Elsevier

Biomedicine & Pharmacotherapy

Volume 109, January 2019, Pages 629-638
Biomedicine & Pharmacotherapy

Hyperbaric oxygen and aerobic exercise in the long-term treatment of fibromyalgia: A narrative review

https://doi.org/10.1016/j.biopha.2018.10.157Get rights and content
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Abstract

Chronic pain is one of the most common clinical presentations in the primary care settings. In the US, Fibromyalgia (FM) affects about 1–3% of adults and commonly occurs in adults between the ages of 40–50 years. FM causes widespread muscular pain and tenderness with hyperalgesia and allodynia and may be associated with other somatic complaints.

Hyperbaric oxygen therapy (HBOT) has been utilized and has recently shown promising effects in the management of FM and other chronic pain disorders. In HBOT, the intermittent breathing of 100% oxygen in a pressurized chamber where the pressure is higher than 1 atmosphere absolute (ATA) has been utilized. HBOT exhibits a significant anti-inflammatory effect through reducing production of glial cells and inflammatory mediators which results in pain alleviation in different chronic pain conditions. HBOT can also influence neuroplasticity and affects the mitochondrial mechanisms resulting in functional brain changes. In addition to that, HBOT stimulates nitric oxide (NO) synthesis which helps in alleviating hyperalgesia and NO-dependent release of endogenous opioids which seemed to be the primary HBOT mechanism of antinociception.

Moreover, aerobic exercise and meditative movement therapies (MMT) have gained attention for their role in pain alleviation through different anti-inflammatory and antioxidant mechanisms.

In this review, we aim to elucidate the different mechanisms of HBOT and aerobic exercise in attenuating pain as adjuvant therapy in the multidisciplinary treatment strategy of chronic pain, and more particularly fibromyalgia.

Abbreviations

ATA
atmosphere absolute
CCI
chronic constriction injury
CREB
cAMP response element-binding protein
CRP
C- reactive protein
CSF
cerebrospinal fluid
eNOS
endothelial nitrate oxide synthase
FM
fibromyalgia
GR
glucocorticoid receptor
HBOT
hyperbaric oxygen therapy
iNOS
inducible nitrate oxidase synthase
MMT
meditative movement therapies
NMDA
N-methyl-d-aspartic acid
NO
nitric oxide
ROS
reactive oxygen species
TCA
tricarboxylic acid
TNF
tumor necrosis factor

Keywords

Fibromyalgia
Hyperbaric oxygen therapy
Exercise
Multidisciplinary treatment

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