New Age Fluff or Real Treatment? Fibromyalgia Hyperbaric Oxygen Therapy Study Opens Eyes

Discussion in 'Relieving Pain' started by Cort, Jun 25, 2015.

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If someone gave you $10,000 to be used for treatment purposes would you use it on HBOT?

  1. Definitely yes

    9 vote(s)
    29.0%
  2. There's a good chance I would

    12 vote(s)
    38.7%
  3. Possibly

    4 vote(s)
    12.9%
  4. Probably not

    4 vote(s)
    12.9%
  5. Definitely not

    2 vote(s)
    6.5%
  1. Cort

    Cort Founder of Health Rising and Phoenix Rising Staff Member

    Hyperbaric oxygen therapy (HBOT) sounds like a "new agey" fluff treatment mostly employed by the athletes and the rich. The revelation that the 120 HBOT sessions improved Joe Namaths cognition, memory and feelings of well-being might feed into that perception. SPECT scans of Namath's' brain showed clear changes which remained a year after the treatment stopped, however, and HBOT therapy therapy has been used to good effect in traumatic brain injury. HBOT therapy has been the object of serious study and is used in a variety of conditions. Best known for its ability to treat the bends but it's also used in wound healing, to treat necrotizing infections, hearing loss, gangrene, burns and radiation injury.

    The increased atmospheric pressure found in hyperbaric oxygen chambers allows them to push oxygen into the bloodstream and ultimately into the brain - a part of the body with a fierce demand for oxygen. Those increased oxygen levels appear to able to enhance brain functioning and may even help form new neural pathways.


    Strong-brain.jpg
    While HBOT is commonly used in burn and wound healing and is getting interest in traumatic brain injury it's record in central nervous system conditions is mixed. A review of 12 multiple sclerosis studies (all completed between 1983 and 1987) concluded HBOT provided no clinical effectiveness. A 2012 review of autism studies found mixed results. Some evidence suggests HBOT could, however, help relieve migraine attacks. HBOT's effectiveness in depression, Parkinson's or Alzheimer's has simply not been studied.

    Some work has been done in chronic pain. A 2009 study found HBOT improved pain threshold scores and various symptom measures in myofascial pain syndrome. Pain was decreased in a small 2004 complex regional pain syndrome (CRPS) study. A 2015 paper "Hyperbaric Oxygen Therapy: A New Treatment for Chronic Pain?" that reviewed 25 studies concluded that HBOT may be helpful in treating pain but that further studies are needed to assess its efficacy. A 2013 rat study suggested it may be able to reverse allodynia.

    HBOT has not gotten much play in FM or ME/CFS or related conditions. A successful 2004 Turkish fibromyalgia study (titled "A new treatment modality for Fibromyalgia") didn't spark much interest. It took 11 years and another team from the Mideast (and Texas) to produce another study.

    The Isreali researchers producing the study got interested in HBOT after two colleagues tried it out. They reported that a graduate student who developed fibromyalgia after suffering a traumatic brain injury in a train crash, and a sociology professor with FM both received "remarkable improvement" from the therapy.

    The Study

    Hyperbaric Oxygen Therapy Can Diminish Fibromyalgia Syndrome – Prospective Clinical Trial. Shai Efrati1,2,3,4*, Haim Golan3,5, Yair Bechor2, Yifat Faran6, Shir Daphna-Tekoah6,7, Gal Sekler8, Gregori Fishlev2,3, Jacob N. Ablin9,3, Jacob Bergan2,3, Olga Volkov3,5, Mony Friedman2,3, Eshel Ben-Jacob1,4,8,10*, Dan Buskila. PLoS ONE
    10(5): e0127012. doi:10.1371/journal.pone.0127012


    Because it was impossible to design an effective sham control group a crossover design in employed. Each of the two groups received the treatment or no treatment for two months and then crossed over and took the option remaining to them.

    Multiple assessments were done including a tender point count, pain threshold tests and measures of functional impairment (Fibromyalgia Impact Questionnaire—FIQ), symptom severity (SCL-90 questionnaire), and Quality of life (SF-36 questionnaire). SPECT scan imaging was done to rates of regional cerebral blood flow before and after the hyperbaric oxygen treatments.

    The protocol was intense: five days a week for 90 minutes for two months. The final SPECT scan was done a weeks after the last HBOT session. The study involved 60 women with fibromyalgia.

