The Role of Hyperbaric Oxygen Therapy for Treating Fibromyalgia, with Shai Efrati, MD

In an interview with HCPLive, Shai Efrati, MD, co-investigator and founder and director of the Sagol Center for Hyperbaric Medicine and Research at Shamir Medical Center, discusses his recent study evaluating hyperbaric oxygen therapy (HBOT) compared with pharmacological treatment among adults with fibromyalgia related to childhood sexual abuse (CSA).

The research program aims to regenerate damaged brain tissue and, initially, investigators focused on patients with traumatic brain injuries. However, Efrati’s interest in fibromyalgia began when his mother’s fibromyalgia had gotten progressively worse—to the point where she could not interact with her grandchildren. This personal experience drove home the reality that fibromyalgia is a biological, not psychological, condition.

With a significant research group at Tel Aviv University and Shamir Medical Center, Efrati and his team realized the problem in fibromyalgia lies in the brain areas responsible for interpreting bodily signals. These signals are misinterpreted as pain despite no physical issue at the pain site, marking fibromyalgia as a central sensitization syndrome. Various triggers, such as traumatic brain injuries, viral infections like Epstein-Barr virus or COVID-19, and severe emotional stress, can cause this malfunction in the brain.

Treatment focused on repairing the brain tissue, which led to significant symptom improvement. The HBOT protocol Efrati and his team implemented involved using a specialized suite where patients receive 100% oxygen by mask at increased pressure. Every 20 minutes, they would remove the mask, causing a rapid decline in oxygen levels, which the body interprets as hypoxia. This hyperoxic-hypoxic paradox (HHP) stimulates stem cells, generates new blood vessels and neurons, and enhances mitochondrial activity, effectively repairing malfunctioning brain tissue. The treatment period spanned 60 daily sessions, 5 days a week, each 2 hours long.

Results of this trial revealed showed significantly better results among patients receiving HBOT, promoting neuroplasticity and long-term recovery by repairing brain tissue rather than merely alleviating symptoms. This approach treats the core malfunction in the brain, offering lasting benefits.

Disclosures: Efrati is head of Aviv’s Medical Advisory Board.