Hyperbaric Oxygen Therapy in management of pain, inflammation and fatigue.
Chronic pain is one of the most common clinical presentations in primary care settings, significantly influencing quality of life mental health and cognitive function of the individuals to just name a few. It is commonly accompanied by fatigue, non-restorative sleep and high levels of distress.
Pain complaints are defined as chronic when the complaints continue for more than three months which is the time that the normal tissue needs to heal. A broad spectrum of conditions including neuropathic pain, complex regional syndrome, migraine, and fibromyalgia have been implicated as causes of chronic pain condition.
Chronic fatigue syndrome (CFS) is a chronic disease with social components that ensue secondary to the incapacity of the person to fulfil work, social and family responsibilities.
Self-reported impairments in concentration, short term memory, sleep disturbances and generalised musculoskeletal pain are also commonly observed symptoms.
In recent years Hyperbaric Oxygen Therapy research has shown to be very promising in management of symptoms of chronic fatigue syndrome, inflammation and fibromyalgia. Hyperbaric oxygen therapy (HBOT) is the administration of pure medical oxygen (100%) at pressures greater than atmospheric pressure, i.e. more than 1 atmosphere absolute (ATA), for therapeutic reasons.
In a published research, (Undersea & hyperbaric medicine: journal of the Undersea and Hyperbaric Medical Society, Inc 40(2):197-200 · March 2013 ) HBOT was shown to reduce the symptoms of chronic fatigue syndrome.
In a paper published in journal of rheumatology (Clin Exp Rheumatol. 2019 Jan-Feb;37 Suppl 116(1):63-69. Epub 2019 Feb 6., Hyperbaric oxygen treatment of fibromyalgia.), the investigators reported that:
" Pain scores and the symptoms of anxiety (but not those of depression) improved after 10-20 sessions of 2 hours each at atmospheric pressures between 2-2.4 ATA, whereas fatigue and FM symptom severity scores significantly improved only after 20 sessions."
In another research study, for the first time case a series of female fibromyalgia patients, in the course of HBOT, suddenly recalled repressed traumatic memories of childhood sexual abuse (CSA). The surfacing of the repressed (dissociative) memories decades after the sexual abuse events was sudden and utterly surprising. No psychological intervention was involved. As the memories surfaced, the physical pain related to FMS subsided. In one patient who had brain single photon emission CT (SPECT) before and after HBOT, the prefrontal cortex appeared suppressed before and reactivated after HBOT.
Patients received hyperbaric oxygen therapy at 2ATA for 60 sessions of 90 min each. (Front Psychol. 2018; 9: 848.)
It is now understood that HBOT exhibits a significant anti-inflammatory effect through reducing production of glial cells (brain's immune cells) and inflammatory mediators. HBOT can also influence neuroplasticity and affects the mitochondrial mechanisms resulting in enhanced energy level and functional brain changes. In addition to that, HBOT stimulates nitric oxide which helps in reducing pain and increase body's own opioids.
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