Low-Pressure Hyperbaric Oxygen Therapy May Aid Pain Management in Women with Fibromyalgia

Pilar Serra-Añó, PhD

Credit: University of Valencia

Findings from a recent study suggest low-pressure hyperbaric oxygen therapy may have notable impacts on psychological constructs related to pain and quality of life in women with fibromyalgia.¹

Results showed an 8-week intervention with low-pressure hyperbaric oxygen therapy led to significant improvements in self-perceived pain intensity; pain catastrophizing; mental defeat; pain acceptance; psychological flexibility; and quality of life in a cohort of women with fibromyalgia who had previously experienced no improvement with pharmacological treatment.¹

“To the best of our knowledge, this is the first study that evaluates the effect of a non-psychological intervention, such as low-pressure hyperbaric oxygen therapy, on psychological constructs that have been proposed as major contributors to quality of life among fibromyalgia patients,” Pilar Serra-Añó, PhD, professor of physiotherapy at the University of Valencia in Spain, and colleagues wrote.¹

According to the US Centers for Disease Control and Prevention, fibromyalgia affects about 4 million US adults. Although its exact cause is unknown, the risk of fibromyalgia increases with age and is more common among women as well as people with lupus or rheumatoid arthritis. Treatment usually includes a combnation of medication, exercise, and various lifestyle interventions, although recent years have seen a growing focus on tailoring treatment to address all components comprising the chronic pain experience.²

To explore the effect of low-pressure hyperbaric oxygen therapy on psychological constructs related to pain and quality of life in women with fibromyalgia, investigators conducted a randomized controlled trial involving women diagnosed with fibromyalgia according to the 2016 American College of Rheumatology criteria. For inclusion, patients were required to be 30 - 70 years of age; have undergone a pharmacological treatment for > 3 months with no improvement; and provide written informed consent.¹

In total, 33 participants were enrolled and randomly assigned to an 8-week intervention with 40 low-pressure hyperbaric oxygen treatment sessions (n = 17) or a control group with no therapy (n = 16). In the intervention group, each low-pressure hyperbaric oxygen treatment session lasted 90 minutes and was conducted 5 times per week. Oxygen (1.45 ATA) at 100% concentration was applied individually through a face mask while the participants were inside the hyperbaric chamber.¹

The following parameters were assessed at baseline and upon completion of the study:

• Pain intensity via 10-cm visual analog scale
• Pain catastrophizing via the validated Spanish version of the Pain Catastrophizing Scale for patients with fibromyalgia
• Pain acceptance via the 15-item Spanish validated version of the Chronic Pain Acceptance Questionnaire for people with fibromyalgia
• Psychological flexibility via the Spanish validated version of the Psychological Inflexibility in Pain Scale
• Mental defeat via the Spanish validated version of the Pain Self-Perception Scale
• Physical, mental, and overall quality of life via the Spanish version of the 12-item Short Form Health Survey (SF-12)

Among the total study population, the mean age was 52.76 (Standard deviation [SD], 8.18) years, the mean weight was 70.47 (SD, 15.17) kg (155.36 lbs; SD, 33.44 lbs), and the mean height was 161.51 (SD, 6.27) cm (63.51 inches; SD, 2.47 inches). Investigators noted both groups were well-balanced in terms of physical condition, time since diagnosis, and previous treatments, with no significant differences observed at baseline (P >.05).¹

Results showed participants in the hyperbaric oxygen therapy group experienced significant reductions in self-perceived pain intensity (P <.001; d = 1.24), pain catastrophizing (P <.001; d = 0.97), and mental defeat (P <.001; d = 0.74) after the intervention. Investigators pointed out these patients also experienced notable improvements in pain acceptance (P <.001; d = 0.70) and psychological flexibility (P = 0.01; d = 0.57). Of note, no significant improvements were observed in any parameter in the control group (P > .05).¹

Regarding quality of life, the hyperbaric oxygen therapy group again experienced significant improvements from baseline, including measures of the SF-12 related to the following variables:

• General health (P = .02; d = 0.41)
• Physical functioning (P = .003; d = 0.79)
• Physical role (P = .02; d = 0.58)
• Emotional role (P = .004; d = 0.60)
• Bodily pain (P <.001; d = 1.36)
• Mental health (P <.001; d = 1.41)
• Vitality (P <.001; d = 1.15)
• Social functioning (P <.001; d = 1.15)
• Total SF-12 score (P <.001; d = 1.31)

However, participants in the control group showed no significant improvements in any of the aforementioned items (P >.05).¹

Investigators pointed out several potential limitations to these findings, including the small sample size, the fact that only female participants were included, and the lack of evaluation of biological mechanisms underlying the observed findings.¹

“Low-pressure hyperbaric oxygen therapy is effective at improving the psychological constructs related to pain (self-perceived pain intensity, pain catastrophism, pain acceptance, pain flexibility, mental defeat) and quality of life among women with fibromyalgia. Therefore, hyperbaric oxygen therapy may be considered a valid therapeutic approach to improving pain management among fibromyalgia patients,” investigators concluded.¹

References:

1. ^{Izquierdo-Alventosa R, Inglés M, Cortés-Amador S, et al. Effects of a low-pressure hyperbaric oxygen therapy on psychological constructs related to pain and quality of life in women with fibromyalgia: A randomized clinical trial. Medicina Clínica. https://doi.org/10.1016/j.medcli.2023.12.016}
2. ^{US Centers for Disease Control and Prevention. Fibromyalgia. Arthritis. May 25, 2022. Accessed June 13, 2024. https://www.cdc.gov/arthritis/types/fibromyalgia.htm}