Oxygen Therapy for Concussions

Concussion treatment with hyperbaric oxygen therapy may not be as beneficial as previously thought

/ Author:  / Reviewed by: Joseph V. Madia, MD Beth Bolt, RPh

(RxWiki News) Some military service members who have had concussions report that intensive oxygen therapy relieved their symptoms. But new research questions the effectiveness of this treatment.

Some past studies have found that this therapy significantly helped military personnel who had suffered traumatic brain injury or concussion.

The authors of a recent study found that hyperbaric oxygen therapy may not be as effective as some past trials have found. R. Scott Miller, MD, of the Uniformed Services University of the Health Sciences in Bethesda, MD, and colleagues authored this study.

Dr. Miller and colleagues said that the results suggest that the observed improvements in the hyperbaric oxygen treatment group were not because of the oxygen therapy but may “reflect nonspecific improvements related to placebo effects.”

The placebo effect refers to the perceived effects that fake treatments might have on patients who believe they are being treated.

With hyperbaric oxygen therapy, a patient takes in pure oxygen in a pressurized chamber. The idea is that a high concentration of oxygen in the blood stream may improve areas of the injured brain.

They studied 72 military service members who had ongoing symptoms from concussion at least four months after the injury.

Patients in both the oxygen and sham groups reported that their symptoms improved — but there was no difference in how much they improved. Those who received no air chamber treatment did not improve.

Common postconcussion symptoms include headaches, balance problems, sleep disturbance, fatigue, forgetfulness, poor concentration, irritability and anxiety, Dr. Miller and team noted.

In an editorial about this research, doctors wrote that the hyperbaric oxygen treatment appears not to work, but the ritual of the treatment does. Charles W. Hoge, MD, from the Center for Psychiatry and Neuroscience at Walter Reed Army Institute of Research in Silver Spring, MD, and his colleague Wayne B. Jonas, MD, of the Samueli Institute in Alexandria, VA, wrote the editorial.

“Additional research is needed to better understand the components of an optimal healing environment,” Drs. Hoge and Jonas wrote. “This study invites us to rethink how we support service members and veterans in their recovery from complex war-related health concerns.”

Dr. Miller and team noted that most service members who sustain mild concussion fully recover within 30 days.

Paul G. Harch, MD, an emergency and hyperbaric medicine physician, is one researcher whose studies have shown successful treatment of concussion with hyperbaric oxygen therapy. In one of his studies, 15 military personnel (all diagnosed with concussion) received 40 hyperbaric oxygen treatments. Each patient showed significant improvements in injury symptoms.

Hyperbaric oxygen therapy has long been used to treat decompression sickness experienced by scuba divers, according to the Mayo Clinic. The therapy has also been used to treat serious infections and hard-to-heal wounds.

The study and editorial were published online Nov. 17 in JAMA Internal Medicine. The Defense Health Program and the US Army Medical Material Development Activity funded the research. The US Army Office of the Surgeon General also funded the study. The authors disclosed no conflicts of interest.

Review Date: 
November 17, 2014
Last Updated:
December 28, 2014