Hyperbaric oxygen therapy for MS – An Article by MS-UK

Adapted from a MS-UK blog, published: 18 June 2025, by Ian Cook

Is it time to look again at HBO?

When I was diagnosed, some 30 years ago, hyperbaric oxygen (HBO) was the go-to therapy for those open to radical new approaches to treating multiple sclerosis (MS). HBO had a dedicated group of followers and I once wrote a story about a man with MS who had a personal HBO chamber or ‘tank’ built in his back garden at a cost of many thousands of pounds.

There was also a certain amount of evidence suggesting that HBO could work wonders in MS. And there was a network of more than 50 HBO centres dotted around the country. Twenty years ago, I visited my local centre in Coventry to meet some people using HBO. I discovered they were mainly older and more disabled MSers there. They all seemed to get something from it, I wasn’t quite sure what, although clearly HBO wasn’t a cure.

Oxygen therapy

So what exactly is HBO, and why am I talking about it today? Well, HBO is basically the medical use of pure oxygen (usually greater than 99 per cent) administered in a sealed chamber with a higher pressure than atmospheric pressure. And I’m talking about it today because a recent academic paper has shown HBO brings dramatic improvements in a model of MS. There are plans for more research.

HBO was developed decades ago as a treatment for ‘the bends’ or ‘decompression sickness’. This happens when divers come up from the deep too quickly. A quickly ascending diver has nitrogen bubbles released into their blood (air is 80 per cent nitrogen and just 20 per cent oxygen). An HBO chamber with pure oxygen at an increased pressure helps a diver with ‘the bends’ to ‘re-compress’ and then ‘de-compress’ safely, reducing the volume and number of nitrogen bubbles in the bloodstream. HBO has saved countless divers’ lives. About 40 years ago it was proposed as a treatment for MS.

After this, and very quickly, a network of around 50 MS therapy centres was set up around the UK to provide hyperbaric oxygen therapy. These centres were independent charitable organisations, each with quite a large local following. Many people still attend these centres for oxygen therapy and report noticeable improvements in their symptoms, particularly fatigue. There is strong anecdotal evidence for HBO as an MS treatment.

The science

In terms of scientific evidence, the case is less clear cut. A review of HBO in 2004 – the Cochrane report – looked at nine clinical trials into HBO. Two trials produced generally positive results, while the remaining seven reported generally no evidence of a positive effect. The conclusion of the Cochrane report was that HBO was not a recommended treatment for MS.

However, despite the Cochrane report, there have been one or two interesting recent studies about how HBO might, after all, benefit MS patients. There have been some recent pathology studies showing a lack of oxygen in the tissues of MS lesions. Another interesting discovery is that animal models have shown oxygen reduces demyelination and loss of oligodendrocytes – the cells that produce myelin. HBO has also been suggested as a stem cell stimulator by increasing the mobilisation of bone marrow-derived stem cells in animal models of MS.

Perhaps the most interesting new research is a recently published paper which showed a reversal of quite profound neurological deficits in animals with experimental allergic encephalomyelitis (EAE) a model of the type of acute inflammation that causes MS relapses. This paper – Oxygen treatment reduces neurological deficits and demyelination in two animal models of multiple sclerosis – was written by researchers at the Department of Neuroinflammation, Queen Square Institute of Neurology, London University. It concludes, “Severe neurological deficits in both active and passive EAE can be caused by hypoxia (lack of oxygen) and be reduced by oxygen treatment. Oxygen treatment also reduces demyelination in active EAE, despite the autoimmune origin of the disease.”

Exactly what one should make of this paper is unclear. First, while EAE is an animal model of MS, it is not MS, and hundreds of papers have shown a ‘cure’ for EAE only to fail when trialled in humans. That said, there is clearly something worth looking at, a point made by Prof. Gavin Giovannoni in his MS-Selfie post on Medium. He says: “I am a big supporter of the need for more research in this area. . . I was helping write a grant to test HBO in acute optic neuritis when COVID-19 came along, and, like many other projects, it was abandoned. Maybe we should revisit it.”

Given that most of the research into HBO is decades old perhaps Prof. Giovannoni is right – this subject should be re-visited. So, could the UK’s 50 or so HBO centres that are still operating get together and start the process of getting a new trial into HBO and MS? This suggestion comes not from me but from Prof. Giovannoni.

Evidence needed 

Responding to the new research he says, “My response to this issue has been to suggest all of the MS Centres get together to do a properly designed and powered randomised controlled trial. NICE’s position is meant to be evidence-based, but the evidence base, in my opinion, is not robust enough. Hence the need for further research.”

When I put Prof. Giovannoni’s suggestion to the Neuro Therapy Network, the umbrella group for 42 of these HBO centres, a spokesperson said, “Funding a clinical trial is likely to be beyond the reach of most of our members as they vary in size and finances differ greatly.”

So, will other funders come forward to fund this research, or will the efficacy of HBO in MS remain one of those many unanswered questions surrounding the condition? If anyone has a spare £2.5M stuffed down the back of the sofa, that’s Prof. Giovannoni’s estimate of the cost of the study using the existing infrastructure of the MS Centres, please get in touch with him – his email is g.giovannoni@qmul.ac.uk.

Comment from The Brightwell

We offer thousands of sessions per year in our Hyperbaric Oxygen Chamber, with hundreds of users benefiting from this therapy

We agree that research is desperately needed, and the funding for it, in these economically challenging times, is difficult to access.

To find out more about Hyperbaric Oxygen Therapy at The Brightwell, please visit

https://www.thebrightwell.org.uk/oxygen-therapy