A study published in Pain Research and Management illustrated the positive effects of HBOT in improving outcomes like quality of life, pain scores, and pain-associated symptoms. This study aimed to summarize the current evidence for the mechanistic rationale of HBOT and to explore its efficacy in neuropathic pain.

Databases such as Embase, Medline, Scopus, PsycINFO, Cochrane, Web of Science, ClinicalTrials. gov, WHO ICTRP, and ProQuest Digital Dissertation were explored in this evidence-based narrative review. The study incorporated articles published in English that involved studies exploring any HBOT-associated intervention in neuropathic pain conditions (acute or chronic).

Overall, 2971 citations were detected through database searching, and 29 studies were incorporated in this study. The mechanisms of action for using HBOT to alleviate neuropathic pain include resolution of edema and hyperoxia (primary effect), and also secondary effects concerning the decrease of inflammatory mediators, production of nitrogen and oxygen reactive species (serving as pain signaling molecules), and nitric oxide-dependent release of opioid peptides.

Strong evidence for the utilization of HBOT in medical practice was found to be linked with chronic primary bladder pain syndrome and chronic regional pain syndrome. Few evidences favored its usage for chronic secondary (peripheral) neuropathic pain incorporating radiation-induced plexus neuropathies, trigeminal neuralgia, and post-herpetic neuralgia.

Studies indicated that HBOT leads to improvement in pain scores, quality of life, and pain-linked symptoms.  However, a systematic methodology of HBOT application is imperative to substantiate its efficacy and safety, concluded the study authors.