Hyperbaric oxygen therapy (HBOT) for multiple sclerosis (MS)

Mar. 18, 2025

Can hyperbaric oxygen treat multiple sclerosis? --Scientific analysis of efficacy + patient cases + equipment selection guide

What is Multiple Sclerosis

Multiple Sclerosis (MS) is an autoimmune disease of the central nervous system. The immune system mistakenly attacks the myelin sheath (protective layer) of nerve fibers, resulting in impaired nerve signal transmission. Symptoms vary from person to person due to the different locations and severity of nerve fiber damage. These symptoms usually include: movement disorders: muscle weakness, difficulty walking; paresthesia: numbness and tingling in the limbs; vision problems: blurriness or blindness caused by optic neuritis; cognitive decline: memory loss, poor concentration, etc.

MS is not always easy to diagnose in the early stages. Usually, patients diagnosed with MS go through several diagnostic stages, which can be an unsettling and frightening experience. According to statistics, the number of people with MS worldwide has increased from 2.3 million in 2013 to 2.8 million in 2020 and 2.9 million in 2023. It affects people of all ages and is more common in young people and women.

Multiple sclerosis treatment and care

Treatment for MS varies from person to person, depending on the stage of the disease and symptoms.

The goals of treatment for MS are to reduce the frequency and severity of relapses, slow disease progression, control symptoms, and improve quality of life.

Specific disease-modifying therapies for MS should be started as early as possible to slow disease progression and prevent relapses.

Sometimes, steroids are used for a short period to treat relapses. Other drugs may be used to reduce symptoms of MS, such as fatigue, muscle tightness, depression, urinary problems, or sexual dysfunction. These drugs do not change the course of the disease, but they help control symptoms.

Rehabilitation specialists can help people improve function and quality of life, and relieve muscle stiffness and spasticity.

Many people with MS experience fatigue. Ways to help with fatigue include:

Regular exercise

Healthy sleep patterns

Avoiding medications that make fatigue worse.

Limitations of conventional treatments for MS

At present, mainstream treatments for MS include immunosuppressants (such as interferon β), hormone shock therapy, and rehabilitation training, but there are obvious defects:

Drug side effects: long-term use of immunosuppressants increases the risk of infection (such as pneumonia, urinary tract infection);

High relapse rate: about 50% of patients relapse within 5 years;

Unable to repair myelin: existing treatments can only delay the course of the disease, but cannot reverse nerve damage.

Patients urgently need: to find non-drug, low-risk auxiliary therapies to improve the quality of life.

Pathological mechanism of multiple sclerosis and principle of hyperbaric oxygen therapy

Pathological mechanism of multiple sclerosis (MS):

Autoimmune attack: MS is caused by the immune system mistakenly attacking the myelin sheath in the central nervous system (CNS), an insulating layer that protects nerve fibers. It mainly involves the activation of CD4+ T cells, as well as the participation of B cells to produce antibodies against myelin proteins.

Demyelination and inflammation: The inflammatory response leads to myelin destruction, affecting the transmission of nerve signals and triggering clinical symptoms. At the same time, inflammatory cells such as macrophages, T cells, and B cells accumulate in the CNS, further exacerbating inflammation and tissue damage.

Nerve fiber damage: Long-term inflammation and myelin destruction can lead to axonal damage, which is the basis for permanent loss of nerve function.

Blood-brain barrier damage: During inflammation, the integrity of the blood-brain barrier is impaired, making it easier for immune cells to enter the CNS.

Impaired nerve regeneration: The damaged nerve has limited regenerative capacity, partly due to the limited regenerative function of oligodendrocytes.

Mechanism of action of hyperbaric oxygen therapy (HBOT):

Increase oxygen partial pressure: HBOT may help reduce the damage of hypoxia to nerve cells and promote the repair of damaged nerve tissue by increasing the oxygen partial pressure in blood and tissues.

Anti-inflammatory effect: Hyperbaric oxygen may reduce the inflammatory response in MS by regulating the function of immune cells and reducing the production of inflammatory mediators.

Promote angiogenesis: HBOT can stimulate angiogenesis, improve blood flow in the lesion area, and provide better nutrition and oxygen supply to damaged nerves.

Antioxidant and reduce oxidative stress: Hyperbaric oxygen may enhance the antioxidant defense system, reduce the generation of free radicals, and protect nerve cells from oxidative stress.

Promote nerve regeneration: In theory, increased oxygen partial pressure can promote the activation and differentiation of neural stem cells and myelin regeneration, but there is limited direct evidence for this in MS.

Regulate the immune system: Studies have shown that HBOT may indirectly affect the immunopathological process of MS by changing the activity and phenotype of immune cells.

Safety and precautions of hyperbaric oxygen therapy

Safety of HBOT: Generally speaking, hyperbaric oxygen therapy is safe, but it must be performed under professional supervision.

Possible side effects:

Tinnitus and ear pain caused by ear discomfort or pressure changes.

Oxygen toxicity (rarely occurs, usually under long-term exposure to high concentrations of oxygen).

Temporary changes in vision (such as worsening myopia, but usually reversible).

Applicable population and contraindications:

Suitable for patients who want to improve MS symptoms, especially those with fatigue and neurological dysfunction.

Contraindications include uncontrolled pneumothorax, severe lung disease, pregnant women (doctor evaluation required), etc.

Treatment frequency and recommended regimen:

A typical HBOT regimen may include 10-40 treatments, each lasting 60-90 minutes, which need to be personalized.

Warm reminder: Hyperbaric oxygen therapy still plays the role of auxiliary treatment for multiple sclerosis. It can improve symptoms but cannot prevent recurrence. Patients are advised to decide after consulting a doctor.

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Hyperbaric oxygen therapy (HBOT) for multiple sclerosis (MS)