Hyperbaric Oxygen for Fibromyalgia: Is It Worth the Cost?

Hyperbaric Oxygen for Fibromyalgia: Is It Worth the Cost?

Hyperbaric oxygen therapy means breathing oxygen in a pressurised chamber. Earlier trials suggested it may help people with fibromyalgia. A new analysis from Brazil asks a different question: does the benefit justify the cost? The study appeared in BMJ Open on October 22, 2026.

The Study

The analysis used data from a randomised trial at the rheumatology department of the Federal University of Juiz de Fora. It included 56 women aged 18 to 70 with fibromyalgia under the 2016 ACR criteria.

• All women received standard clinical care.
• Therapy: 32 to 40 sessions in a pressure chamber at 2.3 atmospheres, 90 minutes per session, five sessions a week.
• One group started in weeks 0 to 8. The other started in weeks 8 to 16, so the two groups could be compared.

The researchers compared costs with quality-adjusted life years (QALYs), a measure that combines length of life and quality of life.

The Results

• At 8 weeks: the therapy group had higher costs (US$2,478 against US$1,068 for standard care alone) and a higher quality-of-life score (0.630 against 0.477).
• At 16 weeks: costs were US$3,546 against US$2,137. The quality-of-life score was 0.642 against 0.477.
• Cost per QALY gained: about US$9,210 at 8 weeks and US$8,540 at 16 weeks.
• Both figures fell below the Brazilian threshold of US$9,315 per QALY. At 8 weeks it was only just below.

In short, the therapy cost more than standard care alone, and it met the threshold Brazil uses to judge whether a treatment is good value.

Limits of the Study

• The group was small, and all participants were women at one centre.
• The quality-of-life values were estimated from a questionnaire (SF-12), not measured directly.
• The model covers only four months. It does not show whether the effect lasts.
• The result depends on Brazilian prices and the Brazilian threshold. It does not apply directly to other countries.
• The authors call for larger, multi-centre studies with longer follow-up.

What This Means for You

This study does not prove that hyperbaric oxygen is a good choice for everyone. It shows that, under these assumptions, the benefit may justify the cost in Brazil. Treatment is intensive (up to five visits a week for two months) and may not be covered by your insurer. If you are considering it, ask which evidence applies to your situation and what it will cost you.