Feb. 14, 2012 -- Can an ice bath really ward off the muscle soreness that can kick in a day or so after an intense workout?

According to a new review, it is better than doing nothing and equal to other remedies such as compression stockings or stretching.

Ice baths are favored by some elite athletes and have become a habit of other exercisers as well.

"We only found an effect in favor of cold water immersion when it was compared to doing nothing -- that is, passive rest after exercise," says Chris Bleakley, PhD, a researcher at the University of Ulster in Northern Ireland.

The ice bath reduced muscle soreness by about 20%, he says.

"There were no differences when cold water immersion was compared to other popular recovery interventions," he says. So the best active treatment is still unclear, he tells WebMD.

The review is published in The Cochrane Library.

Research on the safety of the method is lacking, Bleakley also found.

Those who shudder at the thought of an ice cube-filled bathtub will probably like one U.S.-based expert's take on the new findings.  An ice bath ''does not seem to be any more effective for most people than taking a couple of ibuprofen," says Gary A. Sforzo, PhD, a professor of exercise and sport sciences at Ithaca College, who reviewed the findings for WebMD. "So why go through this torture?"
Ice Baths After Hard Workouts

The soreness that can occur after unaccustomed exercise or a stepped-up workout is known as delayed onset muscle soreness, or DOMS. It usually peaks between 24 and 48 hours later.

It involves muscle stiffness, swelling, declines in strength, and localized muscle soreness.

Experts think it's due to mechanical damage that occurs to the muscle fibers. That can lead to inflammation and pain.

To combat the soreness, athletes take the ice baths in spas, large containers, or the home bathtub.

Typically the water temperature is less than 59 degrees Fahrenheit. People sit in the ice baths for five minutes or longer.
Ice Baths: The Review

Bleakley and his colleagues searched the medical literature to find studies of cold-water immersion to relieve DOMS. They found 17 small studies scientific enough to review. The studies included 366 people.

On average the people studied were 16 to 29.

The temperature of the ice baths varied among studies, usually about 50 to 59 degrees. People sat in the baths for five to 24 minutes. They usually were immersed up to the waist.

The ice baths were typically taken within 20 minutes of finishing the workout. In some studies, people took more than one ice bath after a workout.

Fourteen studies compared ice baths with rest or no treatment. Some studies compared ice baths to warm baths, warm-cold alternating baths, light jogging, and compression stockings. The researchers found no differences in relief between these remedies.

Many of the studies did not look at complications.

Experts are not sure how an ice bath works. "A number of studies used blood samples to examine the effect of immersion on various biomarkers of inflammation and muscle damage," Bleakley says.

However, he says, no studies found an effect on the inflammation response. The researchers did find a reduction in pain, and that can follow inflammation and muscle damage.

The ''placebo" effect -- a measurable effect that isn't due to the treatment -- may be at work,  Bleakley says.

"My advice to athletes is to find the strategy that they feel works best for them," he says. This could include a combination of water recovery, compression, stretching, and other methods, he says.

Water from the tap, with a few trays of ice cubes, could work, Bleakley says.
Ice Baths: Not for Everyone

Not everyone should attempt an ice bath, Bleakley warns. "People shouldn’t underestimate the amount of shock that immersion in cold water can have on the body," he says.

It can affect the heart, blood vessels, and respiratory system, Bleakley tells WebMD. It can raise blood pressure and heart rate. The long-term effects of regular ice baths aren't clear, he says.
Ice Baths Not Well Studied

The ice bath ''hasn't been well studied," says Sforzo, a member of the American College of Sports Medicine. The researchers looked through many data bases, dating back to 1929. They could find only the 17 studies they reviewed as scientific enough to include.

Many other treatments can help reduce muscle soreness, Sforzo says. Massage, for instance, ''is a lot more fun than doing ice water immersion," he says.