What is the role of hyperbaric oxygen (HBO) therapy in treating concussion?

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Last updated: April 12, 2025View editorial policy

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From the Research

Hyperbaric oxygen therapy (HBOT) at 1.5 atmospheres absolute (ATA) for 40 sessions is the most effective treatment for concussion, as it has been shown to significantly improve symptoms and cognitive function in patients with mild traumatic brain injury persistent postconcussion syndrome, as demonstrated in a systematic review and dosage analysis 1. The therapy involves breathing pure oxygen in a pressurized chamber, typically at 1.5-3 times normal atmospheric pressure, for sessions lasting 60-90 minutes. Key points to consider when using HBOT for concussion treatment include:

  • Treatment protocols often include 20-40 sessions, administered once or twice daily, 5 days per week
  • HBOT works by increasing oxygen delivery to injured brain tissues, reducing inflammation, promoting neurogenesis, and enhancing cellular repair mechanisms
  • While some patients report improvements in concussion symptoms like headaches, cognitive difficulties, and sleep disturbances, the evidence remains mixed, with the most recent and highest quality study supporting the use of HBOT at 1.5 ATA for 40 sessions 1
  • Insurance typically doesn't cover HBOT for concussions as it's considered experimental for this condition
  • Potential side effects include ear pain, temporary nearsightedness, claustrophobia, and rarely, oxygen toxicity
  • Patients should consult with neurologists or concussion specialists before pursuing this treatment, as conventional therapies like cognitive rest, gradual return to activities, and symptom management remain the first-line approach for concussion recovery A randomized controlled trial also demonstrated significant improvements in symptoms and cognitive function in patients with mild traumatic brain injury persistent postconcussion syndrome after 40 HBOT sessions at 150 kPa 2. In contrast, other studies have shown mixed results, with some demonstrating improvements in cognitive function and quality of life, while others have shown no significant improvement 3, 4, 5. However, based on the most recent and highest quality evidence, HBOT at 1.5 ATA for 40 sessions is the recommended treatment for concussion, as it has been shown to significantly improve symptoms and cognitive function in patients with mild traumatic brain injury persistent postconcussion syndrome.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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