Clinical GradeFDA Cleared
For Wound Care
Perry Baromedical
Multiplace Series
Hard-Shell Multiplace·2-18+ person
Pressure3 ATA
$150,000 - $400,000+
FDA-Approved Indication●●●●Strong Evidence
Hyperbaric Therapy for Decompression Sickness
The original hyperbaric oxygen application — and still the definitive treatment for the bends.
Key Takeaways
- Decompression sickness is one of 14 FDA-approved indications for HBOT and the original hyperbaric application.
- Early recompression resolves DCS symptoms in 75–85% of cases.
- US Navy Table 6 (2.8 ATA, ~4.75 hours) is the global standard recompression protocol.
- Treatment within 2–4 hours of symptom onset produces the best outcomes.
- DCS requires clinical-grade chambers at 2.8+ ATA — no home chamber can treat this condition.
- DAN reports approximately 1,000 DCS cases annually in the US.
What is Decompression Sickness?
Decompression sickness (DCS), commonly known as "the bends," occurs when dissolved gases (primarily nitrogen) form bubbles in blood and tissues during rapid depressurization — most commonly during scuba diving ascent. DCS was the original medical condition that drove the development of hyperbaric chambers. Symptoms range from joint pain and skin rashes (Type I DCS) to neurological impairment, paralysis, and death (Type II DCS). The Divers Alert Network (DAN) reports approximately 1,000 cases of DCS annually in the US, though mild cases are likely underreported.
How Hyperbaric Therapy Helps Decompression Sickness
HBOT treats DCS through two primary mechanisms. First, recompression reduces the volume of gas bubbles according to Boyle's Law — at 2.8 ATA, bubble volume decreases by approximately 65%. This provides immediate mechanical relief. Second, breathing 100% oxygen at high pressure creates a large nitrogen gradient, dramatically accelerating nitrogen elimination from tissues. The oxygen also maintains tissue oxygenation despite compromised blood flow caused by bubbles, reduces endothelial inflammation triggered by bubble formation, and prevents the cascade of coagulation and immune responses that cause secondary tissue damage.
Recommended Protocol
Pressure
2.8 ATA (US Navy Table 6)
Sessions
1–3 sessions (emergency)
Duration
4+ hours (Table 6 protocol)
What Does the Evidence Say?
●●●●Strong Evidence
HBOT for DCS has the longest evidence history of any hyperbaric application, dating back to the 19th century treatment of caisson workers. The US Navy Treatment Tables (particularly Table 6) are the gold standard protocols, used worldwide. The evidence is considered definitive — no controlled trials comparing HBOT to no treatment have been conducted because withholding treatment would be unethical given the known effectiveness. Observational data shows that early recompression resolves symptoms in 75–85% of cases, with better outcomes for earlier treatment. The UHMS, DAN, and all diving medicine authorities recommend HBOT as the definitive treatment.
FDA-Approved Indication
Decompression Sickness is one of the 14 conditions for which the FDA has approved hyperbaric oxygen therapy. Insurance coverage may be available with a physician prescription and treatment in an accredited facility.
Recommended Chambers for Decompression Sickness
Based on the protocol requirements — minimum 2.8 ATA, Clinical Grade 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
Clinical GradeFDA Cleared
For Wound Care
Perry Baromedical
Sigma 36
Hard-Shell Monoplace·1-person
Pressure3 ATA
$55,000 - $95,000
Clinical GradeFDA Cleared
For Maximum Comfort
Perry Baromedical
Sigma 40
Hard-Shell Monoplace·1-person
Pressure3 ATA
$65,000 - $110,000
Clinical GradeFDA Cleared
For Wound Care
Perry Baromedical
Sigma 40-II
Hard-Shell Multiplace·2-person
Pressure3 ATA
$100,000 - $160,000
Clinical GradeFDA Cleared
For Wound Care
Perry Baromedical
Sigma Elite
Hard-Shell Monoplace·1-person
Pressure3 ATA
$80,000 - $130,000
Frequently Asked Questions
How quickly should DCS be treated with HBOT?
As quickly as possible. Outcomes are best when recompression begins within 2–4 hours of symptom onset. Treatment within 24 hours still provides significant benefit. Even delayed treatment (days to weeks) can improve residual symptoms. While waiting for HBOT, the patient should breathe 100% oxygen at surface pressure, stay hydrated, and lie flat.
What is US Navy Table 6?
Table 6 is the standard recompression protocol for serious DCS. It involves compression to 2.8 ATA (60 feet of seawater equivalent) breathing 100% oxygen, with scheduled air breaks to prevent oxygen toxicity. Total treatment time is approximately 4 hours and 45 minutes. For severe or refractory cases, the protocol can be extended. Table 5 is a shorter protocol used for milder cases.
Can I buy a home chamber for DCS treatment?
No. DCS treatment requires 2.8+ ATA — beyond the range of any home chamber. Treatment must be conducted in a clinical hyperbaric facility with trained hyperbaric physicians. For divers, knowing the location of your nearest hyperbaric facility and having DAN (Divers Alert Network) insurance is critical preparation.
Related Conditions
Sources & References
Last updated: March 2026. Data sourced from manufacturer specifications, FDA databases, and published clinical research.
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