Curtis
Some evidence the addition of hyperbaric oxygen in the treatment of severe fibromyalgia improves disability scores.
Clinical bottom line:
1. The use of HBOT seemed safe and the trial was feasible. |
Citation/s:1.Curtis K, Katz J, Djaiani C, O'Leary G, Uehling J, Carroll J, Santa Mina D, Clarke H, Gofeld M, Katznelson R. Evaluation of a Hyperbaric Oxygen Therapy Intervention in Individuals with Fibromyalgia. Pain Med. 2021 Jun 4;22(6):1324-1332. doi: 10.1093/pm/pnaa416. PMID: 33594439.
Lead author's name and fax: Rita Katznelson: rita.katznelson@uhn.ca.
Three-part Clinical Question:For patients with fibromyalgia, does the use of hyperbaric oxygen, compared to standard therapy, result in any symptomatic improvement in symptoms?
Search Terms: Fibromyalgia; feasibility; chronic pain
The Study:Single-blinded concealed randomised controlled trial with intention-to-treat.
The Study Patients: Adult patients with an established diagnosis of severe fibromyalgia as defined by the American College of Rheumatology and attending a chronic pain clinic.
Control group (N = 9; 8 analysed): Standard care with usual medications, exercise regimens and other therapies already in use for each individual. Crossed to receive HBOT at 3 months.
Experimental group (N = 9; 9 analysed): As above plus 100% oxygen breathing at 2.0 ATA for 90 minutes daily five times each week for eight weeks - 40 sessions in total.
The Evidence:
Measure |
Control Group |
HBOT Group |
Difference |
95% CI | ||
Mean |
SD |
Mean |
SD | |||
FIQR* score [0 (normal) to 100 (maximum)] at 8 to 12 weeks |
73.1 |
6.5 |
45.9 |
6.1 |
27.2 |
-13.8 to 68.2 |
HADS-Depression+ [0 (none) to 21 (maximum)] at 8 to 12 weeks |
12.4 |
1.6 |
7.4 |
1.5 |
5.0 |
2.5 to 7.5 |
FSS# [9 (none) to 63 (maximum)] at 8 to 12 weeks |
6.5 |
0.6 |
5.4 |
0.5 |
1.1 |
0.8 to 1.4 |
*Fibromyalgia Impact Questionnaire Revised, +Hospital Anxiety and Depression Scale – Depression; Fatigue Severity Scale
Comments:
1. Participants randomised to a treatment group and a delayed treatment group who were treated after 12 weeks from recruitment.
2. This trial was also a feasibility study of recruitment and retention of participants in the trial, No sample size calculation was made.
3. The authors concluded that HBO led to a sustainable improvement in clinical outcomes for at least three months.
4. There is a strong possibility of participation bias as the patients were all aware of when they were having HBOT.
Appraised by:Mike Bennett m.bennett@unsw.edu.au; Wednesday, 20 October 2021
Kill or Update By: October 2025