The Condition That Started It All

Decompression sickness, commonly known as the bends, holds a special place in the history of hyperbaric oxygen therapy. It was the treatment of this condition that first demonstrated the life-saving potential of pressurized oxygen and launched the entire field of hyperbaric medicine. Today, HBOT remains the definitive and only effective treatment for decompression sickness.

Decompression sickness occurs when dissolved gases, primarily nitrogen, form bubbles in the blood and tissues during a rapid reduction in surrounding pressure. This most commonly affects scuba divers who ascend too quickly, but it can also occur in aviators, astronauts, and workers in pressurized environments such as caissons and tunnels.

How Decompression Sickness Develops

When a diver descends, the increasing water pressure causes more nitrogen from breathing gas to dissolve into the blood and tissues. During a controlled ascent with proper decompression stops, this dissolved nitrogen is gradually eliminated through the lungs. But if the diver ascends too rapidly, the nitrogen comes out of solution and forms bubbles, much like opening a carbonated drink.

These bubbles can lodge in joints causing severe pain, block blood vessels in the spinal cord causing paralysis, obstruct cerebral blood flow causing neurological symptoms, damage the inner ear causing vertigo and hearing loss, and trigger widespread inflammatory responses. Symptoms can range from mild joint pain and fatigue to life-threatening cardiovascular collapse. Without treatment, decompression sickness can cause permanent neurological damage.

Why HBOT Is the Definitive Treatment

Recompression in a hyperbaric chamber is the only treatment that directly addresses the underlying cause of decompression sickness. Increasing the ambient pressure physically compresses the gas bubbles, reducing their size and the damage they cause. Breathing 100 percent oxygen under pressure accelerates the elimination of nitrogen from the body, creates a large diffusion gradient that draws nitrogen out of bubbles and back into solution, delivers high levels of oxygen to tissues that have been rendered ischemic by bubble obstruction, and reduces edema and inflammation caused by bubble-induced tissue damage. The treatment also promotes healing of damaged blood vessels over subsequent sessions.

Treatment Protocols

The standard treatment protocols for decompression sickness were developed by the U.S. Navy and are used worldwide. The most common is the U.S. Navy Treatment Table 6, which involves recompression to 2.8 ATA with alternating periods of oxygen breathing and air breaks over approximately 5 hours. For mild cases, Treatment Table 5 may be used at lower pressures and shorter duration. Additional treatments may be needed for severe cases or incomplete resolution. All treatment is delivered in medical-grade chambers. Learn about what to expect during treatment.

Treatment at National Hyperbaric

Decompression sickness is a medical emergency requiring immediate recompression. Our team, led by Dr. Allan Spiegel and Dr. Montana, is experienced in treating diving-related injuries using established Navy treatment tables. Decompression sickness is universally covered by insurance as an emergency indication. Visit our cost and insurance page.

If you suspect decompression sickness after diving, call the Divers Alert Network emergency hotline and seek immediate medical attention. Contact National Hyperbaric for emergency HBOT. Review our research library and explore all conditions we treat. Check our FAQ for common questions.