Comprehensive Guide to Hyperbaric Oxygen Therapy Uses

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How to Read This

Hyperbaric oxygen therapy uses offer significant benefits for recovery and wellness. Everyday Hyperbaric provides expert guidance and treatments tailored to your needs. HBOT applications range from aiding decompression sickness to enhancing wound healing. Explore the potential of hyperbaric oxygen therapy uses and book your consultation today for a healthier tomorrow.

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******* All information written in this document are referenced from medical citations and not in any way medical advice nor is it statements from Everyday Hyperbaric*******

 

Hyperbaric Oxygen Therapy (HBOT) — Extensive List of Uses

 

 Widely recognized / guideline-accepted uses (UHMS/FDA)

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·        Decompression sickness (DCS)

·        Air/arterial gas embolism (AGE)

·        Carbon monoxide poisoning (± cyanide exposure)

·        Gas gangrene (clostridial myositis/myonecrosis)

·        Necrotizing soft tissue infections

·        Crush injury / acute traumatic ischemia (compartment syndrome risk)

·        Central retinal artery occlusion (CRAO)

·        Severe anemia (when transfusion is impossible/refused)

·        Acute thermal burns

·        Refractory osteomyelitis

·        Intracranial abscess

·        Delayed radiation injury (soft tissue & osteoradionecrosis)

·        Compromised grafts & flaps

·        Selected problem wounds (e.g., diabetic foot ulcers)

·        Idiopathic sudden sensorineural hearing loss (ISSNHL, guideline-dependent)

 

 Common off-label / investigational uses

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Neurologic & cognitive:

·        Traumatic brain injury (TBI), mild TBI / post-concussive symptoms

·        Stroke recovery (chronic deficits)

·        Hypoxic-ischemic brain injury (post-arrest)

·        Migraine (frequency/severity reduction)

·        Cluster headache (abortive/adjunct)

·        Multiple sclerosis (symptom modulation)

·        Cerebral palsy (motor function, pediatric)

·        Autism spectrum disorder (behavioral/cognitive endpoints)

·        ALS / neurodegeneration (symptom support)

·        Post-COVID cognitive symptoms / brain fog

·        PTSD, anxiety, depression adjunct

·        Parkinson’s disease (motor/non-motor symptoms)

·        Alzheimer’s disease / mild cognitive impairment (MCI)

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Musculoskeletal, sports & pain:

·        Athletic recovery / delayed-onset muscle soreness

·        Muscle/tendon/ligament healing

·        Fracture nonunion / delayed union

·        Avascular necrosis (osteonecrosis)

·        Complex regional pain syndrome (CRPS)

·        Fibromyalgia

·        Myofascial pain syndromes

·        Rheumatoid/autoimmune arthritis (inflammation modulation)

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Wounds & skin:

·        Pressure injuries (bedsores)

·        Venous leg ulcers

·        Non-diabetic chronic wounds

·        Burn reconstruction & graft optimization

·        Keloids/hypertrophic scars (adjunct)

·        Necrobiosis lipoidica / livedoid vasculopathy

·        Pyoderma gangrenosum

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Infection-related (adjunct):

·        Refractory fungal/atypical infections (select cases)

·        Mycobacterial/actinomycotic infections

·        Diabetic foot infections (adjunct to antibiotics/debridement)

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Vascular / ischemia-reperfusion:

·        Critical limb ischemia (adjunct)

·        Raynaud’s phenomenon / digital ischemia

·        Ischemia-reperfusion injury reduction (peri-operative research)

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Radiation-related (beyond guideline-recognized):

·        Radiation cystitis, proctitis, enteritis (symptom control)

·        Radiation-induced lymphedema (adjunct)

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ENT / dental / maxillofacial:

·        Osteoradionecrosis prevention (Marx protocol variants)

·        Refractory idiopathic tinnitus

·        Chronic osteomyelitis of the jaw

·        Temporomandibular disorders (pain/inflammation)

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Ophthalmology:

·        Central retinal artery occlusion (CRAO)

·        Radiation maculopathy/retinopathy

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Endocrine/metabolic:

·        Diabetes-related wound complications (beyond strict payer criteria)

·        Metabolic syndrome/inflammation markers (early data)

·        Diabetic neuropathy pain (exploratory)

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Gastrointestinal/pelvic:

·        Radiation proctitis/cystitis/enteritis

·        Perianal Crohn’s fistula (adjunct)

·        Chronic pelvic pain syndromes

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Dermatology & aesthetic adjuncts:

·        Challenging postoperative wounds / cosmetic surgery optimization

·        Chronic radiation dermatitis

·        Skin rejuvenation/anti-aging claims (limited evidence)

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Oncology (adjunctive care):

·        Management of radiation side-effects

·        Peri-treatment wound healing after tumor resection/reconstruction

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Women’s health:

·        Pelvic radiation injury sequelae

·        Vulvar lichen sclerosus (experimental)

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Post-viral syndromes:

·        Long-COVID / post-viral fatigue

 

Anecdotal / experimental / edge uses

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·        Lyme-associated symptoms

·        Chronic fatigue syndrome (ME/CFS)

·        Autonomic dysfunction (POTS)

·        Erectile dysfunction (vascular causes, speculative)

·        Hearing disorders beyond ISSNHL (e.g., Meniere’s)

·        Cosmetic ‘wellness’/anti-aging marketing claims

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Important Cautions & Disclaimers

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• Not medical advice — consult a hyperbaric physician for protocols and risks.
• Absolute contraindication: untreated pneumothorax. Relative: COPD with CO₂ retention, sinus/ear disorders, certain chemotherapy drugs, and implanted devices.
• Risks: barotrauma, oxygen-toxicity seizures (rare), vision changes, strict fire-safety requirements.
• Evidence varies widely — from high-quality guidelines down to case reports.

