New Breakthrough in Treatment for Fibromyalgia

Hyperbaric oxygen chambers expose patients to pure oxygen at a higher-than-atmospheric pressure.

New research from Rice University and Institutes in Israel shows that women who suffer from fibromyalgia could benefit from a treatment regimen in a hyperbaric oxygen chamber.

Researchers at the Sagol Center for Hyperbaric Medicine and Research at the Assaf Harofeh Medical Center and Tel Aviv University were studying post-traumatic brain injury patients when they realized hyperbaric oxygen treatment (HBOT) could help patients with fibromyalgia.

This led to a clinical trial involving women diagnosed with fibromyalgia in which the painful condition improved in every one of the 48 patients who completed two months of hyperbaric oxygen therapy. Brain scans of the women before and after treatment gave credence to the theory that abnormal conditions in pain-related areas of the brain may be responsible for the syndrome.

About Fibromyalgia

Fibromyalgia is a chronic pain syndrome that can be accompanied by – and perhaps related to – other physical and mental conditions that include fatigue, cognitive impairment, irritable bowel syndrome and sleep disturbance.

More than 90 percent of those diagnosed with the syndrome are women, according to Prof. Eshel Ben-Jacob, a lead author of the proof-of-concept study who developed the analytical method used to show the association between patients’ improvement and changes in their brains. Prof. Ben-Jacob is an adjunct professor of biosciences at Rice University, a senior investigator at Rice’s Center for Theoretical Biological Physics, a professor of physics and member of the Sagol School of Neuroscience at Tel Aviv University.

"Scientists have not pinned down the syndrome’s cause, although another recent study identified a possible RNA-based biomarker for its diagnosis. A variety of treatments from drugs to lifestyle changes have been tried to relieve patients’ suffering, but generally with limited success".

“Most people have never heard of fibromyalgia,” said. Prof. Ben-Jacob. “And many who have, including some medical doctors, don't even admit that this is a real disorder. I also learned from my M.D. friends that this is not the only case in which disorders that target mainly women raise skepticism in the medical community as to whether they’re real or not. However, these days there are increasing efforts to understand the effect of gender on body disorders.”

Results of the Trial

Findings from the clinical trial involving women diagnosed with fibromyalgia reveal that improvement was observed in every one of the 48 participants after completion of two months of hyperbaric oxygen therapy (HBOT). Before and after treatment brain scans show that abnormal conditions in pain-related areas of the brain may be the primary cause of the syndrome.

Half of the 48 patients received 40 HBOT treatments five days a week over a period of two months. Each treatment session lasted for 90 minutes and exposed patients to pure oxygen at two times the atmospheric pressure. The other half of the patient group was the cross-over control group. Evaluation before and after the trial showed no improvement in their conditions but after the control period was over, they were given HBOT treatments and experienced the same relief.

Fibromyalgia, a chronic pain syndrome that is often accompanied by other physical and mental conditions, generally afflicts women. According to lead author Professor Eshel Ben-Jacob, in nearly 70 percent of the women who participated in the study, the symptoms had to do with the interpretation of pain in the brain. These were the participants who showed the most improvement with this treatment.

The researchers noted the successful treatment enabled patients to drastically reduce or even eliminate their use of pain medications. “The intake of the drugs eased the pain but did not reverse the condition, while HBOT did reverse the condition".

Summary

Results from the current trial are encouraging. Patients will require follow up because the abnormalities in brain regions of patients with fibromyalgia may be trigged by different events. That is why the long-term response could be different. However, results clearly demonstrate that when fibromyalgia is triggered by traumatic brain injury, it can be successfully treated with hyperbaric oxygen therapy. But if the trigger is some other cause, patients may require periodic maintenance therapy.

“We have learned, for example, that when fibromyalgia is triggered by traumatic brain injury, we can expect complete resolution without any need for further treatment. However, when the trigger is attributed to other causes, such as fever-related diseases, patients will probably need periodic maintenance therapy.”

One of the reports co-authors Prof. Shai Efrati noted that the findings warrant further study. “The results are of significant importance since, unlike the current treatments offered for fibromyalgia patients, HBOT is not aiming for just symptomatic improvement,” he said. “HBOT is aiming for the actual cause — the brain pathology responsible for the syndrome. It means that brain repair, including even neuronal regeneration, is possible even for chronic, long-lasting pain syndromes, and we can and should aim for that in any future treatment development.” 

Hyperbaric Oxygen Chambers and HBOT Treatment

Hyperbaric oxygen chambers expose patients to pure oxygen at a higher-than-atmospheric pressure. It is used to treat patients with burns, carbon monoxide poisoning, decompression sickness, embolisms and other conditions. When oxygen levels are pushed into a patient's bloodstream and delivered to the brain, they repair chronically impaired brain functions. Previous studies have shown that this improvement could result in an improved quality of life in post-stroke and mild traumatic brain injury patients.

Editor’s note: After the publication of this study, Rice’s Eshel Ben-Jacob died suddenly at his home in Israel June 5. An obituary appears in the June 8 edition of Rice News.