Clinical GradeFDA Cleared
For Wound Care
Perry Baromedical
Multiplace Series
Hard-Shell Multiplace·2-18+ person
Pressure3 ATA
$150,000 - $400,000+
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●●●○Moderate Evidence
Hyperbaric Therapy for Chronic Pain
From fibromyalgia to CRPS — what the research says about HBOT for conditions where standard pain management falls short.
Hyperbaric oxygen therapy (HBOT) for Chronic Pain & Fibromyalgia has moderate clinical evidence. This is currently an off-label use and is not covered by insurance. The recommended protocol is 2.0 ATA ATA for 60–90 minutes per session per session over 40 sessions sessions.
Key Takeaways
- Chronic pain affects 50 million American adults; fibromyalgia affects 4 million.
- Efrati et al. (2015) showed significant pain reduction and brain activity changes in fibromyalgia patients after 40 HBOT sessions at 2.0 ATA.
- HBOT addresses pain at the neurological level by reducing central sensitization and neuroinflammation.
- SPECT imaging showed measurable changes in pain-processing brain regions after HBOT.
- HBOT for chronic pain is not FDA-approved and not covered by insurance.
- Evidence is strongest for fibromyalgia and CRPS among chronic pain conditions.
What is Chronic Pain & Fibromyalgia?
Chronic pain affects an estimated 50 million American adults, with approximately 20 million experiencing "high-impact" chronic pain that interferes with daily life. Fibromyalgia alone affects 4 million US adults. Standard treatments — medications, physical therapy, nerve blocks, and increasingly, avoidance of long-term opioids — leave many patients with inadequate relief. HBOT has been studied as an alternative intervention that addresses pain at the neurological level rather than masking symptoms pharmacologically.
How Hyperbaric Therapy Helps Chronic Pain & Fibromyalgia
Chronic pain often involves central sensitization — the nervous system amplifying pain signals beyond what tissue damage warrants. Neuroinflammation in the brain and spinal cord perpetuates this cycle. HBOT at 2.0 ATA reduces neuroinflammation by suppressing pro-inflammatory cytokines, modulates pain-related neural activity in the brain, promotes repair of damaged nerves (particularly relevant for neuropathic pain), and may help reset the central sensitization that keeps pain persistent. For fibromyalgia specifically, HBOT has been shown to alter brain activity patterns in areas associated with pain processing, potentially "rewiring" the dysfunctional pain circuits.
Recommended Protocol
Pressure
2.0 ATA
Sessions
40 sessions
Duration
60–90 minutes per session
What Does the Evidence Say?
●●●○Moderate Evidence
A 2015 study by Efrati et al. (the Sagol Center) randomized 48 fibromyalgia patients to HBOT at 2.0 ATA or control. The HBOT group showed significant reduction in pain, improvement in quality of life, and — critically — changes in brain activity on SPECT imaging that correlated with symptom improvement. A 2021 systematic review found that HBOT showed promise for fibromyalgia, complex regional pain syndrome (CRPS), and neuropathic pain, though evidence quality was generally low to moderate. For CRPS specifically, several case series have shown dramatic improvement with HBOT. The evidence is more developed for fibromyalgia than for general chronic pain.
Off-Label Use
Chronic Pain & Fibromyalgia is not an FDA-approved indication for HBOT. Treatment is considered off-label and is typically not covered by insurance. Consult your physician before starting any HBOT protocol.
Recommended Chambers for Chronic Pain & Fibromyalgia
Based on the protocol requirements — minimum 1.5 ATA, Clinical Grade or Advanced Wellness tier. Sorted by clinical credibility score.
Clinical GradeFDA Cleared
For Wound Care
Perry Baromedical
Sigma 34
Hard-Shell Monoplace·1-person
Pressure3 ATA
$50,000 - $90,000
View DetailsGet Quote
Clinical GradeFDA Cleared
For Wound Care
Perry Baromedical
Sigma 36
Hard-Shell Monoplace·1-person
Pressure3 ATA
$55,000 - $95,000
View DetailsGet Quote
Clinical GradeFDA Cleared
For Maximum Comfort
Perry Baromedical
Sigma 40
Hard-Shell Monoplace·1-person
Pressure3 ATA
$65,000 - $110,000
View DetailsGet Quote
Clinical GradeFDA Cleared
For Wound Care
Perry Baromedical
Sigma 40-II
Hard-Shell Multiplace·2-person
Pressure3 ATA
$100,000 - $160,000
View DetailsGet Quote
Clinical GradeFDA Cleared
For Wound Care
Perry Baromedical
Sigma Elite
Hard-Shell Monoplace·1-person
Pressure3 ATA
$80,000 - $130,000
View DetailsGet Quote
Frequently Asked Questions
Does HBOT help with fibromyalgia?
The evidence is more promising for fibromyalgia than for many other chronic pain conditions. The 2015 Efrati study showed significant pain reduction and brain activity changes after 40 sessions at 2.0 ATA. Many fibromyalgia patients report meaningful improvement in pain, fatigue, and cognitive symptoms ("fibro fog"). However, results vary and not all patients respond equally.
Can HBOT reduce the need for pain medication?
Some patients report being able to reduce pain medication after HBOT protocols, including opioids. However, any medication changes should be managed by your physician. HBOT should be considered an adjunct to comprehensive pain management, not a replacement for medical care.
How long do pain relief effects last after HBOT?
The duration of benefit varies. Some patients report sustained improvement for months after completing a protocol. Others find that periodic "booster" sessions (1–2 per week) help maintain benefits. The brain activity changes documented on SPECT imaging suggest that some effects may be long-lasting, but more research on durability is needed.
Which types of chronic pain respond best to HBOT?
Fibromyalgia has the strongest evidence, with an Israeli RCT demonstrating measurable improvements in pain, quality of life, and brain activity. Complex Regional Pain Syndrome (CRPS) shows promising case reports and small series. Neuropathic pain and post-herpetic neuralgia may respond due to HBOT's nerve-regenerating effects. Musculoskeletal pain from inflammation typically responds faster than centrally mediated pain syndromes. Headaches and migraines have a separate evidence base. Pain caused by compromised blood flow (ischemic pain, Raynaud's) tends to respond well. Cancer treatment-related pain and radiation-induced nerve damage are areas with emerging evidence.
Can HBOT reduce dependence on pain medications or opioids?
Several case series and patient reports describe reduced need for pain medication following HBOT, including reduced opioid use in fibromyalgia and CRPS patients. The mechanism is plausible: HBOT reduces neuroinflammation, promotes endorphin release, and may restore normal pain signaling pathways. However, no large randomized controlled trials have specifically studied opioid reduction as a primary endpoint. Medication tapering should always be managed by the prescribing physician. Some pain clinics are now offering HBOT as an adjunct to multimodal pain management programs specifically to reduce pharmaceutical burden.
Related Conditions
Sources & References
- Efrati et al. (2015) — Hyperbaric oxygen therapy can diminish fibromyalgia syndrome, PLOS ONE
- Atzeni et al. (2021) — Hyperbaric oxygen treatment of fibromyalgia: a prospective study, Clinical and Experimental Rheumatology
- CDC — Chronic Pain and High-impact Chronic Pain Among US Adults
- NIH — Fibromyalgia Information
Last updated: March 2026. Data sourced from manufacturer specifications, FDA databases, and published clinical research.
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