    Results

    All the measures - pain sensitivity, number of tender points, psychological distress, physical functioning and quality of life - were all significantly improved after the HBOT treatment. The "effect sizes" of the treatments ranged from medium (psychological distress, physical functioning) to large medium (quality of life) to large (pain thresholds, physical functioning (one group)). All the patients who made it through the study (12 dropped out for various reasons) reported improvement. Most were able to reduce their pain medication levels significantly. Many also reported improvements in sleep and energy in addition to the pain and mood enhancements.

    In something of a surprise some of the patients felt worse before they felt better. In fact, for some it took up to 20 sessions to begin to turn corner on their pain.

    Neurology.jpg
    The changes in brain functioning the SPECT scan picked up mirrored the symptom improvement found. Prior to the study the FM patients had higher activity in the somatosensory cortex and reduced activity in the frontal, cingulate, medial temporal and cerebellar cortices. After the therapy their brain patterns started to shift towards normal: somatosensory cortex activity decreased and frontal, cingulate, medial temporal and cerebellar cortices activity increased.

    Essentially the activity in the parts of the brain that sensed pain declined and activity in the parts of the brain that control or interpret pain signals increased.

    In a press release one of the study authors stated the HBOT therapy cured traumatic brain injury triggered FM. While the results of the study were quite positive the clinical effects (from medium to large) did not suggest a cure had taken place for most.

    Cause

    The authors suggested HBOT may have increased the "feel-good" chemicals GABA and/or opioids in the brain. Increased levels of these factors then turned on the inhibitory pain pathways leading to the spinal cord. Balky inhibitory pathways that reduce the intensity of pain signals leading from the spinal cord (the body) to the brain appear to play an important role in FM. Inhibiting those pathways appears to allow the pain regulating portions of the brain to be overwhelmed by pain signals.



    Other studies involving traumatic brain injury and stroke suggest HBOT effects the central nervous system in ways that might make sense for ME/CFS and FM and allied disorders. Blood vessel functioning, for instance, is of great interest in ME/CFS, migraine and POTS and HBOT appears to be able to trigger blood vessel repair mechanisms and improve blood flows. It also reportedly acts as an anti-inflammatory, can promote the integrity of the blood-brain barrier, alleviates oxidative stress, enhances mitochondrial functioning, and, the authors suggested, may normalize glial cell activity. It appears to be helpful in reversing the effects of traumatic brain injury.

    HBOT has not proved effective, however, in some other central nervous system disorders and has been little studied in others.

    Cost/Benefit

    The big knock on therapy has been cost. Most companies promoting HBOT therapy on the web do not post charges but general cost estimates posted on the web they range from $1-200 per hour session. According to one website using an HBOT in a hospital setting for an hour could cost 4 to 6x's more.


    Dollars.jpg
    If these numbers are correct engaging in a 40 session treatment at a private clinic in the U.S. similar to that which occurred in the study would cost from $6-10,000. (This is despite one company bemoaning the fact oxygen is too cheap for drug companies to be interested in it. )

    Cost wouldn't be so much of an issue if the results stuck. Ten grand to reduce significantly reduce pain and improve cognition and sleep in FM patients is a bargain if the brain reset sticks. The fact that HBOT appears in other conditions to foster the development of new neural pathways suggests the results could hold. The authors of the study asserted that people with traumatic brain injury triggered FM might just be cured. People with infection triggered FM, on the other hand, would probably need follow up sessions.

    The cheapest hyperbaric oxygen chamber I could find was a portable one for about $4,000 and they can cost ten times that much. Most appear to be made by small companies. The most cost-effective way to use HBOT for those who can afford it might be try 10 or 20 sessions on one's own and if it appears effective to buy a unit. Companies promoting HBOT treatment assert that multiple sessions are needed. If HBOT is tried enough sessions should be done to be able to assess the results.

    Clinical trials are currently examining HBOT effectiveness in brain injury, diabetes, interstitial cystitis, Crohn's disease, ulcerative colitis, small blood vessel disease and diabetic retinopathy.

    The big question for most fibromyalgia and ME/CFS patients wishing to try this therapy is whether enough studies will be done to validate the treatment enough for insurance companies to pay for it. In that regard HBOT is in the same place as low dose naltrexone except worse. It's an expensive treatment without the possibility of producing a dividend for a major drug company. Since oxygen is cheap and and the hyperbaric oxygen chamber field is populated by small producers more trials are probably not going to come from industry. That leaves, at least in the U.S., academia or non-profits with cash to fill the gaps.

