What is Hyperbaric Oxygen Therapy?

We can live for weeks without food, only a few days without water, but without oxygen, we all die within minutes. That general overview helps everyone understand the obvious importance of oxygen in the hierarchy of things essential for life. When oxygen is breathed in, it attaches to hemoglobin molecules within the red blood cells. In turn, the hemoglobin is transported throughout the body where oxygen is released as needed. One must first understand the level of importance of oxygen and the fact that it sits at the very top of the chart of substances that sustain life itself. By understanding this simple fact, one can then begin to develop a better understanding of how and why hyperbaric oxygen works. Hyperbaric oxygen simply means 100% oxygen given to patients within pressure chambers that generate greater than normal atmospheric pressure which is almost 15 pounds per square inch (14.7 psi actual) at sea level. As a result, a greater than normal percentage of oxygen is forced to saturate the blood and tissues.

During the 1960s, it was discovered that hyperbaric oxygen (HBO) was effective in treating patients with brain ischemia (lack of blood supply), strokes, arterial occlusion in the limbs, myocardial infarctions (heart attacks), multiple sclerosis and osteomyelitis. That list has continued to grow to the present day. In the 1960s and 1970s, the majority of hyperbaric oxygen treatment chambers were owned and operated by the military. Gradually, the non-military medical community began to use hyperbaric oxygen therapy (HBOT) to treat various recognized conditions.


Associated Conditions

Today, there are hyperbaric oxygen therapy centers that are hospital based and others are based in outlying centers that may or may not be affiliated with a hospital. Typically, the centers that are hospital based only offer treatment for conditions that are considered “labeled” traditional conditions. Labeled conditions are those that are approved by the FDA. There are many other conditions that have been shown and proven to respond very positively to hyperbaric oxygen therapy as well, but are still considered “off- label” because they have not been approved by the FDA and are not paid for by health insurance. In some cases, the research studies are more convincing for many of the off-label conditions than for the labeled conditions. Unfortunately, some things take an unreasonable amount of time to become accepted as being treatable by hyperbaric oxygen therapy. As a result, the vast majority of conditions that have proven to benefit from hyperbaric oxygen therapy, have not been accepted and approved, so they remain off-label.

Off-label conditions include such conditions as: strokes, traumatic brain injuries, near drowning, cerebral palsy, autism, brain concussions, seizures, spinal cord injuries, dementia, reflex sympathetic dystrophy, neuropathies, migraines, ALS, depression, Lyme disease, multiple sclerosis, fibromyalgia, interstitial cystitis, post-surgical healing (plastic), general wound healing or post surgical healing, post injury healing (very important in athletes), macular degeneration, ulcerative colitis, Crohn’s disease, chronic fatigue syndrome, infections and overall health. The results for many of the off-label conditions are truly remarkable in many cases, but it is the patient that must pay for the treatment. Most centers offer one hour HBO treatment sessions at a price range from $150 to $225 per treatment.

One issue, that has resulted in confusion regarding conditions that are treatable by hyperbaric oxygen therapy, has been the development of the so-called canvas bag chambers that are often confused with authentic hyperbaric oxygen chambers. The canvas chambers can reach sustained pressures of only 1.3 atmospheres, compared to authentic hyperbaric oxygen chambers that can achieve almost three times that pressure. While many claims are made about the canvas chambers, the laws of physics and physiology still apply and there is no question that authentic hyperbaric oxygen chambers are superior in many ways.

Different diseases and conditions are treated with different pressures. Conditions such as stroke, traumatic brain injuries and concussions are treated at 1.5 atmospheres of pressure. At the other end of the spectrum are non-healing sports injuries or post-surgical conditions. Those and a number of other conditions are treated at a much higher pressure of 2.36 atmospheres. As an example, studies have already been completed and published that have proven hyperbaric oxygen therapy to accelerate healing in athletes by up to 70%!

Associated Risks

Treatment with hyperbaric oxygen therapy is not without risk. Some patients are claustrophobic and have a fear of tight places. Those patients are counseled and treated with anxiety reducing medications if necessary and it usually ceases to be a problem at that point. Another risk is barotrauma or injury to the tympanic membrane (ear drum) as the result of differing pressures outside and inside the eardrum . All patients are instructed to “clear” (another diving term) their ears during the change in pressure. An attendant is always present beside the chamber to facilitate that procedure and most problems can be avoided with a skilled staff in place. Hyperbaric oxygen therapy can result in oxygen toxicity when treatment is given at higher pressures or for extended times, but this can be avoided with proper monitoring and application.


Hyperbaric Oxygen Therapy Overview

  • Oxygen the most important substance for sustaining life
  • Oxygen can be given under pressure (hyperbaric oxygen or HBO)
  • HBO provides an oxygen rich atmosphere that can help many conditions and diseases
  • Fourteen “Labeled” conditions include those covered by insurance: bends, CO poisoning, cyanide poisoning, gas gangrene, air or gas embolism, diabetic wounds, severe anemia, compromised skin grafts, osteomyelitis, osteoradionecrosis, thermal burns, actinomycosis, crush injures and necrotizing tissue infections.
  • Too numerous to mention “off label” conditions (see “read more”)
  • Treatment pressure determined by condition or disease being treated
  • HBO treatment provided in conjunction with other treatments
  • HBO vastly under-utilized in present medical health care system
  • Significant difference between authentic hyperbaric chambers and canvas bag chambers
  • Risks are trauma to eardrum, claustrophobia and toxicity to oxygen (all can be avoided)

The Importance of Alternative Treatments

While age management has become Dr. Knott’s primary focus, he offers other types of treatment as well including peripheral nerve blocks, prolotherapy and hyperbaric oxygen treatment. As a board certified specialist in the field of Physical Medicine and Rehabilitation, he utilizes a variety of physical therapy modalties in order to treat various injuries and/or conditions. Dr. Knott also performs electrodiagnostic testing (EMGs/nerve conduction studies) when needed. The above noted scope of diagnostic and treatment methods are appropriate for patients with injuries or pain in their neck, back, shoulders, elbows, wrists, hands, rib cage, hips, knees, ankles and feet. All patients are unique and that makes a proper diagnosis the key to the chances of a favorable outcome. Contrary to what you may have heard and have accepted as fact, MOST neck and back pain is NOT the result of a ruptured disc or a pinched nerve and an MRI is NOT the best test to make that determination!

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