RCT 2015
From the library

Hyperbaric oxygen therapy can diminish fibromyalgia syndrome — prospective clinical trial

Efrati et al.

PLoS ONE n = 60 2 ATA 40 sessions
Plain English

Efrati et al. (2015, PLoS ONE) is a prospective, active-control crossover trial of HBOT for fibromyalgia syndrome (FMS) in 60 female patients aged 21–67 who had been diagnosed with FMS for at least 2 years. The first-author misattribution to Boussi-Gross in the slug is a legacy of an earlier, fuzzier site copy; the actual first author is Efrati S, and the published author list does not include Boussi-Gross at all. What the trial measured. The study used a deliberate crossover design with the control arm switching into HBOT after the comparator period, so each patient could serve as their own control. Primary outcomes were dolorimeter-measured pain thresholds, tender-point counts, and standardized life-quality scales (FMS questionnaire, SCL-90, SF-36). The objective backbone was SPECT brain imaging, included specifically to rule out a self-report-only effect. Protocol parameters. 40 sessions at 2.0 ATA, 100% oxygen, 90-minute sessions, 5 days per week — the same protocol shape used in the Israeli group's Efrati 2013 stroke and Boussi-Gross 2013 TBI trials, allowing cross-trial mechanism comparison. Results (verbatim from abstract). The dolorimeter threshold tripled following HBOT (rising from approximately 0.5 to 1.5). Tender-point count reduced by a factor of 2 in the treated group and a factor of 3 in the crossover group. Life-quality scores improved significantly across the FMS, SCL-90, and SF-36 instruments. SPECT analysis showed rectification of abnormal brain activity — decreased hyperactivity mainly in posterior regions, and elevation of reduced activity mainly in frontal areas. The control (no-treatment) period produced no improvement on any parameter, providing a within-trial null comparator. Limitations. All-female cohort (FMS has a 9:1 female-to-male incidence ratio, but the trial does not directly extend to male patients). Sample size (n=60) is modest. The 2.0 ATA protocol requires a clinical chamber; soft-shell home chambers cannot replicate it. Long-term durability beyond the protocol's immediate post-treatment window was not the focus of this paper. What it means in practice. For the Saturate Lyme & Chronic Fatigue condition page, this trial is the closest verified analog to HBOT for chronic-fatigue-cluster conditions. There is no published HBOT-for-Lyme RCT — Efrati 2015 fibromyalgia is the strongest available proxy because fibromyalgia is a frequent comorbid or differential diagnosis in the chronic Lyme population, and the underlying mitochondrial / neuroinflammatory / microcirculatory mechanisms overlap. Source: PubMed PMID 26010952.

Key findings

What the trial documented.

  • Dolorimeter pain threshold tripled following the HBOT protocol
  • Tender point count reduced by a factor of 2 in the treated group and a factor of 3 in the crossover group
  • Significant improvement in life-quality measures (FMS, SCL-90, SF-36)
  • SPECT imaging showed rectification of abnormal brain activity — decreased hyperactivity in posterior regions, elevated activity in frontal regions
  • No improvement in any parameter during the control (no-treatment) period

Fibromyalgia syndrome (FMS) is a chronic pain disorder linked to abnormal central-nervous-system processing. Efrati and colleagues tested whether hyperbaric oxygen could change both symptoms and the underlying brain activity.

What the study looked at

A prospective, active-control, crossover clinical trial enrolled female patients with an established FMS diagnosis. Patients were randomly assigned to a treated arm or a crossover-control arm, with brain activity assessed by imaging alongside symptom measures.

What it found

The authors reported reductions in fibromyalgia symptoms and corresponding changes in brain activity in the treated group, with the control group also improving after crossing over to treatment.

How strong is the evidence?

A single-center crossover trial in a specific (female) population; promising but not definitive. Note: the previous slug attributed this to “Boussi-Gross” — the verified first author is Efrati S. We index it under chronic-fatigue-adjacent conditions because Saturate does not yet have a dedicated fibromyalgia page.

Related on Saturate

See our evidence overview of HBOT for chronic fatigue and related conditions.

Source

Efrati S, et al. (2015). Hyperbaric oxygen therapy can diminish fibromyalgia syndrome – prospective clinical trial. PLOS ONE. doi.org/10.1371/journal.pone.0127012 · PubMed

This content is for educational purposes only and is not medical advice. Hyperbaric oxygen therapy carries genuine clinical risks; consult a qualified clinician. Read our full medical disclaimer.

Protocol used

2.0 ATA, 100% oxygen, 90-minute sessions, 5 days/week for 40 sessions

Full citation

Efrati et al.. Hyperbaric oxygen therapy can diminish fibromyalgia syndrome — prospective clinical trial. PLoS ONE. 2015.

Medical disclaimer

This content is for educational purposes only and is not medical advice. Hyperbaric oxygen therapy carries genuine clinical risks; consult a qualified clinician before starting any protocol. Full disclaimer →