Does Hyperbaric Treatment Heal Sprains?

The Utah Deseret News reported on a game where teens scratched letters into their arms. In March, a 14-year-old girl playing the game became infected with necrotizing fasciitis, commonly called "flesh-eating bacteria."

The bacteria don't eat the skin as the name seems to say, but release toxic factors, which quickly destroy skin and muscle, causing pain, disfigurement, and a high death rate. Necrotizing fasciitis is a serious infection. The teen needed over 60 hyperbaric treatments and several surgeries. Hyperbaric oxygen treatment is done in a small room or chamber. The air pressure inside is increased so that the person can receive more oxygen. One or more people can get treatment in the chamber at once. The post Does Hyperbaric Oxygen Help Exercise Ability? explains more of how it works.

Hyperbaric oxygen treatment is effective against necrotizing fasciitis and infections like gangrene in several ways. The bacteria involved are susceptible to high oxygen pressure, the low oxygen area of the infection is raised to a level where the body's white cells can do their job to clear the bacteria, higher oxygen pressure prevents white cells from sticking to vessel lining, and a few other nice effects to be covered in future posts.

Given that hyperbaric oxygen speeds healing in certain infections, crush injuries, problem wounds, diabetic ulcers, thermal burns, ionizing radiation injury, refractory osteomyelitis, osteoradionecrosis, and compromised grafts, it has been hoped by some that it would also be useful for sprains and muscle injury.

One study by diving medicine pioneer Dr. Fred Bove (my advisor for one of my dissertations) and his colleagues, found no effect of hyperbaric oxygen treatment on time to recovery for ankle sprains (Am J Sports Med. 1997 Sep-Oct;25(5):619-25). Another study by Dr. Michael Bennett and colleagues reviewed known past studies using randomized trials of hyperbaric oxygen on soft tissue injury (ankle sprain and medial collateral knee ligament injury) and muscle soreness after exercise. They found there was was not enough evidence that hyperbaric treatment helped ankle sprain, acute knee ligament injury, or soreness (Cochrane Database Syst Rev. 2005 Oct 19;(4)). Dr. Brad Bailey of San Diego did a review of the utility of hyperbaric oxygen for sprains and sports injuries and found no benefit for soreness, but a few studies that showed benefit in acute sprains and strains. There may be aspects of injury, not previously looked at, that may be helped. These are being looked at in newer studies. The next post will cover them.

You can do much to rehab sprains on your own. Posts with helpful information to prevent and rehab sprains are:
How To Treat Ankle Sprains and Prevent Them
and
No More Ankle Sprains Part II.

Labels: hyperbaric, injury, performance enhancing modality, soreness, sprain

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