Could Hyperbaric Oxygen Therapy Help Heal Your Spine?

Usually used for decompression sickness, hyperbaric oxygen therapy may help accelerate wound healing after spine surgery and may even have a place in treating spinal cord injuries. Learn more about this as-yet-unproven but promising treatment.

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What do scuba divers know about treating spine injuries the rest of us don’t? Maybe nothing, but the treatment they use for decompression sickness might provide an edge when you’re healing from back surgery or spine injuries. The treatment is hyperbaric oxygen therapy, and some evidence suggests it can help wounds heal and may even help you function better after a spinal cord injury.

Hyperbaric chamber spineHyperbaric oxygen therapy may help with spine surgery healing and even spinal cord injuries.

What Is Hyperbaric Oxygen Therapy?

Hyperbaric oxygen therapy (HBOT) is a treatment that uses highly pressurized oxygen in a controlled environment called a hyperbaric chamber.

HBOT is a commonly known treatment for decompression sickness experienced by scuba divers, slow-to-heal wounds resulting from diabetes or radiation injury, and serious infections. It may speed healing after spine surgery, and there’s even some evidence to suggest it’s effective i treating spinal cord injuries.

“Simply stated, hyperbaric oxygen therapy is breathing 100% oxygen while under increased [hyper-] atmospheric pressure [-baric],” says Javeed Siddiqui, MD, MPH, and Chief Medical Officer at TeleMed2U.  

Dr. Siddiqui explains that hyperbaric oxygen therapy works by delivering oxygen at high pressure - generally one to three times the air pressure at sea level - resulting in increased oxygen levels in cells and tissues to stimulate healing. 

“The simple explanation is that every cell in the body requires oxygen for normal function. The concept is if a medical procedure can increase the amount of oxygen delivered to injured or damaged cells that in turn will assist in the body’s healing and in wound healing/repair,” Dr. Siddiqui says.

Hyperbaric Oxygen Therapy and Spine Surgery

HBOT can treat a wide variety of conditions, such as:

  • Air or gas bubbles in the bloodstream (arterial gas embolism)
  • Decompression illness
  • Severe anemia
  • Slow-to-heal wounds due to poor blood supply such as diabetic foot ulcers
  • Bone inflammation caused by infection
  • Necrotizing infections

…and more. Dr. Siddiqui relates that based on its successful use in wound healing, hyperbaric treatment for spinal injuries can be a viable treatment approach. He says that all of the wound healing issues “apply in spinal surgery and if determined as appropriate by your medical professional, HBOT may be an important component of your recovery.”

“There are many facets to wound healing and HBOT can impact multiple components of the wound healing cascade. Among the most important issues is that HBOT can increase the formation of new blood vessels known as angiogenesis,” adds Dr. Siddiqui. “It also impacts the production of collagen and fibroblasts which are dependent on oxygen concentrations as well. Finally, HBOT can impact infected wounds as it can increase intracellular leukocyte killing.” That could mean a lower chance of surgical site infection and other complications after spine surgery.

Hyperbaric Chamber Treatment for Spinal Cord Injuries

Based on experimental study findings, HBOT therapy for spinal cord injuries is a promising treatment option. For example, in 11 HBOT therapy spinal cord injury studies done between 2014 - 2016, all showed significant improvement in patients’ motor recovery, according to a 2017 review of literature in Medical Gas Research.

Potential benefits may include:

  • Recovering motor function
  • Improving spinal cord cell health
  • Reducing secondary spinal injury

However, despite clinical research suggesting HBOT benefits, the studies are few in number and not all suggest benefit. Consequently, the spinal healing jury is still out, and more research is needed to determine optimum HBOT treatment protocols and what specific spinal injuries are the best candidates for HBOT therapy.

How Do I Find a Hyperbaric Treatment Center?

Interested in HBOT? You’re not alone. Luckily, there’s probably a facility close to you. There are currently around 1,200 hyperbaric oxygen therapy treatment centers in the United States. Check out the list of Undersea and Hyperbaric Medical Society accredited facilities

Dr. Siddiqui  adds, “I would refer to your local medical professional to know the HBOT sites in your area. Also, you can contact the Undersea and Hyperbaric Medical Society and ask about a specific facility or search their directory of accredited centers.” 

