Managing chronic pain through hyperbaric oxygen therapy and its effects on central sensitization

Central sensitization is a condition of the nervous system that is associated with the development and maintenance of chronic pain. A new understanding of the role of hyperbaric oxygen therapy (HBOT) in central sensitization may be the key to effectively utilizing the benefits of this therapeutic intervention for pain management.

In this study, an experimental first-degree burn injury was induced in 19 healthy male subjects followed by one single hyperbaric oxygen session (2.4 ATA, 100% oxygen, 90 min). The results from the hyperbaric session demonstrated a long-lasting reduction in pain. In addition, the application of HBOT also demonstrated a protective effect through preconditioning. These results strongly support the effects on central sensitization through HBOT and may offer greater clinical applications for those suffering from chronic pain syndromes, particularly towards persistence post-surgical pain and phantom limb pain, among other areas within clinical pain research. <View study — Journal of Pain Research 2019>

Successful Treatment of Long Standing Complex Regional Pain Syndrome with Hyperbaric Oxygen Therapy

Complex regional pain syndrome (CRPS) can be a debilitating disorder associated with severe pain and disability characterized by both auto-inflammatory and autoimmune features.

This publication was a case report of a patient with long-standing CRPS that had a dramatic response to a course of hyperbaric oxygen therapy (HBOT) and was able to successfully lower their prednisone dosage. Symptoms reemerged a few months later so a second course of hyperbaric therapy was prescribed. Similarly to the first course, the patient improved symptomatically and was able to once again lower the dose prednisone.

“This case is unique in that it shows that HBOT can be effective in long-standing CRPS, both initially, and for subsequent flares, and adds to the evidence supporting HBOT as a potential treatment for this condition” <view study>

STUDY REVEALS over 8100 genes affected by hyperbaric oxygen, and it is the pressure that makes all the difference.

Hyperbaric oxygen therapy has been traditionally used for growth, repair, tissue regeneration, and overall recovery. The mechanisms by which these positive effects occur are continuously being explored and our understanding of these effects are growing vastly, and much of these benefits have been shown to occur through the regulation of gene expression in various tissues inside the body. People often wonder why we cannot just breathe pure oxygen and get the same benefits that are achieved through hyperbaric delivery. This study should put those questions at rest and clearly shows the main relevant factor in HBOT is PRESSURE and not the 100% Oxygen. Note, both are considered to be the 2 key variables in dosing hyperbaric oxygen therapy. In this case, the research clearly pointed that the pressure was far more important and just breathing 100% oxygen did not have the physiological benefits that occurred when pressurized oxygen was added. More importantly, researchers in this study observed that pressurized oxygen caused an effect on over 8 thousand genes observed, within a 24 hour period of time following HBOT! <view study>

Hyperbaric Oxygen Therapy Enhances Antioxidant Status Promoting Healthy Aging

Some people still think that HBOT can be harmful by causing excessive oxidative and free radical disease. This study should finally put this controversy at rest. One of the main mechanisms of action in providing HBOT is the body’s compensation and ability to increase its Natural antioxidant defences. In return, the body is more geared at handling our current influx of stressors, including dietary and environmental chemicals. All studies have demonstrated an increase in anti-oxidant protection following HBOT and this study showed the genetic changes in antioxidant levels following HBOT. Here, the gene expressions were increased and thus a considerable elevation in our antioxidant defences. Understanding the role of free radical damage its positive correlation with accelerated aging and chronic disease states, preventative HBOT may hold a key in promoting healthy aging <view study>

Hyperbaric oxygen therapy for traumatic brain injury

This study reviews the effectiveness for applying HBOT for TBI, and makes a strong argument for both the early application, and also for delayed treatments, with the common variable being multiple sessions at low atmospheric pressure. This dosage would reduce intracranial pressure, improve mortality, as well as promote neurobehavioral recovery <view study>

Hyperbaric oxygen therapy protects the body

Free radical, oxidative stress, and inflammation are all common markers that are exhibited during many, if not all, pathologies and the hallmark of many chronic disease states. Hyperbaric oxygen therapy has been traditionally used for reducing the damaging effects of radiation therapy (RT). Since RT has been shown to cause excessive oxidative stress and inflammation, researchers took note of HBOT’s potential to reverse both of these factors involved in radiation damaged tissue <view study>

Hyperbaric oxygen therapy protects and supports the liver

Another study supporting the protective role of hyperbaric oxygen therapy (HBOT). Significant liver protection was observed following HBOT preconditioning. Moreover, both a reduction of oxidative stress, along with a marked enhancement of total antioxidant protection was observed. This is just one of many studies confirming the strong and powerful antioxidant protection that is produced following the application of hyperbaric oxygen therapy <view study>

