Chronic Pain

Chronic Pain – Fibromyalgia, Headaches, Neuropathic Pain

Click on the publications below to view and close the abstracts

Hyperbaric oxygen treatment decreases pain in two nerve injury models
Colleen D. Thompson a, Megan L. Uhelski a, Judy R. Wilson b, Perry N. Fuchs
Neuroscience Research 66 (2010) 279–283

Hyperbaric oxygen (HBO) treatment has been used clinically to treat a variety of ailments, including severe burns and carbon monoxide poisoning, and in research settings has produced promising results when used to treat animal models of inflammatory pain.

However, studies examining neuropathic pain or nerve injury models have been limited to physiological assessments and not whether the pain condition improves. The purpose of this study was to evaluate the effect of HBO on two common models of neuropathic pain, L5 ligation and chronic constriction injury (CCI) of the sciatic nerve. Following surgical manipulations, animals demonstrating mechanical hyperalgesia were randomly assigned to either HBO treatment or control for 90min treatment sessions, after which mechanical sensitivity was assessed at 15min and 6h post.

Daily HBO sessions, with assessments 15min post-treatment, continued for two weeks, followed by 5 days of assessment only. The results indicated that both models demonstrated significant improvement in response to treatment over the course of the two-week period, with CCI animals recovering more quickly and maintaining this recovery throughout the post-treatment period.

Hyperbaric oxygen treatment appears to be successful in relieving neuropathic pain for an extended period of time, and future research should be aimed at investigating the precise mechanisms underlying this positive effect.

Hyperbaric Oxygen Therapy in Chronic Pain Management
Senol Yildiz, MD, Gunalp Uzun, MD, M. Zeki Kiralp, MD
Current Pain and Headache Reports 2006, 10:95–100

Chronic pain is one of the frequently encountered clinical problems that is difficult to cure. Hyperbaric oxygen (HBO) therapy has been reported in chronic pain syndromes with promising results.

In this review, we focus on the effectiveness of HBO in fibromyalgia syndrome, complex regional pain syndrome, myofascial pain syndrome, migraine, and cluster headaches. HBO may be beneficial if appropriate patients are selected.

HBO is a reliable method of treatment. However, physicians performing HBO must be aware of oxygen toxicity. Another problem regarding HBO is the scarcity of centers administering it. Further research is required focusing on the optimal treatment protocol, the cost/benefit ratio, and the safety of HBO in chronic pain management.

Hyperbaric oxygen in the treatment of patients with cerebral stroke, brain trauma, and neurologic disease
Al-Waili NS, Butler GJ, Beale J, Abdullah MS, Hamilton RW, Lee BY, Lucus P, Allen MW, Petrillo RL, Carrey Z, Finkelstein M.
Adv. Ther. 2005 Nov-Dec; 22(6):659-78.

Hyperbaric oxygen (HBO) therapy has been used to treat patients with numerous disorders, including stroke. This treatment has been shown to decrease cerebral edema, normalize water content in the brain, decrease the severity of brain infarction, and maintain blood-brain barrier integrity. In addition, HBO therapy attenuates motor deficits, decreases the risks of sequelae, and prevents recurrent cerebral circulatory disorders, thereby leading to improved outcomes and survival.

Hyperbaric oxygen also accelerates the regression of atherosclerotic lesions, promotes antioxidant defenses, and suppresses the proliferation of macrophages and foam cells in atherosclerotic lesions. Although no medical treatment is available for patients with cerebral palsy, in some studies, HBO therapy has improved the function of damaged cells, attenuated the effects of hypoxia on the neonatal brain, enhanced gross motor function and fine motor control, and alleviated spasticity.

In the treatment of patients with migraine, HBO therapy has been shown to reduce intracranial pressure significantly and abort acute attacks of migraine, reduce migraine headache pain, and prevent cluster headache. In studies that investigated the effects of HBO therapy on the damaged brain, the treatment was found to inhibit neuronal death, arrest the progression of radiation-induced neurologic necrosis, improve blood flow in regions affected by chronic neurologic disease as well as aerobic metabolism in brain injury, and accelerate the resolution of clinical symptoms.

Hyperbaric oxygen has also been reported to accelerate neurologic recovery after spinal cord injury by ameliorating mitochondrial dysfunction in the motor cortex and spinal cord, arresting the spread of hemorrhage, reversing hypoxia, and reducing edema. HBO has enhanced wound healing in patients with chronic osteomyelitis.

The results of HBO therapy in the treatment of patients with stroke, atherosclerosis, cerebral palsy, intracranial pressure, headache, and brain and spinal cord injury are promising and warrant further investigation.

A new treatment modality for fibromyalgia syndrome: hyperbaric oxygen therapy
Yildiz S, Kiralp MZ, Akin A, Keskin I, Ay H, Dursun H, Cimsit M.
J Int Med Res. 2004 May-Jun;32(3):263-7.

Fibromyalgia syndrome (FMS) is characterized by longstanding multifocal pain with generalized allodynia/hyperalgesia.

There are several treatment methods but none has been specifically approved for this application. We conducted a randomized controlled study to evaluate the effect of hyperbaric oxygen (HBO) therapy in FMS (HBO group: n = 26; control group: n = 24).

Tender points and pain threshold were assessed before, and after the first and fifteenth sessions of therapy. Pain was also scored on a visual analogue scale (VAS). There was a significant reduction in tender points and VAS scores and a significant increase in pain threshold of the HBO group after the first and fifteenth therapy sessions.

There was also a significant difference between the HBO and control groups for all parameters except the VAS scores after the first session. We conclude that HBO therapy has an important role in managing FMS.

Effectiveness of hyperbaric oxygen therapy in the treatment of complex regional pain syndrome
Kiralp MZ, Yildiz S, Vural D, Keskin I, Ay H, Dursun H.
J Int Med Res. 2004 May-Jun; 32(3):258-62.

In this double-blind, randomized, placebo-controlled study we aimed to assess the effectiveness of hyperbaric oxygen (HBO) therapy for treating patients with complex regional pain syndrome (CRPS).

Of the 71 patients, 37 were allocated to the HBO group and 34 to the control (normal air) group. Both groups received 15 therapy sessions in a hyperbaric chamber. Pain, oedema and range of motion (ROM) of the wrist were evaluated before treatment, after the 15th treatment session and on day 45.

In the HBO group there was a significant decrease in pain and oedema and a significant increase in the ROM of the wrist. When we compared the two groups, the HBO group had significantly better results with the exception of wrist extension.

In conclusion, HBO is an effective and well-tolerated method for decreasing pain and oedema and increasing the ROM in patients with CRPS.