Hyperbaric Oxygen Therapy for Fibromyalgia: What the Research Shows

Important: Hyperbaric oxygen therapy is not FDA-approved for fibromyalgia. This is an investigational use. Evidence is preliminary. Insurance will not cover HBOT for this condition. All costs are out-of-pocket.

Fibromyalgia is hard to treat. Many patients cycle through medications and therapies without finding enough relief. One small but well-designed trial found that HBOT reduced pain and changed brain activity patterns in fibromyalgia patients. That’s worth knowing about, alongside the real costs and limits of what the evidence shows.

What Fibromyalgia Is

Fibromyalgia is a chronic condition marked by widespread musculoskeletal pain, fatigue, sleep problems, and cognitive symptoms often called “fibro fog.” Studies estimate it affects 2-4% of the US population, and most people diagnosed are women.

The cause isn’t fully understood. The leading theory is central sensitization, where the nervous system amplifies pain signals abnormally. That’s why the same stimulus that wouldn’t bother most people can feel intensely painful to someone with fibromyalgia.

Current treatments include FDA-approved medications (duloxetine, milnacipran, and pregabalin), exercise therapy, and cognitive behavioral therapy. Many patients find only partial relief from any single approach.

Why HBOT Is Being Studied

Some research suggests fibromyalgia involves abnormal activity patterns in specific brain regions and reduced blood flow (hypoperfusion) in those areas. That’s different from a structural injury, but it’s a potential target for a therapy that improves cerebral blood flow.

The hypothesis is that HBOT may reduce neuroinflammation, improve blood flow in hypoperfused brain regions, and reduce the central sensitization that drives fibromyalgia pain. These are biological rationales, not confirmed mechanisms.

What the Research Has Found

Efrati et al. (2015) published a randomized controlled trial in PLOS ONE of 60 fibromyalgia patients. Participants received either 40 HBOT sessions or a control treatment. The HBOT group showed significant improvements in pain levels, quality of life, and brain activity on SPECT imaging compared to the control group (PMID: 25849696).

The brain imaging data is what makes this study stand out. It showed objective changes in brain function that correlated with symptom improvements. That’s not just patients reporting that they feel better.

But the sample size was moderate, and the study came from a single center. Independent replication in larger multicenter trials hasn’t happened yet. That limits how confident we can be in the findings.

Practical Considerations

HBOT isn’t FDA-approved for fibromyalgia, and insurance won’t cover it. At $250-450 per session and a typical protocol of 40 sessions, expect to pay $10,000-18,000 out-of-pocket.

Some patients travel to specialized centers that run intensive multi-week protocols. That adds travel and accommodation costs on top of the treatment itself.

Be cautious about clinics that make strong promises about fibromyalgia outcomes. One well-designed trial is a meaningful start, not a settled answer. Your care team should be part of any decision this significant.

Frequently Asked Questions

Is HBOT covered by insurance for fibromyalgia? No. Insurance won’t cover HBOT for fibromyalgia. It isn’t FDA-approved for this use, and all costs are out-of-pocket.

How many HBOT sessions were used in the fibromyalgia study? The Efrati et al. (2015) trial used 40 sessions. At typical clinic rates, that’s $10,000-18,000 total.

Are there other treatments I should try first? Your doctor is the right person to answer that for your situation. The FDA-approved medications and behavioral therapies for fibromyalgia have more established evidence than HBOT does at this point.

What’s the difference between FDA-approved HBOT uses and investigational uses? FDA-approved conditions, like diabetic foot wounds and decompression sickness, have strong evidence and insurance coverage. Investigational uses like fibromyalgia have early research support but haven’t met the evidence threshold for FDA approval. The what is HBOT guide explains this in more detail.

References

Efrati, S. et al. (2015). Hyperbaric oxygen therapy can diminish fibromyalgia syndrome — prospective clinical trial. PLOS ONE. PMID: 25849696. https://pubmed.ncbi.nlm.nih.gov/25849696/

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Medical Disclaimer: This page is for informational purposes only. It does not constitute medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider before pursuing any medical treatment.