Pain is the most frequent cause for patients to seek medical advice. It covers physical and psychological components and can affect the quality of life.

The International Association for the Study of Pain defines it as an unpleasant emotional and sensitive experience that is associated with a real or potential injury to the tissues. The perception of pain occurs in nerve receptors that respond to noxious stimuli (nociceptors). Many times, this same perception can also be influenced by psychological factors.

The pain can be acute (it does not last more than six months) or chronic (last more than the sixth month). Some examples of acute pain are sports injuries, traumatic injuries, burns, acute radio-lesions, bone and osteoarticular traumas, post-surgical, acute inflammatory diseases such as ulcerative colitis and pelvic inflammatory bowel diseases.

Chronic pains are related to pathologies such as Fibromyalgia, arthritis, osteoarthritis, herniated discs, sciatica, postherpetic pain, trigeminal neuralgia, migraine in clusters, complex regional pain syndrome, diabetic neuropathy, post-ACV pain syndrome, post-radioactive neuropathy or chemotherapy, chronic radio-lesions, and oncological pain. This type of pain is the most difficult to solve by doctors, since it includes physical and psychological components, such as anxiety, reduced mobility, sleep and appetite disorders, and depression.

The symptoms of chronic pain affect the quality of life of patients and cause labor and social limitations. That is why they require the recurrent use of medical resources (consultations with different specialists, medicines and/or analgesics, carrying different therapeutic approaches, etc.), which tends to generate a significant socio-economic burden.

In Europe, the prevalence of chronic pain in the population has been estimated at 20%. Low back pain is the leading cause of moderate to severe chronic pain. The pain not only originates in oncological pathologies, but also in those with inflammatory base, radio lesions, neuro-sensory syndromes, and even in chronic wounds.

How is pain classified according to its intensity?

The pain is classified as nociceptive and neuropathic. Nociceptive pain is caused by the presence of a painful stimulus on the nociceptors. In acute, postoperative injuries and injuries, the main component is nociceptive pain with added inflammation. Neuropathic pain is initiated by an injury or primary dysfunction in the nervous system.

Clear examples of chronic pain to a greater extent are syndromes such as Fibromyalgia, complex regional pain syndrome, myofascial pain, ischemic pain of peripheral vascular disease and multiple sclerosis or amyotrophic lateral sclerosis.

Five out of six herpes infections have neuropathic pain. A significant proportion of patients suffering from chronic back pain, oncological pain or any injury to the spinal cord present a neuropathic component in addition to the nociceptive component.

Neuropathic pain originating in the Central Nervous System can have many causes, but it occurs frequently as a sequela after cerebrovascular accidents or brain traumas and can occur months or years after the event.

How can pain be treated?

There are different treatments for pain. One of them is Hyperbaric Oxygen Therapy (HBOT), a non-invasive method that consists of supplying oxygen at high concentrations in a pressurized hyperbaric chamber at a minimum of 1.4 atmospheres ATM (higher than the normal atmospheric pressure that is 1 atmosphere ). The person is breathing high concentrations of oxygen. This gas is transported to the blood and manages to reach even damaged tissues.

The American Society of Hyperbaric Medicine approved 14 indications with demonstrated efficacy in experimental and clinical studies, but also hyperbaric oxygen therapy is used in more than 100 pathologies in the rest of the world.

Hyperbaric oxygenation is indicated for syndromes that occur with pain, such as Fibromyalgia, complex regional pain syndrome, myofascial pain syndrome, migraine headaches and pain associated with lower limb ischemia due to peripheral vascular disease. However, due to its mechanism of action and activity to reduce neuropathic pain, it can be used to treat all pain related to inflammation.

In pain caused by cancer treatment (chemotherapy or radiotherapy), the hyperbaric chamber therapy showed that it can reduce inflammation caused by radiation and contribute to the decrease of neuropathic pain related to drugs. Therefore, its use allows to reduce the doses of analgesics and modulate the adverse effects of the pathology and conventional treatment.

In rheumatic diseases, it has an anti-inflammatory analgesic effect that is observed mainly in patients with diseases such as Arthritis and mainly in primary and secondary Vasculitis.
Its incorporation in the therapeutic scheme of chronic wound healing not only allows to promote healing but to improve the quality of life and significantly reduce pain in any chronic wound because it reduces inflammation.

In conclusion, HBOT can be considered in any pathology with pain. In addition to being useful in the treatment of neuro-sensitive syndromes, it can be incorporated in the treatment of oncological pain, pain in autoimmune and rheumatological diseases with an inflammatory component, chronic wounds, spinal cord injuries, back pain and even pain in the post-stroke syndrome and brain trauma.

Furthermore, in post-surgical interventions, in addition to promoting healing and reducing postoperative infections, inflammation decreases and quality of life improves in the immediate postoperative period.

Advised: Leonardo Ramallo – (MN 131079)

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