    Still, one study was done and given the right situation others may happen. Jarred Younger, for instance, has been willing - and successful - at exploring non-traditional treatments such as LDN. He's looking at a variety of substances that probably don't have much commercial value but could bring benefit to people with FM and ME/CFS. His goal is finding treatments - not producing profits - and and he has a lab and a budget he controls. That's the kind of researcher that will hopefully pick up and explore HBOT therapy further in FM and ME/CFS.

     

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    Last edited: Jun 25, 2015
  2. mary avery

    mary avery New Member

    I tried this once, since it is upwards of $100.00. I saw no changes, other than feeling as though I had a good nap. Wouldn't do it again.
     
  3. Marya

    Marya New Member

    I've been reading how the treatment helps vets w TBI and PTSD.Since i experience a cluster of those symptoms,I would very much like to try
     
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  4. diane

    diane New Member

    I live in the UK. Here, it is offered through MS Therapy Centres. There is no set charge but it says: 'Therapies are provided on a voluntary contributions basis – meaning they are usually far more cost effective than private treatment.'

    They offer an initial course of 15 sessions, each lasting 1 hour. After that you can have 'top up' sessions, once a week or once a month or whatever. It has to be done with the GP's consent.

    It doesn't directly say if they will accept people with other illnesses but it does list all the illnesses that it could help, including ME, so I suspect they would provide it.
     
    Patty May likes this.
  5. goldenapple

    goldenapple Member

    I read about the study where 7/10 patients had reversed symptoms so I checked out if I could find this therapy near me. I found a private practice in Boulder whose protocol for Fibro and CFS is 90 minutes every day for 30-40 days. If you pay for the whole thing up front it can be as "cheap" as $5,000. I would try it in a heartbeat if I had the money.

    Part of the reason I have enthusiasm for it is that I've been recently staying at sea level (I live at 7,000 feet) and I have been in nearly complete remission in the 6 weeks I've been at sea level. More oxygen is very likely a factor for me.
     
    Patty May likes this.
  6. Cort

    Cort Founder of Health Rising and Phoenix Rising Staff Member

    I hope you can give it a shot! If you've travelled other places did you have a similar result?

    $5K is not bad relative to other places. That you can get that in Boulder (no surprise there!) suggests it might be cheaper than I thought in some areas. .
     
  7. Cort

    Cort Founder of Health Rising and Phoenix Rising Staff Member

    Unfortunately they say it takes multiple sessions to have an effect. In fact some people who feel worse at first feel better after multiple sessions - as in 20 sessions. To bad its not cheaper. Maybe a bunch of us should go in on one...
     
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  8. diane

    diane New Member

    That is an interesting thought. When I visited Switzerland I had a lot of trouble because of the altitude. I would go up a wonderful mountain in a cable car and look around for 5 minutes and think 'I'm too tired. Where's the next cable car to the next spot on my round trip to get me home?' I really didn't see much except when I was in transport vehicles. If I am made worse by altitude, then theoretically I might be made better by oxygen therapy.
     
  9. Folk

    Folk Well-Known Member

    I remember whatching an interview of Dr. De Meirleir about how Oxygen therapy could do more harm than good in some specific cases (if I remember correctly it was in those patients with Lyme).

    Anyone know where does that stand here?

    Well... There's also lecture where he says LDN could make the patients deeply depressed too, and then another video where he says LDN should become the next best treatment for CFS/ME so... perhaps his word isn't worth that much. :|
     
  10. fdotx

    fdotx Active Member

    It's interesting that your improvement is lasting so long - I'd think it would only be days. It'll be interesting if it continues - sure hope so! Isn't there a fatigue clinic of sorts in Layfette, CO?
     
  11. Cort

    Cort Founder of Health Rising and Phoenix Rising Staff Member

    My remembrance from Dr. De Meirleir is that the treatment might help but that the treatment effects would not last. I wonder if he had patients who went through many sessions with it? It takes a real financial commitment to do that given it's not covered by insurance.

    The fact that it may last was the big surprise I got from the study.
     
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  12. shira

    shira Member

    I did hyperbaric oxygen treatment almost 20 years ago for 2 weeks. Don't remember how long each session was. I did not have any improvement.
     
