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Fibromyalgia and Chronic Fatigue Syndrome

Fibromyalgia and Chronic Fatigue Syndrome

Fibromyalgia symptoms arise from poor oxygenation of the muscle tender points and the skin overlying these tender points.  This lack of oxygenation results from a decreased number of capillaries (small terminal blood vessels) compounded by thickened capillary walls.  An abnormality in how the brain processes pain leads to amplification of the pain, further exacerbating the symptoms.  Hyperbaric oxygen therapy (HBOT) can successfully break the vicious cycle of pain and microcirculatory impairment by delivering much needed oxygen to the dysfunctional muscles.  A clinical study (published May 2015) involving 60 patients has shown that 40 hyperbaric oxygen sessions can correct the brain’s pain processing function based on SPECT imaging.  Essentially, Hyperbaric oxygen acts on the root of the problem to improve the symptoms and quality of life of people with fibromyalgia. Chronic pain management is even more successful when hyperbaric oxygen therapy is combined with aerobic activity (published Jan 2019, see reference list).

Similarly, in people with chronic fatigue syndrome hyperbaric oxygen therapy can help improve oxygen delivery to the brain, thereby reducing the severity of symptoms. Hyperbaric oxygen therapy in chronic fatigue syndrome also increases exercise capacity and improves quality of life.




Fibromyalgia is a chronic widespread musculoskeletal disorder characterized by pain at specific areas (tender points) of the body.  This is accompanied by numerous symptoms such as fatigue, sleep disturbance, irritable bowel syndrome, stiffness, muscle spasm, cognitive or memory impairment, anxiety, depression, and functional impairment.

Chronic fatigue syndrome (also known as systemic exertion intolerance disease or myalgic encephalomyelitis) is a disorder characterized by a longstanding fatigue of more than 6 months.  This is accompanied by numerous symptoms such as cognitive or memory impairment, muscle pain, joint pain, sleep disturbance, and excessive post-exertional malaise lasting more than 24 hours.



Fibromyalgia affects 1.5 % of Canadians aged 12 years and older.  Chronic fatigue syndrome affects 1.4% of the same target population, while 0.3% suffer from both fibromyalgia and chronic fatigue syndrome.  Women account for 80% of all cases of fibromyalgia.  Half of those affected are between 40 to 60 years of age, coinciding with an individual’s period of maximum economic productivity.  Thirty one percent of all Canadians with fibromyalgia have unmet healthcare needs (2010 Canadian Community Health Survey).





Benefits of hyperbaric oxygen therapy (HBO) in Fibromyalgia and Chronic Fatigue Syndrome

  • Shifts abnormal pain processing and brain activity pattern towards those of healthy people
  • Delivers oxygen to poorly oxygenated muscles and skin, effectively breaking the pain-hypoxia (low oxygen) cycle
  • Prevents lactic acid build-up in the muscle, thereby reducing muscle fatigue
  • Improves exercise capacity
  • Down-regulates nitric oxide (a potent signaling molecule thought to be involved in pain processing) in the brain, potentially aiding to decrease pain intensity
  • Decreases severity of symptoms and improves quality of life

 Further reading:

  1. Ablin JN, Lang E, Catalogna M, et al. Hyperbaric oxygen therapy compared to pharmacological intervention in fibromyalgia patients following traumatic brain injury: A randomized, controlled trial. PLoS One. 2023;18(3):e0282406. Published 2023 Mar 10. doi:10.1371/journal.pone.0282406
  2. Efrati S, Golan H, Bechor Y, Faran Y, Daphna-Tekoah S, Sekler G, Fishlev G, Ablin JN, Bergan J, Volkov O, Friedman M, Ben-Jacob E, Buskila D.Hyperbaric oxygen therapy can diminish fibromyalgia syndrome–prospective clinical trial. PLoS One. 2015 May 26;10(5) : e0127012.
  3. El-Shewy KM, Kunbaz A, Gad MM, Al-Husseini MJ, Saad AM, Sammour YM, Abdel-Daim MM. Hyperbaric oxygen and aerobic exercise in the long-term treatment of fibromyalgia: A narrative review. Biomed Pharmacother. 2019 Jan;109:629-638
  4. Akarsu S, Tekin L, Ay H, Carli AB, Tok F, Simsek K, Kiralp MZ. The efficacy of hyperbaric oxygen therapy in the managment of chronic fatigue syndrome. Undersea Hyperb Med. 2013 Mar-Apr;40(2) : 197-200. Erratum in:  Undersea Hyperb Med. 2013 May-Jun;40(3) : 312.
  5. Patrick Neary J, Roberts AD, Leavins N, Harrison MF, Croll JC, Sexsmith JR.Prefrontal cortex oxygenation during incremental exercise in chronic fatigue syndrome. Clin Physiol Funct Imaging. 2008 Nov;28(6) : 364-72.
  6. Kasikcioglu E, Dinler M, Berker E. Reduced tolerance of exercise in fibromyalgia may be a consequence of impaired microcirculation initiated by deficient action of nitric oxide. Med Hypothesis. 2006;66(5) : 950-2.
  7. Yildiz S, Kiralp MZ, Akin A, Keskin I, Ay H, Dursun H, Cimsit M. A new treatment modality for fibromyalgia syndrome: hyperbaric oxygen therapy. J Int Med Res. 2004 May-Jun;32(3) : 263-7.
  8. Van Hoof E, Coomans D, De Becker P, Meeusen R, Cluydts R, De Meirleir K.Hyperbaric Therapy in Chronic Fatigue Syndrome. J Chronic Fatigue Syndrome. 2003 Jan; 11(3) : 37-49.
  9. Jeschonneck M, Grohmann G, Hein G, Sprott H. Abnormal microcirculation and temperature in skin above tender points in patients with fibromyalgia. Rheumatology (Oxford). 2000 Aug;39(8) : 917-21.
  10. Larson AA, Giovengo SL, Russell IJ, Michalek JE. Changes in the concentrations of amino acids in the cerebrospinal fluid that correlate with pain in patients with fibromyalgia: implications for nitric oxide pathways. Pain. 2000 Aug;87(2) : 201-11.
  11. Olsen NJ, Park JH. Skeletal muscle abnormalities in patients with fibromyalgia. Am J Med Sci. 1998 Jun;315(6) : 351-8.
  12. Lund N, Bengtsson A, Thorborg P. Muscle tissue oxygen pressure in primary fibromyalgia. Scand J Rheumatol. 1986;15(2) : 165-73.

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Fibromyalgia recovery

Alexandra M S, Surrey, BC

"... No therapy or medication has ever had such a positive effect on my pain and energy. I have had 29 sessions and I have had more energy and less pain than I ever imagined possible. My daily life has completely changed."

 Vlad C., Burnaby

"I recently did a week long introductory course of the hyperbaric oxygen therapy at Burnaby BaroMedical. I had an excellent experience! Good clinic, modern well maintained state-of-the-art equipment, professional, friendly and very knowledgeable staff.

I am trying out this new (for me) type of therapy trying to treat a couple of different chronic conditions of mine. So far, the results are great! I feel better already after just several sessions..

I highly recommend this clinic. And I highly recommend to try out Hyperbaric Oxygen therapy!"

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 Information contained on this site is intended for general consumer understanding and education. It should not be used as a substitute for any medical professional opinion, advice or prescribed medication nor should it serve as diagnosis or treatment of health problems.