A randomized controlled trial was conducted to examine the usefulness of hyperbaric oxygen treatment (HBOT) for fibromyalgia related to traumatic brain injury (TBI).

Patients with fibromyalgia who previously had TBI were randomly segregated to receive either a pharmacological intervention or HBOT. The HBOT treatment included 60 daily sessions that lasted 90 minutes while inhaling only 100% oxygen through a mask at 2 absolute atmospheres. Drug therapy options encompassed Duloxetine or Pregabalin.

Visual analogue scale (VAS) assessments of subjective pain intensity was the major endpoint ascertained. The secondary outcomes were fibromyalgia symptom questionnaires and single photon emission computed tomography (SPECT) brain imaging using technetium-99m-ethyl-cysteinate-dimer (Tc-99m-ECD). An assessment of conditioned pain modulation and pain threshold was also done.

As shown in Figure 1, there was a substantial group-by-time interaction in pain intensity (assessed using VAS) following HBOT contrasted to the medication group, with a considerable net effect size (d = -0.95) in pain intensity decrease post-HBOT in comparison to drugs.

Substantial enhancements in quality of life, elevation in pain thresholds, and conditioned pain modulation were all seen after HBOT in fibromyalgia-related symptoms and pain questionnaires. In the left frontal and right temporal cortex, SPECT displayed substantial group-by-time interactions amid HBOT and medication groups.

HBOT can benefit individuals with fibromyalgia symptoms induced by TBI in terms of social function, emotional stability, quality of life, and pain symptoms. Elevated brain activity in frontal and parietal areas, which are linked to executive function and emotional processing, is connected with the beneficial clinical effect.