Is HBOT FDA-approved for multiple sclerosis?

No. HBOT is not FDA-approved for multiple sclerosis in the United States. It is investigational. Insurance will not cover it for this condition.

Why do UK MS patients use HBOT?

The British Hyperbaric Association has run MS treatment programs for decades. HBOT for MS is more accepted culturally in the UK than in the US. Some UK MS patients report improvements in fatigue and spasticity. This doesn't constitute clinical proof of effectiveness.

Does HBOT stop MS progression?

No. There is no evidence that HBOT stops or slows MS progression. The Cochrane review found no significant effect on primary MS outcomes. Some smaller studies suggest possible benefit for specific symptoms like fatigue.

Hyperbaric Oxygen Therapy for Multiple Sclerosis: What Patients Need to Know

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

Multiple sclerosis involves the immune system attacking the myelin sheath — the protective coating around nerve fibers. This disrupts nerve signals throughout the brain and spinal cord. Symptoms vary widely: fatigue, weakness, spasticity, vision changes, bladder dysfunction, cognitive problems. The disease course ranges from relapsing-remitting to progressive forms.

HBOT has been studied for MS since the 1980s. The evidence, at this point, is mixed at best. Here’s an honest look at what the research shows.

What the Cochrane Review Found

The most rigorous summary of the evidence is the Cochrane review by Bennett and Heard (2004). Cochrane reviews pool and critically analyze all available randomized controlled trials on a topic. They’re the gold standard for evidence synthesis.

This review covered 9 RCTs involving 504 MS patients. The conclusion: no significant benefit for the primary outcomes used to measure MS progression or overall disability. Some benefit was found for bladder control in a subset of patients. PMID: 15266521.

That’s important to say clearly. The strongest available evidence review found no significant primary benefit.

Smaller, more recent studies have suggested possible improvements in MS-related fatigue and spasticity. These haven’t been large enough to change the overall picture, and they haven’t been replicated consistently.

The UK Experience

In the United Kingdom, HBOT for MS is more accepted than in the United States. The British Hyperbaric Association (BHA) has operated MS treatment programs at multiple centers for decades. Some UK neurologists are more open to it as a symptom management option than their U.S. counterparts.

This cultural acceptance isn’t based on stronger evidence — it’s based on long clinical history and patient demand. Some UK MS patients report improvements in fatigue and general well-being. Patient-reported outcomes are meaningful, but they don’t establish clinical effectiveness.

American MS specialists generally follow the guidance of the National Multiple Sclerosis Society, which does not recommend HBOT for MS management and notes the lack of strong evidence.

What HBOT Is Proposed to Do

The theoretical mechanisms in MS center on myelin. One proposal is that HBOT may support remyelination — the partial repair of damaged myelin sheaths. There’s animal model data suggesting possible effects, but this hasn’t been demonstrated convincingly in human MS trials.

The second proposed mechanism is reduced neuroinflammation. MS involves chronic inflammatory damage, and HBOT has documented anti-inflammatory effects in other contexts.

Neither mechanism has been confirmed as the pathway by which HBOT might affect MS. The clinical trial data hasn’t shown an effect large enough to detect in 504 patients across 9 RCTs. That’s a real constraint on how much weight to give the mechanistic theory.

What HBOT Won’t Do

HBOT has not been shown to stop or slow MS progression. The Cochrane review looked directly at this and found no significant effect. Anyone suggesting HBOT can alter the disease course of MS is going beyond what the evidence supports.

HBOT is not a replacement for disease-modifying therapies (DMTs). Drugs like interferon-beta, glatiramer acetate, natalizumab, ocrelizumab, and others have demonstrated effectiveness at reducing relapse rates and slowing progression in clinical trials involving thousands of patients. That evidence base is incomparably larger than anything in the HBOT-MS literature.

Cost and Coverage

Insurance will not cover HBOT for MS in the United States. It’s not a recognized indication.

Session costs run $250-450. If someone is pursuing HBOT for MS symptom management, a shorter protocol (20-30 sessions) is what some UK facilities use for initial assessment. Total costs vary. Talk with the facility about what they recommend and why.

FAQ

Is HBOT FDA-approved for MS? No. It’s investigational in the U.S. Insurance won’t cover it.

What did the Cochrane review find? 9 RCTs, 504 patients, no significant benefit for primary MS outcomes. Some bladder control benefit in a subset. PMID: 15266521.

Why do UK patients use it? The British Hyperbaric Association has run MS programs for decades. It’s more culturally accepted in the UK. This doesn’t mean it’s more effective.

Does HBOT slow MS progression? No. The evidence doesn’t support that claim.

Should I stop my MS medications to try HBOT? No. Disease-modifying therapies have strong evidence. HBOT doesn’t. Talk with your neurologist.

References

Bennett and Heard (2004). Hyperbaric oxygen therapy for multiple sclerosis. Cochrane Database of Systematic Reviews. PMID: 15266521

Medical Disclaimer: This page is for informational purposes only. It does not constitute medical advice. Hyperbaric oxygen therapy for multiple sclerosis is investigational and not FDA-approved. Consult a licensed physician before making any treatment decisions. Individual outcomes vary. This site does not establish a doctor-patient relationship.