Evaluation of a Hyperbaric Oxygen Therapy Intervention in Individuals with Fibromyalgia

Abstract

Objective To evaluate the feasibility and safety of hyperbaric oxygen therapy (HBOT) in patients with fibromyalgia (FM). Design A cohort study with a delayed treatment arm used as a comparator. Setting Hyperbaric Medicine Unit, Toronto General Hospital, Ontario, Canada. Subjects Eighteen patients diagnosed with FM according to the American College of Rheumatology and a score ≥60 on the Revised Fibromyalgia Impact Questionnaire. Methods Participants were randomized to receive immediate HBOT intervention (n = 9) or HBOT after a 12-week waiting period (n = 9). HBOT was delivered at 100% oxygen at 2.0 atmospheres per session, 5 days per week, for 8 weeks. Safety was evaluated by the frequency and severity of adverse effects reported by patients. Feasibility was assessed by recruitment, retention, and HBOT compliance rates. Both groups were assessed at baseline, after HBOT intervention, and at 3 months’ follow-up. Validated assessment tools were used to evaluate pain, psychological variables, fatigue, and sleep quality. Results A total of 17 patients completed the study. One patient withdrew after randomization. HBOT-related adverse events included mild middle-ear barotrauma in three patients and new-onset myopia in four patients. The efficacy of HBOT was evident in most of the outcomes in both groups. This improvement was sustained at 3-month follow-up assessment. Conclusion HBOT appears to be feasible and safe for individuals with FM. It is also associated with improved global functioning, reduced symptoms of anxiety and depression, and improved quality of sleep that was sustained at 3-month follow-up assessment.

Hyperbaric oxygen therapy improves neurocognitive functions and symptoms of post-COVID condition: randomized controlled trial

“…Diffuse muscle and joint pain without local inflammation or malformation is one of the common symptoms of post-COVID-19, resembling other central sensitization syndromes, such as fibromyalgia. A growing number of clinical studies, have demonstrated the efficacy of HBOT in improving pain and quality of life of fibromyalgia patients 14,15,[29][30][31][32] . Previous studies have shown that fibromyalgia is associated with decreased brain perfusion in the insula, hippocampus, putamen, prefrontal and cingulate cortex [33][34][35] .…”

Oxidative Stress in Fibromyalgia: From Pathology to Treatment

“…Therefore, healthy subjects might increase ROS synthesis. However, hyperbaric oxygen therapy has shown positive effects in clinical trials of fibromyalgia treatment, such as improved global functioning, pain reduction, psychological relief, and normalization of brain activity [52][53][54][55][56][57].…”

Efficacy and safety of hyperbaric oxygen therapy for fibromyalgia: a systematic review and meta-analysis

“…After screening, nine studies (three RCTs and six non-RCTs) met the inclusion criteria. 32–40 The flow diagram is shown in figure 1 . A total of 288 patients were included in this study.…”

“…The average MINORS scores for non-comparative and comparative studies were 9.7 and 19.7, respectively. Studies by Efrati et al 39 and Curtis et al 32 were considered high quality. In non-RCTs, lack of bias assessment, study size calculation and follow-up were the most common reasons for low MINORS scores.…”

“…Only one study 32 reported PGIC, which assessed global response to treatment and has been associated with clinical symptoms in patients with FM. Curtis 32 reported that patients with FM had a different degree of symptom improvement after HBOT and at a 3-month follow-up. After HBOT treatment, ‘almost the same’ was the most common impression of global symptoms in FM patients (44.4%).…”