think the FDA is so locked up in big pharma that they’re hesitant to go with something that is naturally going to help the body versus a prescription,” he said. “Honestly, it’s a big plus for us. Right now, because it’s not classified as a medical device by the FDA, we don’t have to run it through insurance. It’s way less paperwork.”

Forever Free charges $30 for an introductory session and clients can buy monthly passes that can bring the cost down to less than $13 per session.

“We see a decently even split between athletes and active 50- to 60-year-old adults who are now dealing with the back inflammation piece of it. They’re seeing joint inflammation and potentially arthritis,” Rachel Ahlberg said. “We have several individuals who have recently been in car accidents or traumatic events where they’re just looking to utilize this as a tool to help relieve the pain they’re dealing with.”

Dr. Tim Bollom, a sports medicine physician with The Center: Orthopedic & Neurosurgical Care & Research, said most of the medical literature on whole-body cryotherapy involves either endurance athletes trying to promote quicker recovery or patients with inflammatory arthritis seeking chronic pain relief.

“There’s a lot of subjective evidence that would argue that patients are getting pain relief; then you have a lot of data in the last year that’s really kind of pooh-poohing it,” he said. “It’s one of those areas of sports medicine that probably needs a fair amount of more study, but there are clearly folks out there who feel it to be beneficial.”

Bollom said the scientific theory behind cryotherapy has some validity and that small studies — almost anecdotal in nature — suggest it can reduce inflammatory markers. There’s enough there that he wouldn’t discourage patients who wanted to try it, he said.

“It would be something I’d have them look into with a skeptical viewpoint,” he said. “Try it, see if you notice a difference.”

Caulfield, the Alberta professor, said that while a generous interpretation of the science suggests the purported physiological effects are plausible, marketing of cryotherapy has far outpaced the science.

“You get these weird kind of ideas that stick to it, like the idea that you can burn 800 calories in three minutes, which is physiologically impossible,” he said. “Pop culture has created this industry and despite the fact that there’s no evidence to support it, despite the fact there may be harms, it continues to grow.”

Whole body cryotherapy is now projected to become a multibillion-dollar industry, he said, in part due to a “sciency veneer” that might be enhancing a placebo effect.

“It’s an extreme activity. I think there’s a little bit of an adrenaline rush. You feel like you’ve achieved something lasting in there for three minutes,” Caulfield said. “I think it adds to that placebo theater.”

Blake Denman, 33, of Bend, first heard of cryotherapy through some fitness podcasts he listened to several years ago. He first tried it on a trip to California two years ago and last month started going to Forever Free in Bend.

“The biggest thing I notice for the remainder of the day is my mood is heightened or improved,” he said. “It’s not like you feel high, you just feel really good. I know for sure I’m going to sleep amazing tonight.”

Denman has been going for cryotherapy sessions about once a week, but plans to ramp up to six times a week going forward. He said it’s helped reduce pain and inflammation in his back and his knees.

“If it’s a placebo effect,” he said, “I don’t really care.”

— Reporter: 541-633-2162, mhawryluk@bendbulletin.com