Bruno asks for clarification about the therapeutic approach to treat fibromyalgia

Good morning,

After two years wandering and several diagnoses such as conversion/somatic symptom disorder, my 27-year-old was diagnosed with fibromyalgia.

Now he takes several drugs and Xanax as required but unfortunately, he doesn’t feel fine.

Do you think HBOT can help him? I, as I doctor, find it difficult to manage this disease.

The potential path would entirely be at my charge or would it be partially at the charge of the Health Care System? How long would the procedure last?

Thank you,


One comment on “Bruno asks for clarification about the therapeutic approach to treat fibromyalgia

  1. Nedjoua Belkacem on

    Dear colleague,
    First I would like to express my regret for what your young son is experiencing and my understanding of the great difficulty you are living as a parent to see your son affected by such a complex disease.

    I try to describe the therapeutic protocol we perform at our centre.
    Fibromyalgia or fibromyalgia syndrome is a disease that has variable clinical manifestations, from the diagnosis to the controversial characteristics, which are constantly analysed and studied.
    As you know, it’s a disease that can be a primary or secondary syndrome also to other rheumatic diseases, the diagnosis is clinical and of exclusion, especially towards other rheumatic affections.

    The patients show a series of symptoms, such as widespread pain, asthenia, easy fatigability, sleeping disorders (difficulty to find a restful sleep) and of concentration, rigidity and mood tone disorders. Many other disorders are linked to the main ones and not of minor importance, such as irritable colon, painful bladder, sexual dysfunctions and migraine.

    The most accredited hypothesis is that it’s is a central nervous system malfunction represented by an alteration of the pain perception. The threshold of pain is considerably reduced due to neuronal sensitization processes (nervous cells) in the brain. These perceptive alterations can captivate also other stimuli, such as heat and noise.
    Nothing goes well with these patients.

    The patient affected by fibromyalgia is like an out of tune instrument, like if he were at different timeframes compared to the environment and the stimuli, both with internal and external. A person affected by fibromyalgia is very sensitive to external stimuli (painful, olfactory and auditory stimuli).

    The Ravenna Hyperbaric Centre has been providing a multidisciplinary pathway for nearly two years where the main treatment is represented by HBOT able to modify the dysfunctioning brain areas from a metabolic and perfusional point of view that elaborate pain responsible for fibromyalgia in order to improve the symptoms of such debilitating disease.

    This statement is supported by studies published in 2015 from the University of Israel.
    HBOT is the therapeutic use of 100% pure oxygen by inhalation through oro-nasal masks, in a closed environment (hyperbaric chambers) where atmospheric pressure is brought to levels higher than normal (1.9 bars in fibromyalgia).

    The treatment cumulative duration goes from 3 (if required, the patient can take 2 sessions per day) to 6 weeks (in case of one session per day).
    Our goal is to reduce pain and improve other associated symptoms that severely compromise the fibromyalgia patient’s quality of life.

    During the first visit, the patient is evaluated to verify the diagnosis correctness with an accurate clinical evaluation and laboratory investigations aimed at excluding other diseases, such as inflammatory diseases, organ-specific and systemic autoimmune diseases, neurological diseases, neuropathic pains, myositis and myopathies, through haematochemical investigation and radiological and echographic tests.

    Subsequently, the 30 daily sessions protocol at 1.9 bars per 90 minutes is explained. Together with our psychotherapist, during the first conversation, a pathway for the psychotherapeutic support and to and for the disease self-management with a behavioural-cognitive treatment to the adaptation to the disease fundamental for the effectiveness of the therapy is explained.
    Both depression and anxiety play an important role in the genesis and in the fibromyalgia worsening.

    Then the physiotherapist evaluates the situation to detect postural weaknesses at the origin or resulting from pain and to establish exercises targeted at muscle relaxation preferably in a hot environment.

    We also propose other non-pharmacological therapies that can be accompanied to increase the HBOT efficacy such as acupuncture, electrostimulation, lymph drainage, osteopathy and breathing exercises with Spirotiger.

    At the end of the first cycle, the majority of patients obtain a partial improvement in the overall symptoms. Unfortunately, there are not yet adequate data to define the maintenance times for this benefit. Therefore, we recommend you to undergo recall cycles with an inferior number of sessions (15-20) at intervals determined on the basis of the preservation of the benefit of the latest cycle undergone.

    Furthermore, the anguish of those affected by this syndrome is worsened by a gap of the national health system: indeed, fibromyalgia hasn’t been inserted in the ministerial tables that guarantee assistance and care to the patients.

    Therefore, all the proposed treatments must be totally paid by the patient.

    We are monitoring the works in progress of the Emilia-Romagna region which has made itself available and sensitive towards these patients. There is also an interest at the institutional level towards chronic disease recognition problems. Therefore I strongly believe that the disease will be recognized, although not in the short time.

    Dear Bruno, I hope I answered your questions and that the information provided is clear and sufficient.

    We will be happy to receive you at our centre with your son. You can contact our Secretariat by calling the telephone number +39 0544 500152.

    Thank you for your attention,
    Dr. Nedjoua Belkacem
    Degree in Medicine and Surgery at the University of Ferrara and Specialization in Internal Medicine. Order of Physicians of Ravenna n. 2794


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