Hyperbaric oxygen therapy significantly reverses learning and memory deficits

Learning and memory deficits are quite often send following injuries or degenerative disorders of the brain, but now are increasingly becoming a major concern for our aging population. This study focuses on the benefits of hyperbaric oxygen therapy for both of these groups of individuals, particularly the ones with ‘aging’ brains. These beneficial effects were found to be through a combination of positive findings including a reduction in both brain oxidation and inflammation, while also being able to effectively regulate aging-related gene expression. These combined physiological benefits were able to cause a significant reversal in the learning and memory deficits normally observed in aging <view study>

Hyperbaric Oxygen therapy’s role in Stem Cell transplantation for type 1 Diabetes

Human Embryonic stem cells have gained wide acceptance for the potential benefit of many conditions. Type 1 Diabetes is one of these conditions where this procedure is being tested. However, these stem cells have consistently failed to generate meaningful numbers of mature, functional β cells. Since oxygen is a strong driver of differentiation, researchers of this animal study looked at applying hyperbaric oxygen therapy to a group of rats following transplanted cells and observed an increase in the maturation of these cells, leading to increased insulin production. The future of embryonic stem cells may be to drive the differentiation and maturation of these cell by following the procedure with a course of hyperbaric oxygenation therapy <view study>

Brain Recovery … Oxygen tensions directly affect the growth of stem cells (neural crest)

The neural crest is an ideal source for multipotent adult stem cells. The results of this study “show for the first time that extreme oxygen tensions directly control NCSC proliferation” <view study>

Hyperbaric oxygen therapy protects the brain & positively impacts Cystain C levels

Cystatin C is a bio marker that is becoming a hot topic in neurology, particularly in its ability to predict new-onset or deteriorating cardiovascular disease. Researchers found that preconditioning the brain with hyperbaric oxygen therapy produces helps to protect the brain (neuroprotection), while positively improving the levels of Cystatin C during injury. They published these findings in the journal of “Stroke” 2017 <view study>

Hyperbaric oxygen helps lower blood sugars

Blood sugar control can be extremely difficult for diabetics and is the main reason why they are at higher risk factors for both strokes and heart attacks. Hyperbaric oxygen therapy has been known to help sensitize insulin levels and thereby help to reduce blood sugar levels. In this study, they took 52 diabetic patients who had just recently had a stroke within the past month and divided them into 2 groups — those who had a stroke within 10 days and those who had their stroke within 30 days. They then gave both groups a series of of hyperbaric oxygen treatments and followed (pre and post) their insulin levels, fasting blood sugars, and hemoglobin A1C levels (which shows longer-term blood sugar control). Both of these groups were able to demonstrate significant improvements in blood sugars with the addition of hyperbaric oxygen therapy. <view study>

Hyperbaric oxygen therapy improves neurocognitive functions of post-stroke patients

A 10 year (2008-2018) retrospective analysis was conducted on (chronic) stroke patients (&gt;3 months)

The hyperbaric protocol consisted of 90 minute daily sessions, each at 2.0 ATA (with 5 minute air breaks every 20 minuets), 5 days per week for a total of 40 to 60 sessions.

Even though the patients were treated after a median of 1.5±3.3 years post-stroke, there were significant cognitive improvements in all the cognitive domains which were measured using objective computerized test <view study>

Functional MRI Imaging confirms long-term stroke patients can improve with hyperbaric oxygen therapy, even 15 years after the stroke

Management of chronic strokes remains a challenge within our current medical system, yet the intervention of hyperbaric oxygen therapy has consistently been shown to improve stroke recovery, even years after the brain insult.

This study followed 4 patients (from 14 months to 15 years post stroke) who were given a typical 8 week hyperbaric protocol consisting of 40 individual sessions (at an effective dosage of 1.8 ATA) and evaluated the outcome measures through functional MRI imaging (fMRI). Note, fMRI is a non invasive, robust and reliable technique to assess and monitor neuronal functional change. The results were very impressive and should give encouragement for this protocol to be more widely used within the stroke recovery community. Here is a summary of all 4 patients along with the details regarding their recovery:

60 year old male (14 month old stroke) with severe, non-fluent aphasia, associated with retained comprehension, dyslexia and dysgraphia, a right upper limb spastic paralysis and a right lower limb paresis, and post-stroke depression.

Results — Aphasia and the ability to speak improved noticeably, helping to regain some social life. Accordingly, the negative attitude was replaced by positivity, good mood and interest. Right lower limb paresis improved with better gait and stance. However, the right hand paralysis did not improve, except for a decrease in spasticity.