    Flora likes this.
  13. Karen PT

    Karen PT Member

    Oxygen may be cheap, but the hyperbaric chamber isn't. The chamber in a hyperbaric medical clinic has to cost in the tens of thousands of dollars. You can buy a portable chamber for around $4000-$17000 on this site (http://www.healingdives.com) in the USA. They rent the chambers for $800/month for the cheapest unit. These are portable units and do not deliver the amount of compression that the metal chambers can. If you are interested in getting a chamber, I would check the research articles to see how much pressure they used and make sure the portable chamber can deliver the same amount of pressure.
     
    Patty May likes this.
  14. Folk

    Folk Well-Known Member


    I got it wrong hehe

    Actually what he said is that it can increase free radicals, which is harmfull, but can help people with sever pain and acidification.
     
    Patty May likes this.
  15. Flora

    Flora Member

    In my humble opinion this is where I'm at: through my alt med Dr I tested positive for Lyme through Igenex. Perhaps it's Lyme provoked CFS as I don't have the FMS trigger points. I was able to try a block of 10 HBOT sessions. By the 10th session my pain was greatly reduced, my fatigue was greatly reduced, and my brain was much clearer. I was then able through a friend to purchase a home/portable HBOT unit along with oxygen condenser and concentrator for around $10,000 for the whole package. Some people it takes 10-20 sessions before they see a difference.

    If I am consistent I would continue to improve; my Achilles is maintaining consistency in the HBOT sessions.
    I'm seeing oxygen and deep breathing coming up lately for FMS/CFS.. The vagus nerve inflammation is helped by deep breathing. Over at the Oxycise (deep breathing w/isometric stretches) success stories page for FMS ladies say their energy is up, pain is down, migraines, panic attacks are down. If oxygen and deep breathing are the key then Oxycise is the cost of a book and/or DVD on Amazon.

    Over at Lyme Net Flash I read of 1 person that was able to get off pain meds by I believe 45 dives. I also believe I read of another whose insomnia was over by 75 dives. It is a commitment to consistency. Oxycise? Yes, I can feel exhausted, and toxic, with the 17 minutes of deep breathing. But one starts with a few deep breaths, laying on the bed or recliner. It doesn't need to be all done at the same time. Yoga also incorporates deep breathing.

    Pardon, Cort, for coming across like an infomercial. It's the oxygen factor I'm looking at. And that breathing exercise is the least intrusive time wise or exertion-wise that I IMHO have come across to improve one's FMS/CFS situation.

    Re: Hyperbaric oxygen therapy: find someone with one that you can try out. See if an alt med clinic might let one do a block of 10 Dives at a reduced cost. Some people invest in a chamber as a group. Also the HBOT Chamber companies can rent it to you so there are some options.

    Thank you, Cort, for this timely article. It's a reminder that I'm ready to renew my relationship with my 'Pod.' And also thank you Very Muchly for the LDN articles and Synergy protocol. I had been praying for something to get me over the hump. I've been able to get off Lortab, reduce my constant tramadol, and reduce my antidepressants as a result of the LDN.

    And kindly pardon the length of this response.
     
    Last edited by a moderator: Jun 25, 2015
  16. Darden Burns

    Darden Burns Member

    I did 30 sessions of HBOT eight years ago and experienced no improvement in my fibromyalgia muscle pain. The only positive improvement in my health was an ability to tolerate traveling to places at high altitudes without experiencing any high altitude sickness. This affect lasted several years and is known benefit of HBOT as it makes the body more flexible in adjusting to various altitudes. Ultimately after many trials of other therapies my fibromyalgia went away by treating Small Intestinal Bacterial Overgrowth (SIBO). SIBO is a leading cause of fibromyalgia. That said there are many variations within the fibro diagnosis.
     
  17. Flora

    Flora Member

    Re: atmospheric pressures: 20+ years ago a friend of mine with Lyme at his onset would feel awful while flying but better while scuba diving. After researching he built his own out of a water heater (as in People DO NOT Try this at home!)

    The portable/ home/ soft shell chambers are the pressure of the deep end of a pool. It's mild pressure has been sufficient for me. I have not needed a higher pressure for my situation .
     
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  18. Cort

    Cort Founder of Health Rising and Phoenix Rising Staff Member

    :wacky: :wacky:
     
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  19. Cort

    Cort Founder of Health Rising and Phoenix Rising Staff Member

    Indeed there are many variations!
     
    Merida likes this.
  20. Cort

    Cort Founder of Health Rising and Phoenix Rising Staff Member

    Thanks Flora for the info. It's good to hear from someone who's used HBOT. How often do you need to use it to see results?
     
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