Trauma & PTSD
Can high-pressure oxygen ease pain and trauma symptoms after abuse?
Open access · cc by · source: Europe PMC
In a small unblinded trial, women with fibromyalgia who had survived childhood sexual abuse reported much less pain, distress and PTSD symptoms after hyperbaric oxygen than during a period of therapy alone, alongside changes in brain scans.
Study at a glance
- Design
- RCT — Randomized 1:1 to 3 months of hyperbaric oxygen (60 sessions) or 3 months of continued psychological therapy, after which the control group crossed over to hyperbaric oxygen; no sham chamber and participants were not blinded
- N
- N=30 · 40 women were randomized, 10 dropped out before baseline, and 30 were analyzed at the second evaluation (28 at the third); brain imaging was available for about 27-28 women
- Population
- Adult Israeli women with fibromyalgia for at least five years and a history of childhood sexual abuse, who had not responded to previous psychological and drug treatments
- Outcome
- Whether women still met fibromyalgia diagnostic criteria (primary), pain and function scales, quality of life (SF-36), psychological distress (BSI-18), PTSD symptom severity (PSS-I), SPECT brain perfusion and MRI-DTI white-matter measures
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Key findings
After treatment, 53.3% of the oxygen group no longer met fibromyalgia criteria, compared with 6.7% of the control group after the control period; 46% of the control group recovered once they crossed over. PTSD symptom scores fell by 29% with oxygen versus a slight 4% worsening during the control period, and distress, depression, anxiety and all quality-of-life domains also improved with large effects. SPECT showed increased activity in several frontal regions including the subgenual cingulate area, and diffusion MRI showed higher white-matter integrity in the thalamus, insula and anterior thalamic radiation. Nine women (32%) had intense emotional flooding with re-experienced childhood memories during treatment.
Methodology
Forty women with long-standing fibromyalgia and a history of childhood sexual abuse were randomized either to hyperbaric oxygen therapy or to a control period, and 30 were analyzed. The treatment was 60 daily sessions breathing pure oxygen at twice normal atmospheric pressure, over about 3 months; both groups also received ongoing psychological support. After the control period, the control group crossed over and also received the oxygen treatment. The researchers compared questionnaires on pain, function, quality of life, distress and PTSD symptoms, plus SPECT brain-perfusion scans and diffusion MRI, before and after each period.
Limitations
The sample was small (30 analyzed), and there was no sham chamber, so the women knew whether they were being treated, which matters because almost every clinical outcome was a self-report questionnaire open to expectation and placebo effects. The control group simply continued therapy rather than receiving an equally intensive daily procedure, so attention and routine are confounded with oxygen. The trial registration was posted only at study completion, and the brain-symptom links rest on many region-by-region correlations in a small sample, which the authors interpret generously as 'neuroplasticity'. Results come from one center that specializes in hyperbaric medicine and apply only to a narrow group of treatment-resistant women.
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