68 year old male (5 year old stroke with moderate signs of dysarthria (he sounded clumsy in reading aloud short passages), an unsteady, wide-base gait and dysphagia

Results — A marked clinical improvement in the language fluency, such that he was able to read aloud a written text, without a hitch. Ataxia and dysphagia improved as well

48 year old male (15 year old stroke) with recurrent seizures, mild signs of dysarthria, upper left limb paralysis, lower left limb paresis, lack of coordination in the right limbs, severe in the lower right extremity and to a lesser extent in the upper right extremity

Results — He dramatically improved his speech fluency. The left lower limb paresis improved together with an increase in walking autonomy, but he was still unable to flex and extend the left foot rhythmically. Also the right limbs coordination improved. On the contrary, the left upper limb paralysis did not change at all.

34 year old male (17 month old stroke) with global non fluent aphasia with some deficits in the reading comprehension, a complete spastic hemiplegia of the right upper limb with spastic hypertonia, a partial paresis of the right inferior limb (but he was able to walk with some walking aids) and right hemilateral hypoaesthesia

Results — Good improvement in the common everyday acts of his life, as speaking and understanding and also in walking, but not in his upper limb paralysis

Once again, it is important to keep in mind that fMRI imagining confirmed these benefits and can play a future role in determining hyperbaric-based protocols for chronic stroke sufferers <view study>

HBOT for Brain Tumors

A new study just published on Feb 2011 in the journal of cancer makes a strong argument for applying hyperbaric oxygenation therapy (HBOT) for those patients who have had either surgery or radiation therapy for brain tumors. The study followed patients who had been treated with HBOT and there was a marked improvement in cognitive function which was supported and documented by standard neuropsychological testing <view study>

Hyperbaric Oxygen therapy may speed up recovery from muscle injury

Only 3 Sessions of Hyperbaric oxygen therapy was shown to play a positive role in the recovery of muscle injury in rats. This should hopefully lead the way to many more studies to determine its effectiveness for speeding up recovery from injured muscles and tissue <view study>

Hyperbaric Oxygen Therapy can Improve Surgical Procedures

Ever wonder why some people recover well from surgery and others can have long term implications including infections and even amputations. It is now clear that hypoxia (low oxygen levels) clearly effects the response and recovery following surgery. Local hypoxic conditions account for longer time for healing and greater susceptibility for infections. Treatments with hyperbaric oxygen therapy can reduce the hypoxia in the body and have a substantial effect on reducing negative clinical outcomes, along with shortening the healing time, and reducing chances of infection. Many plastic surgeons are now recognizing the benefits of HBOT in their discipline and referring for HBOT post-op. This is making for better and safer surgical procedures, along with less down time and hospitalization <view study>

An interesting case of dementia

A 77 year old male went in for a routine knee replacement surgery. Following this procedure, he began to decline in both his physical and mental capacities. The symptoms got progressively worse and about 4 years later, he was evaluated and given a brain imaging (SPECT) scan, and he was immediately given a diagnosis of dementia with major cognitive deficits and aphasia (the loss of ability to understand or express speech). It was determined that the cause of his dementia was a post-op complication from his previous knee surgery and began a course of 40 sessions inside of a hyperbaric oxygen chamber. After 5 months, both his physical and cognitive functions were substantially restored. The follow up brain imaging scan confirmed these results. Complications from major (and even minor) operations are not uncommon and sometimes not even diagnosed at the time, and in cases like this, 4 or 5 years after the surgical procedure. This study brings to light the benefits that can be achieved with hyperbaric oxygen therapy, even years after the surgery. <view study>

Hyperbaric Oxygen Therapy Speeds up Recovery Following Plastic Surgery Procedure

Deep chemical peels are commonly used by plastic surgeons to help with severely sun-damaged skin, coarse wrinkles, scars, and even pre-cancerous growths. The procedure uses a chemical, Phenol, that removes the top layer of skin, causing smoother and younger-looking skin to grow back. Phenol is the most aggressive type of skin peel but can produce more dramatic results. The downside is that it involves longer recovery times. This is where hyperbaric oxygen comes into the picture. Hyperbaric therapy helps to speed up healing. In this study, patients undergoing phenol chemical peel (PCP) were divided into 2 groups. The first group had PCP only and the second group had 5 sessions of hyperbaric oxygen therapy following PCP. The Results: Hyperbaric oxygen therapy following PCP was associated with faster recovery as assessed by both patients and caregivers <view study>

Defining the Role of Hyperbaric Oxygen Therapy as an Adjunct to Reconstructive Surgery

The benefits of hyperbaric oxygen therapy during reconstructive surgery has been confirmed both clinically, and through experimental data, but still widely underutilized by plastic surgeons. This review study details the benefits and role that hyperbaric oxygen plays within the discipline of plastic and reconstructive surgery. <view study>