Hyperbaric Oxygen Therapy
What is hyperbaric oxygen (HBO) therapy? It is treatment when a patient breathes in pure oxygen while under increased air pressure.
This increases the oxygen content in the blood and consequently in different body tissues. Medical conditions such as burns, decompression sickness or the bends, severe infections, radiation-induced tissue injury, and carbon monoxide poisoning can use Hyperbaric Oxygen therapy for treatment.
What is the theory behind oxygen treatment?
Breathing a high level of oxygen for a short time to correct a lack of oxygen in the tissues of the body. Oxygen is not very soluble in blood unless the air pressure is increased. The patient will sit in a pressure chamber or barochamber and breathe pure oxygen though masks. The pressure is increased up to twice atmospheric pressure although it can be higher. Once the correct pressure is reached the patients relax. By breathing pure oxygen under pressure many people find relief from their symptoms and, it is thought, some help in slowing down the progression of the disease. The brain is an oxygen guzzler, MS affects the brain so maybe it is good treatment for MS sufferers.
In 1983 a report in the New England Journal of Medicine reported a controlled, double-blinded study on the effect of hyperbaric oxygenation on the symptoms of multiple sclerosis. The report said that there were scientifically demonstrated benefits but recognised the need for long-term studies.
In 2011 the review identified nine randomised and controlled trials of HBO of a reasonable high quality. Only two of these nine trials produced results in favour of HBO. The other 7 trials found no clear positive effects for people with MS.
The majority of the controlled trials could not show beneficial effects of HBO in people with MS. There is no consistent evidence to confirm a beneficial effect of hyperbaric oxygen therapy for the treatment of multiple sclerosis. Some people swear by it others do not believe the routine use of HBO therapy for the treatment of MS is justified. The majority of the MS Therapy Centres offer HBO as treatment
The mind can play some very strange tricks when testing medicines and treatments. Its known as the Placebo Effect. There are people believe that homoeopathy can cause the body to heal itself. A 2010 House of Commons Science and Technology Committee report on homoeopathy said that homoeopathic remedies perform no better than placebos, and that the principles on which homoeopathy is based are ‘scientifically implausible’.
How important is belief in the healing process? Taking a sugar tablet can have the same effect as the real medication if you believe that the sugar coated pill is the real thing. So much depends upon what you believe. Homoeopathy is a classic example.
The big problem with the placebo effect is with drug trials. This is a very complicated field. Suppose a patient is cured with a dummy medicine and not cured with the proper medicine. Is the placebo effect real or is it in your head? Look at me – I was on a double blinded randomised drug trial for SPMS taking Tysabri. Sometimes I think that I was on a dummy drug and other times I am equally convinced that I was on the real thing.
MS Therapy Centres
There are 55 MS Therapy Centres in the United Kingdom and HBO treatment is available in most of them. There are papers that support the opinion that HBO is of limited medical use to help MS sufferers.
At the end of the day the question that remains is why do the MS Therapy Centres invest precious resources in a treatment that has little or no benefits? The NHS almost never sanction HBO for treatment of multiple sclerosis because of the lack of proof that it actually reduces progression.
Brain injuries such as stroke or bruising to the brain can to respond to HBO. Other illnesses such as Type 1 Diabetes, Radiation wounds, Cerebral Palsy and Ulcers may respond to HBO. In the case of multiple sclerosis there is no significant improvement to the condition of the patient.