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How does hyperbaric oxygenation help in pain management?  

 How does hyperbaric oxygenation help in pain management?

Related to crush injuries, pain results from swelling around sensory nerves.  Hyperbaric oxygenation acts internally to reduce swelling. Swelling causes ischemia, lack of oxygen circulation. When ischemia is severe and persistent it may lead to an anaerobic form of tissue metabolism that perpetuates the entire ischemic process. Reference: W. Boyd A Textbook of Pathology 8th edition pg. 69.

Irritation of nerve roots with muscle spasms along the segmental distribution of nerve roots can create ischemic changes that can lead to serious impairment.  Reference: R. Jackson The Cervical Syndrome 4th edition pg 148.

A major cause of musculoskeletal pain originates from ischemia, that compares with the pain experienced in angina. Reference: T. Lewis “Pain in muscular ischemia” Archives Internal Medicine 1932;49(5):713-27.

Many conditions of the central nervous system stem from vascular ischemia. Reference: N.A. Hood “Diseases of the central nervous system” British Medical Journal 1975;3:398-400.

It has been well known for several decades that ischemia has a depressant effect on nerve conduction, especially in the more sensitive afferent fibers. Reference: J.W. Magladery,et al “Electrophysiological studies of nerve and reflex activity in normal man” Bulletin John Hopkins Hospital 1950;86:291-312.

Ischemic changes in nerve root microcirculation often leads to intraneural edema that worsens the trouble. Reference: B.Rydevik, M.D.Brown, “Pathoanatomy and pathophysiology of nerve root compression” Spine 1984;9(1):7-15.

Recovery of nerve (and other tissue) depends on eliminating ischemia in the affected tissue.                 Reference: F.H.Bentley, W.Schlapp “Experiments on the blood supply of nerves” Journal Physiology (London) 1943;102:62-71.

Hyperbaric oxygenation has proven benefits in reversing the effects of ischemia. References: J.D.Yeo “A study of the effects of hyperbaric oxygen on the experimental spinal cord injury” July 30, 1977 The Medical Journal of Australia pg.145-147.  I.Eltorai “Hyperbaric oxygen in the management of pressure sores in patients with injuries to the spinal cord” Journal Dermatological Surgical Oncology 7:9 Sept 1981; 737-739.  A.Sirsjö et al “Hyperbaric oxygen treatment enhances the recovery of blood flow and functional capillary density in post-ischemic striated muscle” 1993 Circulatory Shock 40:9-13.

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