Review Article

Mechanistic Rationale and Clinical Efficacy of Hyperbaric Oxygen Therapy in Chronic Neuropathic Pain: An Evidence-Based Narrative Review

Table 6

HBOT and neuropathic pain–human studies characteristics.

First author, yearArticle titlePain modelStudy design, n patientsInclusion criteriaIntervention (HBOT pressure, duration, n of sessions)Comparator/control

Kiralp, 2004 [33]Effectiveness of hyperbaric oxygen therapy in the treatment of complex regional pain syndromeCRPSRCT, n = 71 (37 intervention, 34 placebo)Clinical CRPS, type I or II2.4 ATA, 90 min x 15Placebo: 2.4 ATA breathing air, 90 min x 15, once daily

Peach, 1995 [35]Hyperbaric oxygen and the reflex sympathetic dystrophy syndrome: a case reportCRPSObservational case reports, n = 1Clinical CRPS, type I2.8 ATA, 46 min x1 + 2.0 ATA, 90 min x 1 + 2.4 ATA, 90 min x 1None

Williams, 2009 [36]Chronic regional pain syndrome after subtalar arthrodesis is not prevented by early hyperbaric oxygenCRPSObservational case reports, n = 1Clinical CRPS type I, Norman Harden and Bruehl diagnostic criteria2.2 ATA, 90 min x 19None

Katznelson, 2016 [37]Successful treatment of lower limb complex regional pain syndrome following three weeks of hyperbaric oxygen therapyCRPSObservational case reports, n = 1Clinical CRPS, type I2.4 ATA, 90 min x 15None

Binkley, 2019 [38]Successful treatment of long standing complex regional pain syndrome with hyperbaric oxygen therapyCRPSObservational case reports, n = 1Clinical CRPS, type I2.4 ATA, 90 min x 40. Second course 7 months later, 2.0 ATA, 90 min x 33.None

van Ophoven, 2004 [39]Hyperbaric oxygen for the treatment of interstitial cystitis: long-term results of a prospective pilot studyICObservational prospective case series, n = 6Symptom criteria of the National Institute of Diabetes, Digestive and Kidney Diseases for IC2.4 ATA, 90 min x 30None

van Ophoven, 2006 [40]Safety and efficacy of hyperbaric oxygen therapy for the treatment of interstitial cystitis: A randomized, sham controlled, double-blind trialICRCT, double-blind, sham controlled, n = 21 (14 intervention, 7 placebo)Diagnostic criteria of the National Institute of Diabetes and Digestive and Kidney Diseases for IC2.4, 90 min x 30Placebo: 1.3 ATA breathing air, 90 min x 30, once daily

Tanaka, 2011 [41]Hyperbaric oxygen therapy for painful bladder syndrome/interstitial cystitis resistant to conventional treatments: long-term results of a case series in JapanICObservational prospective case series, n = 11Diagnostic criteria of the National Institute of Diabetes and Digestive and Kidney Diseases for IC2.0 ATA, 60 min x 10 (8 pts) or x 20 (3 pts)None

Wenzler, 2017 [42]Treatment of ulcerative compared to nonulcerative interstitial cystitis with hyperbaric oxygen: a pilot studyICObservational prospective pilot case series, n = 9Diagnostic criteria of the National Institute of Diabetes and Digestive and Kidney Diseases for IC2.2 ATA, 90 min x 30None

Pritchard, 2011 [43]Double-blind randomized phase II study of hyperbaric oxygen in patients with radiation-induced brachial plexopathyRIBPRCT, double-blind, sham controlled, n = 34 (17 intervention, 17 placebo)Confirmation of RIBP, freedom from cancer recurrence, fitness for HBOT2.4 ATA, 90 min x 30Placebo: 2.4 ATA breathing 41% oxygen, 90 min x 30

Videtic, 1999 [44]Hyperbaric oxygen corrects sacral plexopathy due to osteoradionecrosis appearing 15 years after pelvic irradiationSacral plexopathyObservational case reports, n = 1Clinical diagnosis2.5 ATA, 90 min x 30None

Stowe, 2020 [45]Hyperbaric oxygen therapy for radiation-induced brachial plexopathy, a case report and literature reviewRIBPObservational case reports, n = 1Clinical and radiographic diagnosis2.4 ATA, 120 min x 30None

Peng, 2012 [46]Effect of hyperbaric oxygen therapy on patients with herpes zosterPHNRCT, not blinded, n = 68 (36 intervention, 32 control)Clinical diagnosis of acute herpes zoster2.2 ATA, 80 min x 30, twice a day + medical therapy [antiviral (acyclovir), nerve nutritive (mecobalamin), pain relief (tramadol), and antidepressive (nortriptyline)]Controls: only medical therapy

Gu, 2012 [18]Hyperbaric oxygen therapy attenuates neuropathic hyperalgesia in rats and idiopathic trigeminal neuralgia in patientsTNRCT, n = 42 (22 intervention, 20 placebo)Clinical diagnosis of idiopathic TN1.8 ATA, 70 min x 10Placebo: 1.03 ATA breathing air, 70 min x 10

n = number; HBOT = hyperbaric oxygen therapy; CRPS = chronic regional pain syndrome; IC = interstitial cystitis; RIBP = radiation-induced brachial plexopathy; PHN = postherpetic neuralgia; TN = trigeminal neuralgia; RCT = randomized controlled trial.