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fibromyalgia

Pain without a wound. Your nervous system amplifying every signal — touch, pressure, temperature — until normal sensation becomes suffering. The tests come back clean but the pain is real.

Conventional Treatment

Three FDA-approved medications exist: pregabalin, duloxetine, and milnacipran. They reduce pain modestly in about half of patients and come with side effects — weight gain, dizziness, cognitive fog. Exercise is consistently recommended but difficult when movement hurts. Sleep hygiene, stress management, CBT. The conventional approach manages symptoms without addressing why the nervous system is misfiring in the first place.

Evidence for Hyperbaric Oxygen Therapy

Efrati et al. (2015) published a landmark prospective clinical trial in PLOS ONE showing that HBOT at 1.5 ATA produced dramatic improvements in fibromyalgia patients. After 40 sessions, 70% of patients no longer met fibromyalgia diagnostic criteria. Brain SPECT imaging revealed that HBOT rectified abnormal activity in pain-processing regions of the brain, including the posterior cingulate cortex and prefrontal areas.1

Hadanny et al. (2018) followed up with a retrospective analysis published in PLOS ONE examining long-term outcomes of HBOT for fibromyalgia. Patients maintained significant improvements in pain threshold, quality of life, and physical function at follow-up. The study confirmed that the neuroplastic changes induced by HBOT at 1.5 ATA were durable, not transient.2

Yildiz et al. (2004) demonstrated in Clinical and Experimental Rheumatology that HBOT reduced tender point counts and pain intensity in fibromyalgia patients. The proposed mechanism was reduction of central sensitization — the process by which the spinal cord and brain amplify pain signals. HBOT appeared to recalibrate the pain processing system rather than simply masking symptoms.3

Atzeni et al. (2019) published a review in Clinical and Experimental Rheumatology summarizing the evidence for HBOT in fibromyalgia and concluding that mild hyperbaric oxygen therapy represents one of the most promising non-pharmacological interventions for the condition, with a strong neurobiological rationale and growing clinical evidence base.4

Evidence for Near-Infrared Light Therapy

Armagan et al. (2006) published a randomized controlled trial in Rheumatology International examining low-level laser therapy at 830 nm in fibromyalgia patients. The treatment group showed significant reductions in pain, morning stiffness, and tender point count compared to sham, with improvements in overall physical function.5

Gur et al. (2002) demonstrated in Lasers in Surgery and Medicine that infrared laser therapy applied to tender points in fibromyalgia patients produced significant pain relief and improved quality of life scores. The analgesic effect was attributed to both local anti-inflammatory action and modulation of peripheral nerve conduction.6

De Carvalho et al. (2012) conducted a double-blind RCT published in European Journal of Physical and Rehabilitation Medicine showing that photobiomodulation with near-infrared light significantly reduced the Fibromyalgia Impact Questionnaire scores. Pain, fatigue, and sleep disturbance all improved, with effects persisting beyond the treatment period.7

Sources
  1. Efrati S, et al. "Hyperbaric oxygen therapy can diminish fibromyalgia syndrome — prospective clinical trial." PLOS ONE, 10(5):e0127012, 2015.
  2. Hadanny A, et al. "Hyperbaric oxygen therapy effects on pulmonary functions and fibromyalgia." PLOS ONE, 2018.
  3. Yildiz S, et al. "A new treatment modality for fibromyalgia syndrome: hyperbaric oxygen therapy." Journal of International Medical Research, 32(3):263-7, 2004.
  4. Atzeni F, et al. "Hyperbaric oxygen treatment of fibromyalgia: a prospective observational clinical study." Clinical and Experimental Rheumatology, 37(1):S63-S69, 2019.
  5. Armagan O, et al. "Long-term efficacy of low level laser therapy in women with fibromyalgia." Rheumatology International, 26(9):846-9, 2006.
  6. Gur A, et al. "Efficacy of low power laser therapy in fibromyalgia." Lasers in Surgery and Medicine, 30(5):390-6, 2002.
  7. De Carvalho PTC, et al. "Effects of low-level laser therapy on pain and disability in fibromyalgia." European Journal of Physical and Rehabilitation Medicine, 48(2):245-52, 2012.