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FDA/UHMS‑Recognized Indications (Examples)

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The Undersea & Hyperbaric Medical Society (UHMS) lists a set of indications widely recognized by payers and regulators. Examples include: air or gas embolism; carbon monoxide poisoning (± cyanide); gas gangrene; crush injury/compartment syndrome; decompression sickness; central retinal artery occlusion; enhancement of healing in selected problem wounds; severe anemia; intracranial abscess; necrotizing soft‑tissue infections; refractory osteomyelitis; delayed radiation injury (soft tissue/bony necrosis); compromised grafts/flaps; acute thermal burns; idiopathic sudden sensorineural hearing loss. [1][2][3]

The FDA advises receiving HBOT at facilities accredited/inspected for this purpose and warns against promotional claims for uncleared uses. [4]

The FDA has also referenced large zippered bag devices that are intended to pressurize for altitude‑sickness scenarios; these are not cleared for connection to oxygen tanks or concentrators for hyperbaric treatment. [4]

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Evidence Highlights (Selected Areas)

 

• Diabetic foot ulcers (DFU): Multiple meta‑analyses of randomized trials suggest HBOT, as an adjunct to standard care, can increase complete healing and may reduce major amputations in selected patients, though heterogeneity exists and adverse events can be more frequent. [5][6][7][8]

• Late radiation tissue injury (e.g., osteoradionecrosis, radiation cystitis/proctitis): Cochrane reviews report signals of benefit in some outcomes but emphasize small trials and the need for better evidence. [9][10]

• Carbon monoxide poisoning: Evidence is mixed. An influential RCT suggested reduced cognitive sequelae with HBOT, while the latest Cochrane review concludes evidence remains insufficient due to trial limitations and inconsistency. [11][12]

• Neurologic conditions (e.g., stroke recovery, traumatic brain injury/post‑concussion syndrome): Some randomized trials report improvements in selected outcomes, but other assessments find no advantage over sham in mild TBI and call for more rigorous studies. Findings should be interpreted cautiously. [13][14][15][16]

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Safety & Contraindications (Non‑Exhaustive)

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Absolute: untreated pneumothorax. Relative/considerations include COPD with CO₂ retention, certain ear/sinus disorders, claustrophobia, some ophthalmologic histories, recent thoracic surgery, active URI/sinusitis, and specific implanted devices (require manufacturer pressure testing/clearance). Risks include barotrauma (ear/sinus), oxygen toxicity/seizure (rare), vision changes, and very rare fire risk—thus the emphasis on accredited facilities and following manufacturer instructions. [17][18][4]

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Important Disclaimers

 

• Everyday Hyperbaric does not provide medical advice in this document. For treatment decisions, consult your physician or schedule a clinical consultation.

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References

 

[1] Undersea & Hyperbaric Medical Society. HBO Indications (15th ed., list). https://uhms.org/... (accessed 2025).

[2] Moon RE. HBO Indications — UHMS. https://www.uhms.org/... (accessed 2025).

[3] StatPearls. Hyperbaric Patient Selection / Indications (NCBI Bookshelf).

[4] U.S. FDA. Consumer Update: “Hyperbaric Oxygen Therapy: Get the Facts.” FDA also advises care at UHMS‑accredited facilities.

[5] Asian Journal of Surgery (2022). Meta‑analysis of HBOT for DFU: ↑healing, ↓major amputation (20 RCTs).

[6] Int Wound J (2024). Systematic review/meta‑analysis: ↑complete healing; mixed amputation effects.

[7] Int Wound J (2024/2025). Meta‑analysis updates; note retraction notice on one analysis; see PubMed records.

[8] Salama et al., 2019 RCT: ↑complete closure vs. standard care in non‑ischemic DFU.

[9] Cochrane Database Syst Rev (2023). HBOT for late radiation tissue injury — cautious conclusions.

[10] Cochrane Database Syst Rev (2012 update). HBOT for late radiation tissue injury.

[11] Weaver et al., NEJM (2002). HBOT reduced cognitive sequelae post‑CO poisoning at 6 weeks.

[12] Cochrane Database Syst Rev (2022). HBOT for carbon monoxide poisoning — insufficient evidence overall.

[13] Efrati et al., PLoS One (2013). RCT: improvements in post‑concussion syndrome after HBOT.

[14] Boussi‑Gross et al., Stroke‑related RCT (2013): late neuroplasticity in chronic stroke with HBOT.

[15] Rapid Evidence Assessment (2016): HBO2 for TBI — mild TBI no better than sham; mixed results otherwise.

[16] 2020 RCT (mTBI/PPCS): improvements vs. control at 150 kPa.

[17] StatPearls. Hyperbaric Oxygen Therapy — Contraindications and risks (NCBI Bookshelf).

[18] FDA / UHMS safety communications: follow manufacturer IFU; fire‑safety protocols for HBOT devices.