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Indications treated with Hyperbaric Oxygen Therapy

There are currently 13 indications that are reimbursable by Medicare in the U.S.  Throughout the rest of the world there are over 65 conditions treated routinely with HBOT.

The following is the list of Conditions treated with HBOT throughout the rest of the world but are currently considered "Off label" in the United States.

Neurological Disorders:

Cerebral Palsy Near drowning
Traumatic Brain Injury Parkinson’s disease
Peripheral nerve injury Epilepsy due to hypoxia
Cerebral edema Autistic disorders
Migraine RSD
Headaches, Cluster TOS
Vegetative coma Hypoxic birth disorders
Stroke Candidas and fungal infections
Multiple Sclerosis Spider bite
Near hanging Mycoplasma
Chemical Poisoning/ Pesticide Mercury Poisoning
Spinal Cord injury Neurovascular compression  

Orthopedic Disorders:

Fracture repair, delayed and non-union Osteoporosis
Bone Grafts Post surgical instability
Aid to prosthesis rehabilitative care Degenerative Joint disease
Sacroiliac Syndrome Inflammatory arthritis
Avascular Necrosis

Auto Immune Related Disorders:

Lupus Rheumatoid Arthritis
Fibromyalgia Scelodrema
Chronic Fatigue Syndrome Guillain-Barre syndrome
Silicone induced disorders  

Traumatology:

Soft tissue musculoskeletal injuries Compartmental syndrome
Closed head injury  

Other:

Lyme Disease

Meniere's Disease

Bell's Palsy

Wound Healing

Pre and Post Surgery healing, reconstruction and cosmetic surgery

Delayed wounds, recurrent ulcers an infections

Acute and Chronic arterial insufficiency

Acute and Chronic Anemia

Retintis Pigmentosa

Macular degeneration

Sudden deafness

Gastric and Duodenal Ulcers

Crohn’s Disease

Colitis

Diabetes

 

CEREBRAL PALSY
The term "cerebral palsy" is not a specific diagnosis, but is now generally applied to children who experience some form of brain trauma either at the time of birth or shortly before. Typically, these children manifest some degree of cognitive impairment as well as physical impairment, often with weakness and spasticity of arms and legs. Typically treatment therapies for children with cerebral palsy have been directed at the physical manifestations of the underlying problem. That is, most efforts are geared to increase range of motion, reduce spasticity, and increase strength, along with specific therapies designed to enhance skills of communication and academic performance.

Evidence from around the globe is now accumulating providing strong support for the use of hyperbaric oxygen therapy (HBO) as an approach to the actual underlying problem in children with cerebral palsy - a technique which actually targets the abnormalities of brain function. The use of hyperbaric oxygen therapy in cerebral palsy offers an exciting new therapeutic approach for the treatment of cerebral palsy. In actuality however, hyperbaric oxygen therapy itself is not a new technique. It has been utilized for decades for the treatment of injuries related to underwater diving, and in addition has found great utility in the treatment of poorly healing wounds, burns, various bone disorders, complications of radiation therapy, circulatory problems, carbon monoxide poisoning, multiple sclerosis, head injury, and stroke.

The effectiveness of hyperbaric oxygen therapy in children with cerebral palsy is likely a manifestation of enhanced function of previously damaged neurons. These neurons have been called "idling neurons" in that while they are still alive, they have been damaged to the extent that their function is compromised.

While it is important to recognize that hyperbaric oxygen therapy clearly represents an important tool in the treatment of children with cerebral palsy, it should be viewed as an adjunctive form of therapy to be used in conjunction with other established treatment protocols including physical therapy, occupational therapy, speech therapy, as well as pharmaceutical therapy designed to reduce spasticity. The use of HBO in children with cerebral palsy is becoming more popular in the United States and there is no doubt that because of its profound effectiveness, its utilization will become much more widespread.

STROKE

It has been estimated that at the present time there are about 1.7 million stroke survivors in this country. Regrettably, a commonly held belief is that once an area of the brain has been damaged by a stroke, nothing can be done to restore the function of that area. Recent scientific research has revealed that while the more central areas of stroke involve brain tissue may be irreversibly damaged, there exists an area surrounding this tissue which may be functionally salvaged with the use of hyperbaric oxygen. Since the early 1970’s, scientific journals have reported over 1,000 cases demonstrating a 40-100% rate of improvement for stroke patients treated with HBO. In the journal Stroke, Dr. Richard Neubauer, a pioneer in the use of hyperbaric oxygen and various neurological diseases, reported outstanding results in a group of 122 stoke patients treated with HBO. In one case, significant functional improvement was noted when HBO therapy was given 14 years after the initial stroke event.

The benefit of hyperbaric oxygen in stroke patients likely results from its ability to enhance the metabolism of so-called "idling nerve cells" as well as increasing oxygen supply surrounding the area of maximal damage.

West Germany has long recognized the effectiveness of HBO in stroke rehabilitation to the extent that now virtually all stroke patients in West Germany receive a three week intensive course of hyperbaric oxygen paid for by insurance companies.

AUTISTIC DISORDERS

"Autism" is not a diagnosis but rather a description of one symptom of a brain-injured child who is usually injured in the cortical and midbrain areas of the brain.  This is opposed to a child with Cerebral Palsy, who's brain injury is in a different area of the brain, the subcortical areas.  This helps explain why Autistic children are improving with HBOT.