How to Prepare for Your Hyperbaric Oxygen Therapy Session

Once you’ve found a treatment center, it’s time to get ready for your treatment. Here’s some guidelines to follow and some questions to ask. It’s imperative that you adhere to the specific requirements of your HBOT treatment facility.

Some general preparation guidelines include:

  • Don’t consume carbonated beverages or alcohol 
  • If you’re a smoker or use other tobacco products, quit their use during the treatment period.
  • Don’t wear any jewelry, wigs, deoderant, hair products, makeup, or jewelry.
  • Do eat protein-rich snacks or meals to maintain your energy level.

Let your treatment team know:

  • If you’re currently experiencing an ear or sinus infection, flu, cold, or other congestion
  • Your list of nonprescription and prescription medicines
  • If you’re possibly pregnant
  • If you’re having diarrhea, vomiting, or nausea
  • If you’ve not eaten on the day of your treatment

Preparation for hyperbaric therapy also includes banning any potentially combustible devices or substances due to the treatment’s hypersaturated oxygen environment. For example, battery-powered devices, lighters, or other items that produce heat are forbidden in the hyperbaric chamber.   

For the procedure you’ll wear scrubs or a hospital-provided gown. Your health care team will give specific instructions on therapy preparation.

Dr. Siddiqui advises asking your HBOT provider the following clarifying questions:

  1. What is the aim or goal of the HBOT? 
  2. How many treatment sessions do you anticipate I will have to receive in order to achieve this goal?
  3. How long will the HBOT sessions last and at what frequency will they occur?
  4. When will we evaluate if the HBOT is helping the clinical situation? You should have periodic evaluations to assess if the HBOT is making an impact on the clinical issue.
  1. What are the side effects I would anticipate?
  1. What can I bring into the HBOT chamber with me?
  1. How frequently will you be communicating with my primary medical provider?

What to Expect from Hyperbaric Oxygen Therapy

Hyperbaric oxygen therapy is usually an outpatient procedure, although treatments can also be done if you’re hospitalized. Generally, there are two kinds of hyperbaric oxygen chambers:

  • One-person unit: For the individual unit, you’ll recline on a table that’s slid into a clear plastic treatment chamber.
  • Hyperbaric treatment room for multiple-person treatments: The hyperbaric treatment room allows for multiple people to receive simultaneous treatments. You can either lie down or sit. You’ll receive your oxygen via a facemask or by a clear lightweight hood positioned over your head.

During treatment, the room’s air pressure will be two to three times that of normal air pressure. You may experience a “full” feeling in your ears, much like what you may feel when you’re flying in an airplane or in a highly elevated area. Swallowing or yawning can help to alleviate the “full” feeling.

Typically HBOT treatments for most conditions last around two hours. You’ll be constantly monitored during your treatment by the facility’s health care staff.

“Every HBOT client should meet the team of professionals that they will be working with. You need to look at the chamber, how comfortable you will be in the chamber, the attentiveness of the clinical care team, and how well the care team communicates with you and your health care partners,” says Dr.Siddiqui. “You should ask the HBOT team how long the sessions will last, how many sessions per week, if there are conveniences such as video or audio entertainment, also what staff is present at the center, how do they handle emergencies, and what type of emergencies are they able to manage.”

Depending on your specific medical condition, it’s likely you’ll need multiple treatment sessions. For example, a nonhealing wound may need up to 40 or more sessions. while in the case of carbon monoxide poisoning, it may require as little as three treatments.

Hyperbaric oxygen therapy is commonly a facet of a comprehensive treatment plan used in conjunction with medications and other therapies tailored to  your specific condition.

After Therapy - What to Expect During Recovery

After the chamber therapy is finished, you’ll typically have an ear exam and blood pressure and pulse check. Your blood glucose will be tested if you have diabetes. Once the therapy team completes their evaluation, they’ll release you to leave.

Post-treatment, you might be hungry or tired, though not to the extent it would limit your normal activity.

Dr. Siddiqui recommends you talk to your HBOT professional about what to expect during recovery as it will be dependent on the medical issue addressed by the hyperbaric therapy.  

Looking to the Future

HBOT shows promise for incision site healing after spine surgery and for some facets of spinal cord injury recovery. The future looks bright for HBOT when it comes to your back, but it’s nowhere near gold standard treatment for any condition yet.

Updated on: 01/29/21
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