The study results have been published in PLOS One, an open-access journal.
What Is Fibromyalgia?
Fibromyalgia, a chronic pain syndrome, affects soft tissue and muscles. The symptoms of this syndrome are painful trigger points or tender points, sleep problems, fatigue, and chronic muscle pain. It can be relieved with stress management, changes in lifestyle, and use of medications.
According to Eshel Ben-Jacob, a leading author of the study who also designed an analytical process for showing the link between improvement in patients and changes within their brain, women comprise over 90% of people affected by fibromyalgia. Ben-Jacob is also a biosciences adjunct professor in Rice University, a senior investigator in Rice’s Center for Theoretical Biological Physics, and a physics professor and member of Sagol School of Neuroscience in Tel Aviv University.
He explains that in about 70% of women who participated, symptoms were related to pain’s interpretation in their brain. He added that these individuals displayed the most remarkable improvement with HBOT, with significant changes in brain activity occurring.
Another recent study in PLOS One has identified an RNA-based biomarker for the diagnosis of fibromyalgia. Ben-Jacob reported that various treatments, from lifestyle changes to drugs, have been applied to relieve the suffering of patients, with limited success. He also highlighted that most people are unfamiliar with fibromyalgia, and those who are, including many doctors don’t consider it a real disorder. Disorders like fibromyalgia, which affect mainly women, often give way to skepticism among the community of medical professionals. These days, fortunately, efforts to understand the influence of gender on body disorders are increasing.
Researchers in Sagol Center for Hyperbaric Medicine and Research in Tel Aviv University and Assaf Harofeh Medical Center were studying the patients of post-traumatic brain injury when they realized that HBOT treatment for fibromyalgia can prove to be quite effective. Dr. Shai Efrati, lead author of the study, head of the research and development department in Assaf Harofeh Medical Center, and a member at Sagol School of Neuroscience in Tel Aviv University, reported that, for patients affected by fibromyalgia along with post-concussion symptoms, symptoms were completely resolved.
What Is HBOT?
Hyperbaric Oxygen Therapy (HBOT) is a medical treatment in which patients are exposed to 100% oxygen inside a hyperbaric chamber, at higher than normal atmospheric pressure. HBOT is commonly employed in treating decompression sickness (the bends), carbon monoxide poisoning, burns, and embolisms.
Such exposure to high oxygen levels pushes more oxygen into the bloodstream of a patient, which then makes its way to the brain. Earlier trials conducted by Efrati found that this therapy induces neuroplasticity, resulting in repair of brain functions that are chronically impaired. The trials also discovered that HBOT improves the quality of life in cases of mild traumatic injury and post-stroke patients, even after years following the initial injury.
Ben-Jacob outlined that two patients pioneered the push for conducting the study. One of them was a graduate student from Oxford who became affected by fibromyalgia after being involved in a train crash that led to traumatic brain injury. Coincidentally, the secretary of the unit where she used to work is the mother of a nurse who is in charge of HBOT. She advised her to go and try HBOT for fibromyalgia treatment, stated Ben-Jacob.
The other patient is a sociology professor specializing in post-traumatic stress disorders induced by child abuse. The professor had been suffering from fibromyalgia for a number of years, and while her symptoms became worse during the initial treatments — a common experience for the other patients in the study — her symptoms eventually subsided.
By completion of Hyperbaric Therapy, both women showed significant improvement, reported Ben-Jacob.
Efrati noted that some patients may need follow-up sessions, as the abnormalities within the brain regions that cause the chronic pain sensation associated with fibromyalgia can be triggered by various events. Long-term responses may therefore differ.
When traumatic brain injury triggers fibromyalgia, the syndrome can be completely resolved without requiring any further treatment. When triggers are, however, led by other causes, like diseases related to fever, patients are likely to require periodic maintenance therapy.
The Clinical Trial
60 women who had been affected by fibromyalgia for at least 2 years were involved in the clinical trial. 12 women left the trial for varying reasons, but the remaining 48 women completed the training. Half of them were given 40 treatments of HBOT for fibromyalgia treatment, for 5 days a week over 2 months. Each treatment, which lasted for 90 minutes, subjected the patients to 100% oxygen at an atmospheric pressure double than the normal.
The other half of the patients were a part of the crossover-control group. They were evaluated prior to the trial and following a control period, during which their conditions didn’t improve. After the control period of 2 months, the same Hyperbaric Oxygen Therapy was given to them as the other group and resulted in considerable relief.
As noted by the researchers, the successful treatment allowed the patients to significantly lower or even eliminate pain medication use. The researchers highlighted that taking the drugs relieved the pain, but didn’t reverse the condition. On the other hand, HBOT reversed the condition.
Efrati believes that the findings demand further study in this field. Unlike current treatment options available for the syndrome, HBOT for fibromyalgia doesn’t aim for just improvement in symptoms, but rather targets the real cause – the pathology in brain responsible for fibromyalgia syndrome. It implies that repair of the brain, including even regeneration of neurons, is possible for even long-lasting, chronic pain syndromes. We can and we should aim for this in future treatment developments.