Read about one of our patient's amazing improvements in his treatment journal.

MULTIPLE SCLEROSIS
Over the past two decades, extensive international medical research has demonstrated that HBO can play an extremely important role in the treatment of multiple sclerosis (MS). In many European countries, HBO is now considered an integral part of the MS treatment program - in England alone, over 10,000 MS patients are currently receiving hyperbaric oxygen treatment.

In a recent publication in the prestigious New England Journal of Medicine entitled, "Hyperbaric Oxygen Treatment of Multiple Sclerosis, a Randomized, Placebo Controlled, Double-blind Study," researchers demonstrated significant objective improvements in a variety of MS symptoms in 70% of patients treated. At one year after treatment, deterioration was noted in 55% of MS patients not treated as compared to only 12% of patients who underwent hyperbaric oxygen treatment.

Read a patient testimonial.

BELL’S PALSY
 Bell's palsy is a common affliction characterized by the fairly sudden onset of weakness of one side of the face. Typically, patients are offered steroids early in the course of their illness in hopes of reducing swelling of the nerve involved in facial movement. Exciting new research demonstrates that hyperbaric oxygen therapy is significantly more effective than steroids in the treatment of Bell's palsy - both shortening the length of illness as well as increasing the likelihood of full recovery.

MENIERE’S DISEASE
Patients diagnosed with Meniere's disease typically suffer from recurrent attacks of disabling vertigo with progressive hearing loss. Until recently, therapeutic options were limited to either aggressive surgical or medical approaches.

Recent research confirms usefulness of HBO in Meniere's disease. HBO treated patients experienced significant improvement in attacks of vertigo as well as hearing. These improvements continued when these patients were re-evaluated two years after the hyperbaric oxygen treatment program.

LYME DISEASE
Lyme disease, first discovered in 1975, is an infectious illness transmitted by ticks. In the past decade, Lyme disease has spread across the nation and has increased in incidence some ten fold. Lyme infection may produce muscle and joint pain, immune system dysfunction, nervous system abnormalities, cardiac problems, and fever.

Typically, if aggressive antibiotic therapy is initiated early in the course of the illness, successful treatment is achieved. Unfortunately, many patients do not adequately respond to antibiotic therapy and essentially become incapacitated by this illness.

New and exciting research showing the efficacy of hyperbaric oxygen therapy now offers hope to patients crippled by chronic Lyme disease. Dr. William Fife at Texas A & M University has published extensive research demonstrating profound improvements in chronic Lyme disease patients treated with HBO. These improvements include pain reduction, return of clarity of mentation, reduction of depression, and frequently the ability to discontinue antibiotics.

REFLEX SYMPATHETIC DYSTROPHY
 Although uncommon, reflex sympathetic dystrophy can be a crippling disease characterized by swelling and severe pain of an extremity, at times following what would otherwise have been trivial trauma. Treatment options including injection techniques and medication have met with only limited success. Having demonstrated its usefulness in clinical studies, HBO offers an effective treatment option in treating reflex sympathetic dystrophy.

WOUND HEALING
Without question, one of the most widely recognized applications of hyperbaric oxygen has been in the area of wound healing.  These conditions include decubitous ulcers, venous stasis ulcers, arterial insufficiency ulcers, burns, crush injuries, severed limbs, non-healing bone fractures, diabetic foot ulcers, brown recluse spider bites, poorly healing skin grafts, and osteoradionecrosis (bone damage as a result of excessive radiation exposure). The mechanisms by which HBO enhances healing include:

bulletHyperoxygenation - increase tissue levels of oxygen
bulletNeovascularization - enhance growth of new blood vessels
bulletAntimicrobial effect - destroys harmful bacteria
bulletLeukocyte activation - enhances ability of white blood cell to remove bacteria and debris
bulletFibrolastic proliferation - increases growth of cells which form reparative tissue.

Hyperbaric oxygen therapy can be an important adjunct in a comprehensive wound healing program utilized in conjunction with other modalities including surgical, medical, and physiotherapeutic techniques.  

Medicare Reimbursed Indications
  1. Air or gas embolism
  2. Carbon monoxide poisoning and CO poisoning complicated by cyanide poisoning.
  3. Clostridal myositis and myonecrosis, (gas gangrene)
  4. Crush injury, compartment syndrome, and other acute traumatic ischemias.
  5. Decompression sickness
  6. Enhancement of healing in selected problem wounds
  7. Exceptional blood loss (anemia)
  8. Intracranial abscess, actinomycosis
  9. Necrotizing soft tissue infections
  10. Refractory osteomyelitis (Infected bone)
  11. Delayed radiation injury (soft tissue and bony necrosis)
  12. Skin grafts and flaps (compromised)
  13. Thermal burns

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Disclaimer:  In Full Support of the FDA., Hyperbaric Oxygen Therapy for indications other than the 13 UHMS approved indications is considered Off Label.

The content and information provided within this site is for informational and educational purposes only. Consult a doctor before pursuing any form of medical treatment, including Hyperbaric Oxygen Therapy.

The Information provided within this site is not to be considered Medical Advice. Please consult with your Treating Medical Physician.
                                                                                      
Last modified: 01/15/08