What has cold water exposure got to do with the mind-body approach to treating chronic pain?

Being exposed to cold water can be stressful for human beings. Science has now shown that there is a strong link between chronic pain and the stress response. Some of the techniques used to overcome the stress response of cold-water exposure can also be applied to overcoming chronic pain.

Stress is a normal part of everyday life, and it does not cause health problems if it is short-lived. In fact, the physiological stress response helps us to rise to the challenge and increase our resilience to future stressors. However, chronic or overwhelming stress caused by ongoing fears, whether they be physical, emotional, psychological or social, can put our nervous system in a state of constant fight, flight or freeze. This results in sensitization of tissues, the release of inflammatory chemicals, reduced immunity, fatigue, insomnia, digestive issues, tissue tension, pain, anxiety, and depression. The good news is that we don’t need to remove all sources of stress to be healthy and well.  But we can become self-empowered by learning how to regulate our stress response more successfully so that we suffer less, and our issues don’t get stuck in our tissues!

This brings me to Wim Hof, who got his nickname “The Iceman” by breaking many records relating to cold exposure. His ability to use his mind and breathing techniques to maintain his body temperature when exposed to extreme cold proved that it is possible to control some aspects of the autonomic nervous system. This was previously thought to be impossible. Although he is an expert in this, he is not unique, as he has been able to teach many others to do the same.

Cold water exposure is like an exercise in extreme mindfulness. When you are faced with this intense sensation on your skin, you cannot be worrying about your future, or ruminate on the past, as the intense sensation keeps you out of your head and in the present moment. When Wim’s wife tragically died, he went into a spin. When he jumped into cold water, he finally experienced some peace in his “bee-hive mind”. Cold water has been shown to have several positive physical health benefits. It also releases our own opioids, (but without any of the side effects) which lifts our mood and gives a feeling of euphoria. This is why so many people have learned to enjoy the potential physical and mental benefits of cold-water exposure.

As cold water is a physical stressor, it can be used as a practice medium with which you can learn to control your response to stress.  If you can get into the cold water, and yet remain calm in your thoughts, behaviour, and physiology, you can apply these strategies to control your response to other stressors in life so that they don’t overwhelm you.

In our modern comfortable life, we have become averse to discomfort, causing an exaggerated fear response to the cold: this is what you can learn to overcome. When faced with cold water, just like any stressor, the sympathetic nervous system responds by releasing adrenaline and cortisol, causing an increase in heart rate, and breathing rate, reduced digestion, and constriction of blood flow to the extremities.  This is a normal survival response, but it can be disproportionate. The stress response can be inadvertently exaggerated by fear, trying to resist the cold, holding our breath, bracing our body and negative self-talk. This is all about learning to control the physiology of our body through the power of our minds.

How do these principles relate to the mind-body approach to resolving chronic pain?

1. Accurate Belief

As Wim has been quoted saying, our limits are our minds, not our bodies, and we are capable of far more than we realise. Providing up-to-date knowledge to reduce fear and give you confidence that despite your very real pain, your body is not broken and you don’t need to be fixed. Learning about other mechanisms causing the pain, which can be resolved.

2. Regulating breathing techniques

Consciously changing how we breathe allows us the ability to change the state of our nervous system from a state of freeze or collapse, fight or flight and back to a rest/digest/repair state. Chronic stress and pain often cause a disordered breathing pattern of shallow rapid upper chest breaths, which fuels the vicious pain and stress cycle. Also, we often hold our breath and go into freeze in response to pain.

3. Developing a recovery mindset

It is about breaking through our perceived limits, replacing fear messages with safety messages, learning how to set our intention, controlling where we direct our focus and attention, and aiming for a positive, committed, confident mindset to overcome pain.

4. Progressive exposure to the physical stress

With accurate knowledge, fear is reduced by moving your body, and a plan can be devised to progressively expose the body to loading and movement without fear, to have corrective experiences which increase your activity levels and can lead to you returning to the activities you enjoy.

5. Changing your relationship to pain

Using techniques to experience the painful sensations without fear, bracing and self-judgement and being able to regulate the stress response to it, which helps to break the cycle of pain and rewire pain-free neural circuits.  

6. Meditation and Mindfulness techniques

It is about taking some self-care time out of the day to slow down and go within, to quieten the mind and connect to the sensations in the body. To develop an observer self to increase awareness of our inner chatter and, and how this can be inducing stress, and fostering our ability to observe our thoughts and sensations without judgement.

7. Eliciting the relaxation response

Resisting and bracing in response to pain, increases our suffering and ironically creates more tension and pain. You can learn techniques to activate your relaxation response, in the face of pain, which has the effect of reducing the intensity and your distress.

8. Stimulating the release of feel-good chemicals

Teaching you how you can release your own opioids, serotonin and dopamine without the side effects which come with taking medications. These chemicals are the antidote to the stress chemicals which cause disease.

9. Reconnecting to nature

Our modern lifestyles which are often indoors and full of constant stimulation and relentless busyness can be overwhelming for our nervous systems. Taking time out every day to slow down and connect with nature soothes and calms our nervous system to help it move out of a state of chronic agitation.

It is important to check with your GP if it is safe for you to do cold water exposure.

Follow the advice from Professor Mike Tipton about safety in water by following this link.

For more information about the link between stress and chronic pain, follow this link to a talk by Dr Howard Schubiner.

For more information about the Wim Hof method, you can go to his website.

If you have chronic pain and are interested in learning the principles presented which are used in the mind-body approach, you can book an appointment to see Irralee.

Irralee Andrzejowska

Senior Physiotherapist & Pain Management Specialist

Irralee is an Australian Chartered Musculoskeletal Physiotherapist with over 30 years of experience. She the only Physiotherapist in South Yorkshire who is trained as a SIRPA Practitioner (Stress Illness Recovery Practitioners Association - www.sirpa.org).

Irralee Andrzejowska

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